Author Topic: Surgeries per year  (Read 9453 times)

jawsaw

  • Jr. Member
  • **
  • Posts: 70
  • Karma: 3
Surgeries per year
« on: July 24, 2015, 11:03:58 PM »
When seeking a surgeon to perform orthognathic surgery, what is an adequate amount of surgeries performed per year? One would not want to have it done by someone who does 5 procedures a year. Is 50 an okay number? That would basically be a procedure a week. This is based on the assumption that the more frequent a surgeon performs a procedure, the better they are at it. It would be hard to imagine a surgeon who does 100 'bad' surgeries a year. Should one be weary of a surgeon who performs too many procedures a year, indicating hasty conveyer belt maxo-mandibular-mill haste? 50 seems like a reasonable number to me.

jawsaw

  • Jr. Member
  • **
  • Posts: 70
  • Karma: 3
Re: Surgeries per year
« Reply #1 on: July 24, 2015, 11:15:36 PM »
like..

jawsaw

  • Jr. Member
  • **
  • Posts: 70
  • Karma: 3
Re: Surgeries per year
« Reply #2 on: July 24, 2015, 11:21:25 PM »
I'm beginning to think that a pretty high level of uncertainty when choosing a surgeon is unavoidable. I have seen 4 surgeons who would perform sleep apnea orthognathic surgery on me. All 4 are highly reputable in their field. The locations are Boston, NYC, Washington DC, and Rochester NY. I don't believe there is a way to make a definitive choice on who will perform the best surgery. Thoughts?

Rico

  • Hero Member
  • *****
  • Posts: 882
  • Karma: 10
Re: Surgeries per year
« Reply #3 on: July 25, 2015, 12:14:09 AM »
the truth is not much data will help you in choosing

it's a gamble

ok you can choose between surgeons who had more cases like you or less. who has little better opinions..but once again, the surgeons who try to help more number of patients in more complicated cases always have  more unsuccesful surgeries...
You can go to Z.. who avoid complicated surgeries and has very good reputation. The less you do the less critics ;)
I tried to aim in the middle...I mean, I ruled out too conservative and too confident ones. (too optimistic)  If you know your problem well, then you can easily determine who are not enought true with you. Nowadays medicine still sucks.... still a surgeon barely can repair something in 100%. mostly never. There is no 0% and 100% in medicine.

it's surgery, not picnic..everything may happen

one surgeon told me the best way of thinking when it comes to surgery is to:
Make few consultations (not too much) check where you feel better and then
if you think that  your problem is not bothering you too much - avoid surgery
if sometimes you feel OK, sometimes not (with your mostly imaginated problem) - avoid surgery
if the issue really interfere with your life , then undergo

i think it's the most important key
« Last Edit: August 01, 2015, 01:40:05 PM by Rico :) »

needadvancement

  • Sr. Member
  • ****
  • Posts: 406
  • Karma: 11
Re: Surgeries per year
« Reply #4 on: July 25, 2015, 12:26:02 AM »
one surgeon told me the best way of thinking when it comes to surgery is to:
Make few consultations (not too much) check where you feel better and then
if you think that  your problem is not bothering you too much - avoid surgery
if sometimes you feel OK, sometimes not (with your mostly imaginated problem) - avoid surgery
if the issue really interfere with your life , then undergo

i think it's the most important key

interesting advice. No more further surgeries for me then by this logic.

Serra

  • Private
  • Full Member
  • *****
  • Posts: 115
  • Karma: 3
  • Gender: Female
Re: Surgeries per year
« Reply #5 on: July 25, 2015, 08:54:11 AM »
the true is not much data will help you in choosing

it's a gamble

ok you can choose between surgeons who had more cases like you or less. who has little better opinions..but once again, the surgeons who try to help more number of patients in more complicated cases always have  more unsuccesful surgeries...
You can go to Z.. who avoid complicated surgeries and has very good reputation. The less you do the less critics ;)
I tried to aim in the middle...I mean, I ruled out too conservative and too confident ones. (too optimistic)  If you know your problem well, then you can easily determine who are not enought true with you. Nowadays medicine still sucks.... still a surgeon barely can repair something in 100%. mostly never. There is no 0% and 100% in medicine.

