Welcome to Dr. Nelson's
Choosing a Doctor Page
You are here because you have a hand problem and don't know which way to go! You need to decide if Dr. Nelson is the right hand surgeon for you.
Choosing a hand surgeon can be confusing. It need not be, please read on..
Your hand is important: you use it every day. Choosing the right doctor for your hand is also very important. There is no one right way to choose a doctor, but here are some things you should consider.
1. Choose a doctor who is Board Certified in Hand Surgery, not something else
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. A hand surgeon who has such a certification will list it in their yellow pages ad or their website; if it is not listed there, they are not Board Certified in Hand Surgery. You deserve to be seen by a Board Certified hand surgeon, not someone only with Board Certification in something else, such as only plastic surgery or only orthopedic surgery, as they have limited training in hand surgery, even if they claim to be a "hand surgeon."
2 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 follow up visit. 85% of doctors in the United States spend an average of less than 25 minutes, according to a nationwide survey of 15,000 physicians in 2011. 20% spend less than 12 minutes with each patient.
In the San Francisco Bay Area, the majority of hand surgeons see 40 to 50 patients a day; some see 60.
3. Who provides the care that you receive?
Most physicians now employ "physician extenders" that provide most of the care that you receive. On some office visits, you may not even see the doctor! Most doctors have Physician Assistants or Nurse Practitioners that see you instead of the doctor, an xray tech that does the xray, a cast tech that applies or removes the casts. Offices do this to save money.
4. How long will you have to wait in the doctor's office?
Is your time important? Are you often in a rush? If so, 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 to be 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.
5. 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 or their website: 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. If their website emphasizes cosmetic face or breast surgery, you can guess what is important to them. It is not your hand.
6. 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 7 below for important information.)
7. 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.
8. 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.
9. 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 hand 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.
10. Where does the doctor practice? Will they be there when you need them?
Many doctors have more than one office, and some come to Marin only a half day a week. If you need to seem them on another day, or if you have an emergency and need to see them right away, you will have to travel outside of Marin, typically to San Francisco, to see them.
We hope that these suggestions will help you in deciding if you would like to make an appointment with our office. Call if you have any questions. Our number is 415-925-0501.