How do I find a private orthopaedic surgeon?

[EllaView]

My mum is in her eighties and desperately needs a hip replacement. Unfortunately, she is in Canada and her doctors feel that it would be unethical to put her through the surgery. She is determined to spend what remains of her life free of pain and as mobile as possible. SHe is hoping to travel to Scotland (where I live) for surgery, but I don’t know where to start to help her find a surgeon. Any ideas or recommendations for where to start? She is a British citizen, if that makes a difference.

You could contact your local private hospital. Generally you need a referral from a GP to get seen, but the arrangements might be different if coming from overseas. Is she in good health apart from her hip? Do you know why the Canadian doctors feel it would be unethical?

FWIW my great-gran was turned down for surgery for years. At 95 she finally persuaded someone to do her hip and was delighted with the results. She lived until nearly 100.

Have a look for the nearest private hospital and give them a call.

Do a postcode search on the websites for Bupa , Nuffield, spire, or Ramsay healthcare to find the closest to you.

Most private doctors nowadays take self-referrals. Literally just look at your local private hospital and ring them up, say you are self funding.

However do the Canadian doctors think it is unethical or unsafe to put her through the surgery? Finding a private doctor who is more risk happy in a person who is high risk for anaesthetic may not be the right answer.

She will still need the anaesthetist to agree as well as the surgeon, wherever she is.

Thank you so much for your responses! She is in reasonably good health - the concerns seem to be more around her age than anything else.

I will contact private hospitals tomorrow. I really have no idea about private healthcare.

Which city do you live in?

Private is defo the way to go in the U.K. as the nhs waiting list is horrific.

My neighbour needs a hip and has needed it for years but is still on the waiting list. Covid won’t help that either.

I think if you google bupa (although that’s health insurance and they won’t do anything for you and I’m not suggesting them) they have a list of surgeons they deal with on their website. Presumably they must be half decent or bupa wouldn’t use them. So that’s where I would start.

I had a private hip replacement in November 2019. I did a lot of research on line to find the best surgeon. There's something called the National Hip Register (or something like that) which gives you the rating of different surgeons. Apparently, the surgeons who have the best outcomes are the ones who are doing the operation many times... I think mine was doing 200 a year.

Thanks for all the info. We live near Aberdeen, so we are a little limited in terms of accessing private hospitals. I have put some feelers out, so hopefully I’ll be able to start moving things forward for her.

anaesthetics can be dangerous op.
are you sure she is in good health?

Would you want a surgeon who would take the money to operate but would do something that was considered dangerous and unethical...? I could pay someone to do a hip replacement for me now but as I've been told it would be an extremely dangerous idea (for other reasons) I'm not going to pay I'm going to listen to the professionals... This sounds like a bad idea!

My late 80s mother broke her hip last year, so there was no choice but to have a hip replacement. She has multiple health conditions and was on warfarin at the time. Due to her age and health she had a local anaesthetic and sedation as a general was too risky.

It is not up to me. My mum is fiercely independent, of very sound mind, and believes that she is best placed to assess risks versus benefits. She isn’t afraid of death, but she is afraid of spending what time she has crippled and in pain. Her motto is ‘I’m going to live until I die’.

The Golden Jubilee Hospital in clydebank is where a lot of nhs patients get sent. Under half an hour by train to Glasgow city centre.

It used to be a private hospital, initially built for Arab sheiks apparently, and it’s very nice inside, it’s got an attached hotel that I’ve been to weddings in, that’s how nice the complex is compared to normal nhs hospitals! So you could stay next door for three days while she recovers and then take her home.
But I’m not sure it it’s totally nhs now or a mix of both. It’s got a good reputation for hips as far as I know.

It’s got a list of surgeons they use on its website that you could cross reference against the list a pp said exists.

My ex’s aunt had her hip done there in her 70s on 23rd December on year. She was totally fine and out in a couple of days. I don’t know who the surgeon was sorry.

Your Mum sounds fabulous, OP. Best of luck for the surgery and an excellent outcome.

She is entirely fabulous! The most adventurous, intelligent and vital person I know.

I’ll look into the Golden Jubilee Hospital.

Honestly, thank you all for your help . You are all amazing.

They don't usually put under anaesthetic they do a lumbar puncture I think. If you search online for surgeons you can read their specialities etc to get some idea of one youlike the sound of.

Just to say it’s not unethical to do a hip on someone in the later years - it’s down to both the surgeon and the patients attitude to risk. There are a few surgeons who (understandably) don’t want to take on the added risk of the very elderly and then there are those who have a frank discussion and leave it up to the patient. Pain is a dreadful thing and destroys quality of life. We’ve done THRs on both those in their 90s and those with multiple severe medical conditions and so long as it’s reasonable to offer an anaesthetic (and we have excellent anaesthetists) and the patient is fully informed we will offer them surgery.

Golden Jubilee is NHS only.

Rosshall Hospital in Glasgow have Orthopaedic Surgeons, maybe look at Dominic Meek who is a hip specialist. Although I only know his work from his NHS role, he is very well respected.

Thanks - I’ll check out Rosshall. It is a shame about Golden Jubilee, although I am delighted that NHS patients have access to such a fantastic facility.

Some of the posters here seem to think that doctors abandon their ethical code when they enter the private sector. That is definitely not the case! Doctors are still required to operate to the same technical professional and ethical standards wherever they are working. It is ridiculous to suggest that you can simply get an operation on demand by paying for it and other considerations are somehow ignored. The surgeon and anaesthetist will make their own assessment of whether the patient is fit for the operation. Believe me, they have no shortage of patients (look at the NHS waiting lists....) so they are not grabbing anyone who walks in and booking them in without a proper assessment. The difference in the private sector comes down to more comfortable facilities, private rooms, choice of dates and having a consultant to treat you throughout. The quality of medical decision making is no different - if anything, it is better, because the doctors are all experienced consultants.

A couple of thoughts….
Orthopaedic surgeons are generally happy to operate on anyone with a pulse (tongue very slightly in cheek….. but it’s not at all unusual to do joint replacements on octogenarians and nonogenarians) - for them to have said it would be ‘unethical’ for her to have this operation simply because of her age is unusual. Is there really not a more concrete concern that’s got lost in translation somewhere? It’s major surgery and although it can be life changing in a good way, it can come with significant risks too.

Being a British citizen and being entitled to NHS care are not necessarily the same. She should at least find out if there would be additional cost implications for her if she were to develop complications that would ordinarily require transfer from the private to NHS care.

She’d need to have a real think about how long she plans to stay - long haul flights are a risk factor for DVT/PE & it wouldn’t be ideal to take one immediately before/soon after major surgery (which is also a risk factor for dvt/PE). Also, what sort of style would she be flying in? - would the surgeon be happy for her to fly to Canada in an economy class seat with a new hip replacement or should she factor first class/medical repatriation into the cost? Travel insurance for medical tourism is also expensive. HTH.

Thanks for your comments. She is more than aware of the risks, and conscious that a private surgeon may come to same conclusion.
She has already factored in business class travel, spoken to her health insurer regarding complications in the uk, and is prepared to stay here with me as long as necessary. Trust me, this isn’t a spur of the moment decision.

If you look at the consultants listed on the private hospital websites then search for them by name and see who pop's up as still holding positions within the NHS or look at NHS hospital and search by name for where they practice privately. There's something a little bit comforting (in my opinion) in consultants who are employed in both private & NHS.