it's surgery, not picnic..everything may happen

one surgeon told me the best way of thinking when it comes to surgery is to:
Make few consultations (not too much) check where you feel better and then
if you think that  your problem is not bothering you too much - avoid surgery
if sometimes you feel OK, sometimes not (with your mostly imaginated problem) - avoid surgery
if the issue really interfere with your life , then undergo

i think it's the most important key
really good advice.

molestrip

  • Private
  • Hero Member
  • *****
  • Posts: 735
  • Karma: 40
Re: Surgeries per year
« Reply #6 on: July 26, 2015, 01:54:03 AM »
Volume of procedures is absolutely important! I asked an oral surgeon once this exact question and his response was that he'd let any oral surgeon operated on him who made jaw surgery a major part of his practice. He didn't give me a number but he emphasized the importance of recent procedures over the total number.

Short term volume is important to maintaining skills. Studies have compared surgery to playing video games, so much so that some surgeons actually play games before procedures to warm up. Ever play a video game, get really good at it, and then come back after not playing for a while? Sure, you have a good idea of what's going on and it may come back quickly but you need practice - recent practice - in particular to be great at a procedure. Operation time is critical to success, there's hundreds of steps, and you don't want a surgeon stumbling around because he's hazy.

Long term volume is important for better handling of corner cases. Surgeons who've done hundreds of procedures will have ironed out the common mistkaes. Surgeons who've done thousands of procedures will understand all the anatomic variants. Those who've been doing it a long time will have a better understanding of the fundamentals, the alternatives, the evolution of the procedure. That's nearly impossible to replace. Those with long term experience appreciate results, others have to settle for reading the text others wrote.

That aside, surgery is business and the more procedures a surgeon is doing, the more investment they can afford to make in improving it. That means subscribing to the latest crazy expensive journals, traveling to conferences, trying all the newest technologies, reading expanded textbooks, etc. I was just looking at oral surgery textbooks tonight. Your average surgeon receives about 100 pages of training material on oral surgery. Jaw surgery textbooks can be 10 times that length. He's not going to read all that unless he has good reason to. It's no wonder my local surgeon seems to lack a fundamental understanding of the etiology of my problems.

There are surgeons with high volume who are good but not great. High volume guarantees at least average performance and it is a necessary but not sufficient condition for great performance. The opposite can be said for low volume. What are the numbers? It seems that an average bad surgeon does 10/yr, an average good surgeon 50/yr, and a great surgeon 150-500/yr. That's 1/mo vs 1x/week vs 3-5x/week. A good surgeon has done at least a few hundred surgeries and a great surgeon has done a few thousand.

It should be noted not everyone needs a great surgeon. Many problems are simple to fix and a good local guy is sufficient. The trouble is, it can be hard to determine who is routine and who isn't. The patient certainly can't tell and it appears even orthodontists can't. The orthodontist in my city whose done the most adult surgical cases called my case "very routine", having only examined by teeth but never looking at my imaging. My dentist, by contrast, called my case very extreme. The next most experienced orthodontist I found, whose done hundreds of surgeries, has admitted that even he hasn't quite seen a case like mine yet. So if all these "professionals" can't agree on who's routine and who isn't, the only way for a patient to tell where they belong is to start by consulting the great guys and see what their opinion is. The sad reality of surgery :(

Rico

  • Hero Member
  • *****
  • Posts: 882
  • Karma: 10
Re: Surgeries per year
« Reply #7 on: July 26, 2015, 09:58:14 AM »
Some surgeons public (part of research) from time to time opinions of the patients relative to specific surgery procedure. (with some, but unfortunately not many pictures - but still it's something)
Notes like:
not satisfied
satisfied
very satisfied

Most surgeons in big hospitals (good ones) make a lot of surgeries.....and all of them make less or more mistakes
« Last Edit: July 26, 2015, 10:08:07 AM by Rico :) »

Rico

  • Hero Member
  • *****
  • Posts: 882
  • Karma: 10
Re: Surgeries per year
« Reply #8 on: July 26, 2015, 10:03:00 AM »
interesting advice. No more further surgeries for me then by this logic.

