Fibroid Surgeon: How to pick one
You may have heard horror stories about surgeries gone wrong. Nobody wants to go through the effort of having surgery only to find out you could've made a better choice about your surgeon. Let me help you avoid this situation by giving you a few tactics you can use to ensure that you have the best possible fibroid surgeon.
1. Social Proof (Word of Mouth)
If you know of anyone who has had a similar surgery or similar problem, then ask them if they had a good experience with their surgeon. Other patients can give you first-hand knowledge of the surgeon’s personality, skill level and responsiveness.
Sidenote: I've seen some sources claim that you can ask your surgeon for references of patients who have had the same procedure for a similar problem. Be aware that this would constitute a violation of the Health Insurance Portability and Accountability Act (HIPAA). Surgeons cannot give out this information without express written permission from those previous patients. So if a surgeon declines to give you this information, it is less likely that they are trying to hide something, and more likely that they are complying with the law.
If you happen to know any physicians or nurses who have interacted with the fibroid surgeon you are considering, then ask them. Ask several physicians or operating room nurses who they would send their family member to for this particular problem, and when more than one mention the same surgeon, you'll know you have a winner.
Now let me take a moment to touch base on online rating systems. You’ll want to be careful when using them because motivations can vary when writing reviews. Patients may be more likely to leave a review following a negative experience versus a positive one, especially considering that a positive experience is expected. This doesn't mean that online reviews can’t be useful. Sometimes you can get a clear indication of a problem surgeon by seeing a pattern of unfavorable online ratings and comments.
2. Ask About Experience
Many studies show surgeons performing more procedures have better outcomes. In general, your surgeon should be performing at least 12 to 14 major procedures (such as hysterectomy) per year. Ideally, each year they should be performing more than 12 to 14 of the specific major procedure you're going to have (e.g. laparoscopic hysterectomy, etc).
Be sure to ask the surgeon if they have any additional training for the particular procedure you're going to have, or if they have any additional fellowship training. Some procedures require specific training and documentation to be performed, while privileges for other procedures are granted based on a specific residency or fellowship training program.
You want to find out if your surgeon is Board-Certified. Gynecologists are certified by the American Board of Obstetrics and Gynecology. If your surgeon is not Board-Certified, ask why. Lack of Board Certification can be a red flag. It either indicates that the surgeon is within their first several years after graduation from training (potentially less experienced), or indicates another problem, such as an inability to pass the oral or written board examinations.
To check if your fibroid surgeon is Board Certified, go to www.abog.org, scroll down a little and click on the button labeled “Is Your OB/Gyn Certified?” You should see your surgeon once you fill out the form and hit “Search.” Click on the surgeon name and you should see a table with the “Certification Status” listed as “Valid” with an expiration date. This same table will indicate if the surgeon is meeting requirements for Maintenance of Certification. Here is mine at the time I was writing this blog post:
Many online physician profiles also list board certifications. For example, every profile in TriHealth’s searchable physician database lists their board certifications. For example, here is mine:
The more experienced your gynecologist is in dealing with fibroids, the more likely they will be to offer you uterine-sparing treatments. You’ll get more options, and will understand the success rates and risks of treatments that can help you avoid hysterectomy.
3. Insurance Coverage
Use your insurer’s website to check if your fibroid surgeon accepts your insurance. More importantly, find out if the hospital where you will have surgery accepts your insurance. For some patients this could be a deal-breaker because using a provider outside of your insurance network can run up huge bills for your surgery.
That being said, some patients will still consider using a surgeon outside of their insurance network. Many times insurers will still give an out-of-network discount on the services provided, even when they don't pay the full bill. Also, the hospital will be billing you for the larger share of the services, not the surgeon. This means that, for those who are financially able, you can still pick a more experienced surgeon who is out of network.
Be sure to do your homework and know your costs up front. Ask your surgeon and your hospital beforehand.
4. Surgeon Website
Most of the time a surgeon’s website isn't very useful. Many use a generic business page with little actual content. But some surgeons do have websites with rich content. If the website is focused on one main treatment option, then they probably don't have your best interests in mind. If you find this, or if you find the website touting a miracle cure, just move on to the next option.
A gynecologist who really is trying to serve your needs and uphold your right to make your own decisions will be one who listens. In fact, if you’re suffering from fibroids and your physician is really acting to help you make decisions, they should be offering you at least three options. Your physician should never give you just one answer.
Be aware that each of these tactics on its own will yield a biased viewpoint. You will need a surgeon that makes patients and staff happy, listens, and has the necessary experience and skill.
Use all of the above tactics to get the information you need to make an informed decision. By doing this, and using the questions that follow, you can stay in control of what happens to your body.
Questions to ask your fibroid surgeon:
- Is surgery necessary? What are the other treatment options for my condition? Are any medical devices going to be used and what are their risks?
- Are you Board Certified by the American Board of Obstetricians and Gynecologists (ABOG)? Do you participate in ABOG Maintenance of Certification?
- What specific training have you had for this procedure? How often do you do this specific procedure? How many surgeries do you perform in a month? How many major surgeries do you perform each year?
- What are your success, failure and complication rates?
- At which hospital will the procedure be done?
Birkmeyer J et al. N Engl J Med Nov 2003;349:2117.
Mowat A et al. AJOG Jul 2016;215(1):21.
Kelly E et al. Obstet Gynecol Jul 2016;128(1):65.
Last Updated: April 26, 2018