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A difficult choice - Experience or Continuity

Which is more important? Experience of the Surgeon or having followup by the same Surgeon as did the surgery?

A) More experienced (150 to 250 per year) Surgeon (and physically closer to the AMS and Coloplast representatives in Seattle), with followup by a local (in my residence city of Anchorage Alaska) surgeon, but who did not observe the surgery.
B) A less experienced (20-25 per year, but nevertheless qualified) local Surgeon perform the surgery and have followup by the same Physician who handled my innards personally.

The VA is willing to send me to Seattle (where Dr. Walsh practices) for implant surgery. This is a compromise between Maryland VA with Dr. Kramer and my local surgeon who has less experience.

Unfortunately, I am a couple of months late to be seen by Dr. Walsh as he is withdrawing from practice at the V.A. Dr. Ostrowski will (probably) do my surgery. Dr. O trained under Dr. W and has been performing or assisting about 150-250 a year.


Advantages of Option A are more permanent, I think, but a 3 hour plane trip a couple days after surgery and inflated 50%-60% might be a bit uncomfortable. But the disadvantages are temporary.

The advantages of Option B are the convenience of proximity and followup by the same surgeon , but are essentially temporary, unless there are complexities where continuity would make a difference.

What would you do? And why?

I am favoring option A, as the VA will "own" the surgery (my local surgeon is authorized by the VA, but not a VA physician, per se) and the canard "there is no substitute for experience" has been mentioned many times here on FrankTalk.

I invite comments. Thanks for reading.

Lost Sheep wrote:A difficult choice - Experience or Continuity

Which is more important? Experience of the Surgeon or having followup by the same Surgeon as did the surgery?

A) More experienced (150 to 250 per year) Surgeon (and physically closer to the AMS and Coloplast representatives in Seattle), with followup by a local (in my residence city of Anchorage Alaska) surgeon, but who did not observe the surgery.
B) A less experienced (20-25 per year, but nevertheless qualified) local Surgeon perform the surgery and have followup by the same Physician who handled my innards personally.

The VA is willing to send me to Seattle (where Dr. Walsh practices) for implant surgery. This is a compromise between Maryland VA with Dr. Kramer and my local surgeon who has less experience.

Unfortunately, I am a couple of months late to be seen by Dr. Walsh as he is withdrawing from practice at the V.A. Dr. Ostrowski will (probably) do my surgery. Dr. O trained under Dr. W and has been performing or assisting about 150-250 a year.


Advantages of Option A are more permanent, I think, but a 3 hour plane trip a couple days after surgery and inflated 50%-60% might be a bit uncomfortable. But the disadvantages are temporary.

The advantages of Option B are the convenience of proximity and followup by the same surgeon , but are essentially temporary, unless there are complexities where continuity would make a difference.

What would you do? And why?

I am favoring option A, as the VA will "own" the surgery (my local surgeon is authorized by the VA, but not a VA physician, per se) and the canard "there is no substitute for experience" has been mentioned many times here on FrankTalk.

I invite comments. Thanks for reading.

Personally, I would choose B. First of all, 20-25 a year is still a couple a month and that's not nothin'. Just because the man isn't doing 250 a year does not mean he isn't a skilled surgeon. Having the same doctor for follow up is important because if the had a spot to keep an eye on, or whatever, this is the man that did the surgery in the first place. 150-250 while maybe impressive, does not speak to skill, it speaks to good advertising. Just my 2 cents.

Larry

Lost Sheep, My choice would be the more experienced Dr. for the implant and the less experienced (but still capable) Dr for the follow up. I am from Louisiana and went to Baltimore for a total revision in December, flew home on the 3rd day after. Trip home was 16 hrs from hotel to home. 3 legs , about 7 - 8 hrs in the plane, 4 different airports and it was not a big deal.
Only issue that I had was TSA (3 pat downs)at Baltimore hassling me about my "bulge" even though I told them that I just had a penile implant but let me go when I offered to show them the little fellow.

You shouldn't worry too much
Dave

Hi lost
I opted to have my local doc do mine. I wanted someone I felt comfortable with cutting my dick and balls open. I'm sure the guys in Baltimore or Seattle will say they are the best. When I went back for my 2 week check he explained why I can feel the tubing on the side of my shaft. This is the same guy who is going to pump me up next week and explain how this thing is going to work. I just feel better with someone I'll see for several years from now. Being in Philly I'm only a few hours from Baltimore .

This was a concerning question for me too. I could of went with a high volume younger female doctor, or the doctor I ultimately chose, a local 69 yo veteran. Although he only did about 20-25 a year, he had been doing them for over 30 years. Just got a good feeling with him, and I'm happy with the results. Either of the two were local, only 15 miles away, so that was nice. I just felt better about going to the same guy who did the surgery, although each time he saw me (3 times), it was for 5 minutes.

I would go with local and have. My surgeon is in the 20 to 30 per year range on this surgery, but is also well known for expertise in working with prostate cancer and recurrent prostate cancer. His is also my urological oncologist until the time comes when I need a more specialized oncologist.

If the skill set and experience is sufficient, I believe that continuity of treatment is a large bonus.

David

In your case I would go local. I almost went my local doctor that I have seen for 25 years, but I found Dr. Hakky in Atlanta. It is a less then 4 hour drive and I can drive anywhere in the same day, if it is only 8 hours round trip. I am 8 weeks and after surgery I saw him at 24 hours and 48 hours. I drove back twice more for follow ups and will see him again next week and hopefully a final time in October for my ultrasound check to see if everything is OK. I am, one of those guys that hate to talk on a phone. I like to se them in person. I did the same with my prostatectomy. I drove 4 hours to Orlando several time for 3 month check up till the one year mark. Depends on what makes you feel the most comfortable. lot of great surgeons out there. As I have said before, in 2016 there were 52,000 implants surgeries preformed. The big 3 doctors do about 1800 of them. Who does the other 50,200? Lot of great surgeons out there.

For my (first) implant, I chose to use my wife's urologist: 'I do them all the time - I did 3 last week'. I think he lied. If something does screw up, it takes another surgery to fix it. I didn't know of the forum then. One year and one day later, Dr Perito fixed what the first guy screwed up. I'd go for experience. In both my revisions Dr Perito encountered complications and his experience helped those not to become MY complications. Good luck!!!

I pretty much went for your option A. My flight was a little less than 2 hours. Although partly inflated, no pain or problems at all. The expierence was the deciding factor for me. Depending on who you choose and your medical condition, you may not have to go for a follow up. I did at 5 weeks but had already activated myself. Doc said I could have saved a trip by calling. I did have a couple of concerns early. Took a couple of pics and sent them along with a text and my concerns. The reply was fast and comforting saying all was normal.

Tybeeman wrote: As I have said before, in 2016 there were 52,000 implants surgeries preformed. The big 3 doctors do about 1800 of them. Who does the other 50,200? Lot of great surgeons out there.

52,000 is a lot! Where did you get the figure from? Was that volume done in the US alone or worldwide? If worldwide - how many in the U S?