If someone still can't answer himself, then should consider this:
     Everyone with mild problems (not big "deformations") who are too sensitive too permanent nerve damages - for some people it can be really annoing - should avoid surgery. Who may be too sensitive?  the one who afraid about it too much

If still can't ;)
    just go... take the risk. Will be ok or not ;) You do not have whole live for thinking about one problem

Rico

  • Hero Member
  • *****
  • Posts: 882
  • Karma: 10
Re: Surgeries per year
« Reply #9 on: July 26, 2015, 10:17:13 AM »
You are talking about obvious things ;)

phantom: I asked you about that one time too :) 

So I wonder if there is any commission which check if the data is not manipulated in the meaning all patients results for specific procedure and period were shown in publication.
For example. The comission may check how many patients were treated for specific problem - ICD number
then check number of these patients with numbers on the publication
I chose very good hospital. Very good hospitals has very good procedures. Perhaps there is a chance that all is checked

anyone know something about it ?

Quote
manipulate results and public or dont public at all you know don't ever trust statistics that you haven't falsified yourself .
when you ask a surgeon how many succesful surgeries he has performed, he also may lie to you.

conclusion: all of this , is a gamble

triot

  • Jr. Member
  • **
  • Posts: 89
  • Karma: 15
Re: Surgeries per year
« Reply #10 on: July 26, 2015, 10:25:21 AM »
You are talking about obvious things ;)

phantom: I asked you about that one time too :) 

So I wonder if there is any commission which check if the data is not manipulated in the meaning all patients results for specific procedure and period were shown in publication.
For example. The comission may check how many patients were treated for specific problem - ICD number
then check number of these patients with numbers on the publication
I chose very good hospital. Very good hospitals has very good procedures. Perhaps there is a chance that all is checked

anyone know something about it ?
when you ask a surgeon how many succesful surgeries he has performed, he also may lie to you.

conclusion: all of this , is a gamble

In Germany you can check case-numbers on www.weisse-liste.de where you can check Doctors and Hospitals. You can set the filter to avarage case numbers or above avarage.

Rico

  • Hero Member
  • *****
  • Posts: 882
  • Karma: 10
Re: Surgeries per year
« Reply #11 on: July 26, 2015, 12:21:58 PM »
on tnat website, there's no maxillo facial surgeons . anyway I chose the surgeon

Triot: do you know any good german page with doctore opinions

triot

  • Jr. Member
  • **
  • Posts: 89
  • Karma: 15
Re: Surgeries per year
« Reply #12 on: July 26, 2015, 01:13:27 PM »
on tnat website, there's no maxillo facial surgeons . anyway I chose the surgeon

Triot: do you know any good german page with doctore opinions

Sure there are. I checked it by myself. (the German term for maxfac aurgery is "Mund-, Kiefer-, Gesichtschirurgie")

No, there aren't such websites or atleast there aren't any popular ones.

Rico

  • Hero Member
  • *****
  • Posts: 882
  • Karma: 10
Re: Surgeries per year
« Reply #13 on: July 27, 2015, 02:36:22 AM »
Apparently there is only few surgeons. I put the name of the city and found 0 max fac surgeons... while there are at least few :)

I FOUND BETTER SITE:

EXAMPLE: http://www.jameda.de/berlin/aerzte/mund-kiefer-gesichtschirurgen/dr-ramin-zarrinbal/bewertungen/80422065_1/

Rico

  • Hero Member
  • *****
  • Posts: 882
  • Karma: 10
Re: Surgeries per year
« Reply #14 on: August 01, 2015, 01:37:35 PM »
"Volume of procedures is absolutely important!"

So the best choice is MM :D