Would you have your electrician do your plumbing work? Likely not. Then why have any orthopedic surgeon treat your shoulder or elbow? Maybe you think that all orthopedic surgeons are the same. They are not. In fact within the specialty of orthopedics there are over 10 different areas of subspecialization. Shoulder and elbow surgery is one of them.
Attaining mastery in any pursuit takes significant time, effort and purposeful practice. Elite musicians don’t play every instrument. World-class athletes don’t compete in 20 different sports. And highly competent surgeons don’t treat every condition because it’s just not possible to be an expert in it all.
Experts in any field tend to specialize.
The world is becoming ever more specialized and knowledge is becoming ever more specific. Certainly medicine is no different. In fact, one could argue that the pace of specialization in the medical field is increasing at a more rapid pace than most because it is largely driven by technology- whose growth is nearly exponential.
The advantage of specialization in medicine
The specialist can focus his time and efforts on attaining a deep mastery of one area within a particular field. If he focuses his energies he will gain a vast clinical experience, a sharp intuitive feel and a deep understanding of a very specific set of problems and their solutions. Having a more focused practice will likely give him a broader experience with not only the common but also, the rare and challenging cases within the field.
As knowledge about orthopedic conditions expands, the ability for any orthopedic surgeon to master and keep up with the most advanced treatments for all bone and joint conditions dwindles. This trend favors the specialist.
The shoulder and elbow are two of the most complicated joints in the body. Treating them demands fine attention to detail. I am one of a minority of orthopedic surgeons in the country that dedicates his practice almost exclusively to the treatment of shoulder and elbow problems: from the simplest to the most complex.
For you this means a greater sensitivity to your shoulder or elbow issue; a deeper understanding about how to get your shoulder moving more quickly, easily, safely, and more predictably; a greater knowledge of the most recent advances in the field; a vast depth of clinical experience in treating shoulder and elbow conditions; a better understanding of the pitfalls of certain treatments and a feel for which treatment considerations you should prioritize to optimize your condition.
I have commited my professional life to attaining mastery in the treatment of shoulder and elbow disorders. And my goal is to employ that expertise in a way that helps you get your arm moving again in the most comfortable, low risk and efficient way possible.
The making of a shoulder and elbow specialist
What distinguishes a shoulder and elbow specialist from other orthopedic surgeons?
One of the distinguishing traits of most shoulder and elbow specialists is that they have attained fellowship training in the field. A fellowship is a yearlong period of dedicated learning in a specialty topic that follows one’s residency (a 5 year training period after medical school to become an orthopedic surgeon). The fellowship involves intensive, focused clinical and surgical training in the treatment of shoulder and elbow disorders under expert mentors. These fellowships tend to be very competitive. About 500 orthopedic trainees graduate in the United States each year and only about 35-45 complete dedicated shoulder and elbow fellowships.
Do other orthopedic surgeons train in shoulder and elbow surgery?
Yes. In fact all orthopedic surgeons and Sports Medicine specialists train broadly in knee, hip, wrist, ankle, spine, elbow and shoulder conditions. What’s the difference then?
Shoulder and Elbow Fellowships prepare the surgeon to be competent in treating the full spectrum of shoulder and elbow conditions with a full complement of techniques from open surgery to arthroscopy. Sports Medicine training can be more variable and depending on where one trains, may be geared more toward treating knee conditions or focus more exclusively on arthroscopic techniques.
Shoulder and elbow fellowships focus strictly on shoulder and elbow conditions. They typically produce surgeons that are comfortable treating all types of shoulder and elbow problems with a wide range of treatments including physical therapy, injections, arthroscopic surgery and open surgery.
Why a shoulder and elbow specialist might be right for you
As it turns out, there are some shoulder conditions that most orthopedic surgeons rarely treat. Shoulder replacement, for example is relatively uncommon compared to hip and knee replacement. And only about 3% of orthopedic surgeons perform more than 10 of these procedures per year. Shoulder replacements are complex operations and require significant skill and “feel” that can only be obtained by preforming them repeatedly.
In addition, if you are looking for a physician who is familiar with the full set of tools necessary to treat virtually any shoulder and elbow problem, you may want to consider a fellowship trained shoulder and elbow specialist.
I personally pride myself in being competent with a full range of techniques for treating shoulder and elbow conditions. This allows me to fit the proper technique to the patient and not the other way around.
A shoulder and elbow specialist is likely going to have a better understanding of the downsides and risks associated with various shoulder and elbow treatments thus allowing him to treat a complication should one arise or better still, avoid one altogether.
Sometimes going straight to a specialist can help you avoid many unnecessary tests. For instance some shoulder specialists rely less heavily on tests like MRI than other doctors because they have a better clinical “feel” for when it’s appropriate to obtain one. Keeping you away from time consuming and costly testing when it is not in your best interest can be an advantage.
If you have a shoulder or elbow problem you may want to consider a specialist.