"Dr. Wahl did arthroscopy surgery on my shoulder with disastrous result, and later he sent me to an other surgeon to perform open surgery to repair the damage he did to my shoulder. However, I never regained full function of my shoulder.” - HA on Google Review

 

The profession of surgery is an inexact science--one that is simultaneously incredibly gratifying, and also occasionally as incredibly demanding (physically and emotionally). I have worked tirelessly for the past 26 years--through medical school, internship, residency, two fellowships, and countless hours of continuing education, journal reading, meetings, research and publication to be the very best surgeon I can at this profession. While I do make my living as a surgeon, I do it not for the money, but because I still believe that it is a very special privilege to be entrusted by my patients with their care--to be given the opportunity and ability to enrich their lives and (more often than not) to restore function that they've lost to injury, accident, or age. 

Despite all my efforts, the fact remains that this is an inexact science. The same surgery performed in the same manner in two different unique individuals can have markedly different results. Sometimes this is due to factors that could have been mitigated, other times it remains a mystery why a surgical result has not turned out as both surgeon and patient had hoped. Every surgeon has failures, complications, and unexpected or less-than-optimal results; it is the nature of our profession. The best of us work hard to grow from the experiences, so that we do not make the same mistakes and improve our care. We are transparent that all has not gone as expected, we encourage our patients to seek other opinions, and we either address the issue personally or get the patient into the hands of someone with whom they are more comfortable. This, I believe, is why they call it a surgical practice.

I was quite disappointed to come across this negative review on Google. Federal privacy laws that govern protection of a patient's protected health information prohibit a provider to respond in any substantive way to a "negative" review, whether appropriate or whether they provide misleading, unfair, or inaccurate information. I can speak for myself and all my partners at OPA that we are dedicated to providing comprehensive care to our patients, and at any time welcome our patients and their families to contact us to address any concerns.

In any case, realize that it is not taken for granted that it takes an inordinate amount of courage for a patient to entrust a surgeon with their care -- to cause harm in the effort to relieve pain and disability. Both surgeon and patient are saddened when a patient does not fare well. I'd only wished that you might have considered corresponding with me personally in this matter so that we could reach an understanding and resolution, rather than my learning of your frustrations via an anonymous post that undermines the faith other patients put in me and my excellent care, and undervalues the efforts I make every day to be the best physician I am able. If you have further concerns or would appreciate speaking about your disappointment personally, I am always willing to do so.


"This doctor came highly recommended by someone whose opinion I value.  Perhaps his skills as a surgeon surpass his skills in addressing non-surgical cases.  I left frustrated by his unwillingness to understand my concern and to offer practical advice for next steps I could take to improve my condition and reduce the risk for greater problems in the future.” -Anonymousvia Press-Ganey Survery

 

We recommend, that if a patient already knows they have a "non-surgical case" then they are best served by seeing a non-surgical provider rather than a surgeon.  Although we discuss and counsel patients on the armamaterium of non-surgical options, primary care physicians, primary care sports medicine physicians, physiatrists, physical therapists, etc are a wealth of knowledge and can recommend, counsel and provide conservative/non-surgical treatments options.   Some conditions just don't have quick and easy, or "practical" solutions but we often try to lay out all the available options.  If you feel like you left the visit with misunderstood goals or with more questions than answers, please feel free to call us so we can further discuss your care. 


"The front desk is very short and seems annoyed.” - Anonymousvia Press-Ganey Survery

 

If you encounter an unprofessional, rude or discourteous team member please let us know, as we want our patients to feel welcomed in our clinic.  Frustrating moments, delays and errors throughout the day can get the best of us, but we could all use a small reminder that hospitality and medicine go hand in hand.


"You are routinely 15 minutes behind.” -Anonymousvia Press-Ganey Survery

 

Yes, this is certainly frustrating, not only for our patients, but also for us.  And yes, we will verify that this is a true statement, on occasion.  We value your time and try our best to not keep you waiting.  Unfortunately, our day can unpredictably change in an instant, often for reasons out of our control.  There are occasional unplanned urgencies and emergencies, patients with unexpected complex problems that require more than the scheduled "15 to 20 minute visit", or unplanned patient needs arise.  Patients are not "one size fits all" with cookie cutter problems or assembly line solutions; we are taking care of individuals, each with unique histories, injuries, social circumstances and treatment options.  This variability can change the flow and efficiency of the day in an instant.  We build buffers into our schedule that allow for delays and catch-ups, but despite this we still sometimes run a little late.  We sincerely apologize for any delays; we do our best to keep the ball rollin', as we respect the time our patients take out of their day to visit us.  


"After my cortisone shot, I didn't receive any paperwork or instruction about aftercare.  I didn't know how long I would have to wait to begin activities again.  I wasn't aware of how much or little I should do after the shot.”  -Anonymousvia Press-Ganey Survery

 

Although we discuss what can be expected with certain medications, there is nothing more tangible than the written word.  So, based on this feedback, we now provide patients with an informational handout on "cortisone injections".  We value patient feedback and are always open to making changes that allow for better patient care.  Additionally, if you ever have questions about your visit, symptoms, timeline of recovery, etc, please do not hesitate to call us; we are always happy to clarify any questions or address any concerns.  


