My son had surgery last week. It was a reminder to me how all parents must feel during this very stressful time. My partners and I anesthetize many children at our facility and a reminder of what it is like to be on the patient’s and parent’s side is a good thing.
I picked his surgeon by thinking through the surgeons I had seen do this surgery and make it look easy. Picking a surgeon at our facility is very tough because there are so many great ones to choose from. Often times when I am asked by a friend to refer them to a surgeon I base my response on personality issues and who I think they will like the best, as the skill set amongst our partners here is so far above the norm that making a referral on ability wouldn’t rule any one out!
I narrowed the surgeon choice for my son down to four orthopedists. I had seen these four guys do this particular operation and make it look easy. My boy had his operation, it went well, and he is fine. I have an insight as a facility owner and director and as a physician that few others have about the quality of my son’s experience here. Suffice it to say that as a connoisseur of surgery center operations there is not one thing (nothing) that I would have had done differently. It was simply a perfect experience. My most sincere gratitude to those who helped my boy.
As I write this I can’t help but wonder how the administrator at a big hospital would choose his surgeon. What if he was one of those guys who had been aggressive with physicians and hostile towards them? What if he had hired surgeons? In my experience surgeons that are employees of big hospitals are typically the victims of hostile takeovers of their practices or surgeons who don’t compete very well in private practice. The first guy would be angry with the administrator and the second guy probably isn’t very good. So what would the administrator do…how would he choose? How would he choose a facility? Would he “take one for the team” and have his surgery at his own facility by one of his employed doctors and bet the farm that there is no difference between doctors “A” and “B?” Or would he go to a competitor’s facility and use a reputable surgeon, knowing that was the best thing for him, but not for his business plan?
And what would he do if something went wrong? What if at his own facility, his employee surgeon made a mistake, the severity of which was such that the entire medical community knew what had happened within hours? Would he begin to think that physicians and facilities disciplined by the marketplace provide better care than those protected by his cartel-like arrangements?
Oh well. If this were to happen, I would wish him a speedy recovery and hope that he might entertain the possibility that as a victim of the non-free market medical world he has helped to create and maintain, there is a better way.
G. Keith Smith, M.D.
