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Choosing the right doctor is a very important and, at times, complex problem. There is no one right way to choose a doctor, but here are some things you should consider.
1 Academic qualifications
The first thing to consider is the doctor's academic qualifications: is he or she board certified in hand surgery? The highest certification that a doctor can have in hand surgery is called the Certificate of Added Qualifications in Hand Surgery. Most hand surgeons who have such a certification will list it in their yellow pages add; if not, call the office and ask. Do not be afraid to ask questions when you are choosing a doctor: it is your hand, after all! If the office does not want to answer questions about the doctor's qualifications, you do not want to go to that doctor.
Dr. Nelson has such a certification. You can review all of his qualifications here.
2 Practice Type
Does the doctor do only hand surgery, or is hand surgery something
they only do occasionally or in addition to other types of surgery? You
can usually find this out by asking the office receptionist. Another good
way to find out how important hand surgery is to the doctor is to look at
their yellow pages ad: if they have a small ad in hand surgery, but a very
large ad in another specialty, such as plastic surgery, you can probably
guess which area of medicine is more important to them.
Dr. Nelson limits his practice to only hand surgery, and he does hand surgery
full-time. This is documented here on the website,
as well as on his stationery and his business card. His ad only appears
under hand surgery (actually, the yellow pages has "Hand Surgery"
under "Surgery, Hand") and orthopedics (his original board certification);
both specify that he limits his practice to hand surgery. He does not do
general orthopedics, plastic surgery, or general surgery.
3 Is the doctor in your plan?
You probably want to stay within your insurance plan, since
it will be more expensive to see a doctor outside of your plan. However,
depending on how serious your problem is, or how important your hand is
to your work or recreation, you may consider seeing someone outside your
plan, at least for an initial consultation. (See Section 4 below for important
information.)
Dr. Nelson participates in a variety of health plans; click
here for a list. If your insurance plan is not accepted, call the office
to get an estimate of how much it might cost to go out of plan. But be sure
to read this entire page for important information about choosing a doctor
for your hand problem.
4 Does the doctor within your plan have any financial incentives to limit your treatment?
Many patients don't realize that many plans pay financial incentives to their participating doctors to limit the treatment that they offer to their patients, such as restricting referrals only to same-plan doctors. This is the "managed" part of "managed care." There are other, more subtle ways that managed care may affect your hand problem. For important information on this, read Financial Incentives: The Hard Facts for Patients.
Dr. Nelson does not participate in any plans that pay financial incentives to limit patient care.
5 How much time will the doctor spend with you?
An interesting and insightful question when you are selecting a doctor is to ask the receptionist how much time they allot for a new patient visit or for a routine followup visit.
In Dr. Nelson's office, the standard appointment for a new patient is 30 minutes. If the patient has been referred by another doctor or has seen another doctor, the standard appointment is 45 minutes; if they have had surgery or have been seen by more than one doctor, the standard appointment is 60 minutes. We do not have any return appointments for less than 15 minutes.
6 How long will you have to wait in the doctor's office?
An interesting and insightful question when you are selecting a doctor is to ask the receptionist what the average wait is for the doctor. If they don't know, it means that they haven't studied this part of their practice and you might wonder if they consider your time important. If they say the average wait is an hour or more, you know that they don't respect their patients or consider their time important.
We think that your time is just as important as ours. We have kept track of the time patients wait in our office for several years, and the average time is less than 15 minutes.
7 How long will you have to wait to get an appointment?
Many patients are finding that they cannot get a timely appointment, even for an urgent matter such as a fracture.
Our office policy is that any patient with a new fracture will be seen in the office the next day we are in, whether or not there is an appointment opening. Rather than overbook the schedule, Dr. Nelson will either come in early, skip lunch, or stay late. Obviously, emergencies cannot be scheduled or be put off until it conveniently fits into the doctor's schedule, and it would not be appropriate to make other patients wait unless it was absolutely necessary.
8 Does the doctor have a special skill or interest in your problem?
The field of hand surgery is so broad that not all doctors have the same level of skill or interest in all problems. Dr. Nelson has a special interest in distal radius fractures, wrist pain, wrist kinematics, and post-operative pain management. (See his Resume to see his research and talks on these topics.) For example, Dr. Nelson has written many articles on distal radius fractures, including the one on the website of the American Academy of Orthopedic Surgery (see it here). Dr. Nelson has a wide experience in standard hand problems such as fractures, carpal tunnel syndrome, trigger finger, and Duputyren's. However, Dr. Nelson is quite frank is stating that he is not an expert on burns, skin grafts, congenital anomalies, or brachial plexus, and refers patients with these problems to other hand surgeons who are specialists in these fields. Be sure that your hand surgeon has a special skill and interest in your hand problem.
We hope that these suggestions will help you in deciding if you would like to make an appointment with our office. Our number is 415-925-0501.