Surgery is never a decision that should be taken lightly.  It’s often made at the end of a long journey towards healing.  Ideally, you’ve built a trusting relationship with your doctor along the way.  

That’s why nothing is more important than choosing the surgeon that will do the very best job given your diagnosis.  We’ve outlined 6 things to look for when choosing your surgeon.

1. Fellowship Training

Most medical doctors in the United States begin with 4 years of medical school – 2 years of textbook training, and 2 years of clinical training. A Doctorate of Medicine (MD) is earned after successful completion of 4 years of post-graduate schooling. With this doctorate, doctors go on to complete a residency program (usually 3-5 years long), in which they rotate through all aspects of their field.  However, in many fields, there are sub-categories or specialties that demand further expertise.  For example, orthopaedic surgery requires 5 years of residency rotating through the 9 sub-specialties of Orthopaedic Surgery:

• Hand
• Foot/ankle
• Oncology
• Pediatrics
• Spine
• Sports medicine
• Joints
• Trauma
• Shoulder/Elbow

Fellowship training is an extra year after the required five years of general Orthopaedic surgery training, focusing on a specific specialty in Orthopaedics. This allows the fellowship-trained physician to become an expert in their chosen specialty field.

Dr. Greg Tchejeyan is a board-certified orthopaedic surgeon who offers expertise in many of these subcategories.  After his residency, he spent one year in fellowship training specializing in joint replacement and sports medicine.

2. How Deep Is Your Surgeon’s Toolbox?

Oftentimes, a surgeon is so focused on one particular procedure, that they cannot offer a range of options for each patient.  A good surgeon offers a breadth of different techniques for each joint, allowing options that are the best fit for the patient.  

For example, although Dr. Tchejeyan is skilled in a variety of orthopaedic specialties, he specializes in the knee, and is often referred to as the “LA Knee Guy”.  He has expertise in arthroscopic, total, partial, and revision knee surgeries.  Instead of choosing a knee replacement every time, Dr. T. takes the time to understand the patient’s symptoms and treat their unique situation.  In fact, one patient came to him for a second opinion after being told Total Knee Replacement was her only option.  Dr. T. was able to spare her from unnecessary surgery and instead moved forward with a partial knee resurfacing.  Read her story (including pictures!) here.

3. Volume

How many procedures has your surgeon performed? A patient can be confident in a surgeon who is comfortable with a procedure and does them on a regular basis.  When in surgery, Dr. T. performs no more than 4 – 6 surgeries a day, each of which takes about one hour.  This allows him to give his best effort, avoid fatigue, and still handle enough cases to be considered the best in the area.  He has completed over 11,000 surgeries in his career!

4. Peer Review

Other physicians and patients have a lot to say about surgeons – and it’s worth listening to!  The physical therapists that see the patient after surgery often have the greatest insight into a surgeon’s expertise.  They watch the results of a procedure and the healing process closely.  These word of mouth recommendations are usually the most trustworthy, valuable opinions to consider.  

5. Performance Data

Nowadays, clinical outcomes are available online for surgeons everywhere.  This data is captured and shared to determine which doctors have complications with surgery, and what their statistical results are. Even high-volume surgeons are not always meeting the criteria to be the best.  A surgeon may perform several thousand surgeries, but if the many of them require revisions, that is not true success.  

Online databases have a sophisticated process of analyzing quality metrics in 5 categories – mortality, complications, readmissions, inpatient quality, and patient safety.  They factor in patient demographics, healthcare, co-morbidities, and historical data to come up with an overall composite score, scaled to local and national averages.  The most qualified surgeons show statistically significantly higher scores than even the national averages. 

The above charts show Dr. Tchejeyan’s overall composite scores within the online Metrics for national and state averages.

6. Accessibility

Larger medical group facilities are suffering now more than ever due to the loss of personalization.  It is often the case that larger hospitals or clinics have more employees and significant overhead, necessitating more surgeries per day.  While it works for some people, Dr. Tchejeyan has always preferred an individual relationship with each patient.  Owning his own practice allows him to maintain open communication with patients, and offering a truly customized approach. 

Accessibility means that if a patient has a question or concern, they can call or email the office and expect a response the same day.  Solving small problems before they become a bigger issue is easy when a facility can answer a quick question about something like a rash, rather than making you wait until next week’s appointment.  Dr. T. believes that accessibility to your surgeon is best for both the patient and the surgeon alike.

Choose Your Surgeon Wisely!
Regardless of the type of surgery, you’re facing, these 6 tips for choosing your surgeon will be a helpful guide for making the right choice.  If orthopaedics is your area of need, Dr. Tchejeyan is one of the area’s top surgeons and would be more than happy to get to know you and your needs. You can get to know him a little better here!