Ortho question

[Bunion 2020]

Had rotator cuff injury last January. Went in for consultation and was prescribed 30 days PT. That did not alleviate the problem so MRI. That revealed major damage and surgery in March. Ortho did a good job AFAICT, went back in for follow up post op 2 months and ortho was who I saw.

Since then been back 2x and was seen by his PA. She seems knowledgeable. No real complaints.

Friend went to see the same ortho for a knee issue, the ortho is also a personal friend of both of us. Pain when walking downhill & clicking, had some work done on that joint 7 years ago with different ortho.

Only seen the PA, ortho was elsewhere. Went back in for an MRI and then a follow up with ortho. Again, only seen by PA. Next day the PA calls and says the ortho had a look at the MRI results and has some concerns and wants a follow up along with 30 days PT and then decide the next steps.

His question and mine is, is this normal? If I am paying (insurance is) for ortho consultations, should it be with the actual ortho and not the PA?

[MagnificentUnicorn]

The ortho did give you a consult, the PA screened you, the ortho looked at imaging. It’s kind of shitty but that’s how it works these days and the insurance is more than happy with it. A mid level office visit with orthopedic consult is less expensive for the insurance company

The expectations for the ortho to see X number of patients is unreasonable. Most patients with ortho consults can reasonably be handled by a PA and kicked up to the surgeon if necessary. That’s how it is everywhere


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[Bunion 2020]

Good enough, will pass along to my friend. And FWIW, the PA is a HAF babe while the Ortho is about a 50 dude and kinda meh.

[Dantheman]

Yeah, pretty standard, and PAs usually know their shit. I would be more concerned about seeing a shoulder guy for a knee issue, especially if surgery is a possibility.

[Bunion 2020]

The Ortho in question did my ankle (Modified Brostrum) and my shoulder. Good results from both. He has cut a lot of patrollers as well as Bozeman skiers.

[MagnificentUnicorn]

Yeah, pretty standard, and PAs usually know their shit. I would be more concerned about seeing a shoulder guy for a knee issue, especially if surgery is a possibility.

A sports medicine fellow will have both covered, depends on the doctor of course


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[old goat]

When I had a big ski accident I was billed by an ortho for two visits. He saw me once for less than 60 seconds. Presumably he counted looking at the CT scan as a visit. Both were billed as full complex visits. I told Kaiser not to pay. I don't know if they did or not. I do know they wound up paying total 1M on a 4M bill. And that doesn't include the week I spent in Kaiser after being transferred.

[North]

I've seen my ortho at every visit since my injury got elevated to the 'requires' surgery level. Both pre and post op. He's always running behind schedule, but it's because he gives you as much time as you need to get all your questions answered. I've never felt rushed, great guy. Pretty aggressive on post op recovery timelines, which I appreciate. If anybody needs a foot/ankle guy in Denver lmk.

[Whiteroom_Guardian]

No idea where you went.......my experience at the big fancy shop aka BO is as you described.

My PT here in town, a surgical nurse here in town who's been at it 20ish years, etc all say: Just go see Dr. Pete at Alpine. You actually see the docs there. At least my experience in the past at Alpine. I'm actually waiting two weeks to see Dr. Pete just so I don't have to go to BO Urgent assuming this pain stays at a 6 or less.