"He made several comments to the student doctor without including me unless I specifically asked him to.  I'm always willing to accommodate teaching opportunities: however, if there is a comment the doctor-in-training needs to hear about my condition, it's insulting for the doctor to assume that I'm not interested or intelligent enough to hear the comment, too.  No one is more interested in the patient's health than the patient.”  -Anonymousvia Press-Ganey Survery

 

Dr. Wahl was an Associate Professor at UW and UCSD for 10+ years where he taught residents and medical students everyday in the clinic and operating room.  Academic surgeons, are not only given satisfaction scores by the patients, but also the residents/medical students.  So, when teaching, the surgeon typically includes everyone in the room, spending moments speaking to/teaching the student in front of the patient, which by proxy teaches the patient at the same time, and vice versa.  We agree, "no one is more interested in the patient's health than the patient", and realize that this style of care is probably best in an academic setting, where patients know they are in an teaching environment, rather than in private practice. Academic medicine is very different than private practice, and we appreciate the feedback so that we can tailor our patient care differently.  


"Your 48-hour pain medication refill policy ("Request for medication refills may take 48 business hours to complete and will not be refilled on an "urgent basis”) is frustrating and not practical.”  -Anonymousvia Press-Ganey Survery

 

We do our best to refill prescriptions as quickly as possible, but we are not in the clinic/available everyday, as we are in the operating room several times a week.  Therefore, we kindly ask you plan ahead and notify us in a timely manner when refills are necessary.


"The PA entered the room without being introduced or identifying herself and the doctor proceeded to inform this "stranger" of his observations and my personal information.”  - Anonymousvia Press-Ganey Survery

 

This is great feedback.  As a MD-PA and husband-wife team we have taken for granted that we have worked together for 10+ years and we just assume that all of our patients understand how we work as a pair.  In addition to always wearing name tags/hospital-issued ID badges, we now display signs in the exam room that inform the patient who the team members are so that no one is caught off guard if a "stranger" walks in the room.  The patient will likely encounter the MD, PA and medical assistant during their visit; it takes a crew to keep this ship afloat!


"I was not given a prescription for pain medications to treat my pain.”  Anonymous via Press-Ganey Survery

 

We take prescribing pain medications very seriously, as the United States is in the midst of an epidemic of opioid drug use, misuse and abuse.  We act responsibly when prescribing narcotic pain medications and only provide prescriptions to our post-surgical patients or patients with traumatic fractures.   For further details, please refer to our pain medication policy.

The American Academy of Orthopedic Surgeons has noted that "according to the U.S. Food and Drug Administration (FDA), more than 50 million Americans were prescribed some type of narcotic pain medication in 2011, which represents a nearly 100 percent increase in narcotic pain medication prescriptions since 2008. This increase in opioid prescription medication corresponds to an increase in opioid diversion to nonmedical users as well as a resurgence in heroin use.  Opioid overdose is now the leading cause of accidental death in young adults.  Opioids are associated with a higher risk of postoperative death.  Opioids also increase the risk of fall and fracture in the elderly." 


"There is too much paperwork that needs completed prior to the appointment.”  Anonymous via Press-Ganey Survery

 

In short, we can thank the federal government, as they enacted legislation that has led to more and more time-consuming documentation.  In long, the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act mandated that certain criteria had to be met by healthcare providers in order for them to be paid fully for providing services to Medicare and Medicaid patients.   Unfortunately, the reporting requirements apply to all patients (not just Medicare and Medicaid), including those with private health insurance.  Based on this, healthcare practices must collect numerous "objectives and measures" if they don't want to be fined, have reimbursements reduced or be prohibited from seeing patients.  We recognize and sympathize that the paperwork is laborious...for both the patient and the provider.  Paperwork may be filled out prior to an appointment either online or via paper; please refer here if interested in filling out the paperwork ahead of time.


"I did not see hand washing, but the exam room was clean.”  Anonymous via Press-Ganey Survery

 

This is an important comment.  The CDC recommends that "when hands are visibly dirty or contaminated with proteinaceous material or are visibly soiled with blood or other body fluids, hands should be washed with either a non-antimicrobial soap and water or an antimicrobial soap and water".  When hands are not visibly soiled, the CDC recommends using an "alcohol-based hand rub for routinely decontaminating hands".  We have alcohol-based hand rub dispensers at the entrance to our dictation room, in the dictation room next to our computers and in the patient exam rooms.  We routinely use the dispensers in and around our dictation area before entering a patient exam room and after exiting a patient exam room (we call this "gel in, gel out").  Due to location, the use of this is typically unwitnessed by the patient, which is not ideal for your reassurance.  We will do our best to use the dispensers in the exam room, but please be guarenteed that we routinely practice hand hygiene and understand the extreme importance of promoting patient and provider safety and preventing infections.  


"I left two messages and spent a long time on hold before I finally heard back from someone.”  - Anonymous via Press-Ganey Survery

 

We apologize, and recognize that this can be extremly frustrating.  We want to be as available as possible to our patients and make it an effortless endeavor for them.  Our main phone number is answered by a group of hardworking individuals who answer every phone call that comes into OPA for 25+ physicians.  They are diligently answering every call, some which are quick and concise, others which are lengthy and complex leading to longer wait times.  If you are calling Sophie, our assistant, she is often in the clinic with us, seeing and assisting in the care of patients.  Please leave any non-urgent messages on her line, as we will call you back within a business day. For urgent issues or time-sensitive issues, please press 0 to be transferred to our call center and they will track us down!