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Toledo Talk   (musing about Lake Erie West and beyond)

Article source for : Third Medical Opinion?

An minor ongoing medical issue prompts me to post this experience:

Medical Problem - A small common cyst on a finger for about two years which disfigures the nail and looks like it could burst. Gets in the way of filing and some other office work as well as gardening, aquarium and koi pond maintenance work. Patient has a history of a hospital aquired MRSA.

Surgeon # 1 Takes an x-ray
Plan of care: Outpatient surgery with IV sedation, pre-op testing required. Vancomycin to prevent MRSA will be given by IV just prior to and during surgery.
Three weeks until sutures are removed. Surgery in the joint from where the cyst arises may cause some slight permanent stiffness.

Surgeon # 2 Does not review the x-ray. Says and I quote "I know exactly what's going on in there without an x-ray".
Plan of Care: The surgery will be under IV sedation with pre-operative testing required. Will not administer prophylactic antiobiotics. Requires patient to visit an infectious disease doctor for full communicable disease workup and "plan" prior to scheduling the procedure. A skin graft will be necessary to cover the area of the incision. The finger will be splinted for three weeks. Finger physical therapy (?????) may be necessary to regain full use of the digit.

Surgeon # 3 Reviews the original x-ray and orders an additional view taken.
Plan of Care: Surgery with local anesthetic. Patient to take oral Clindamycin on the day prior to, day of and day after surgery for infection prevention. Stitches will be out in twelve days. No permanent stiffness expected.


I chose Surgeon #3 for obvious reasons. The offending digit is on the right hand middle finger. That is the finger I would like to give to surgeon #2.

It pays to shop around. I can just imagine what the co-pays and out of pocket expenses would have been had I chosen surgeon #2. All unnecessary. Talk about running up the cost of health care. This guy's the poster child for runaway health care expenses.