The name of Dr Stéphane Delajoux is in the news again. The neurosurgeon, known in particular for having treated several personalities, is the subject of new testimonies from former patients who are considering prosecution. According to a survey published on September 5 by The Parisianthree women today denounce complications that occurred after their interventions.
His career had already been marked by several legal proceedings, as well as by the controversy born after Johnny Hallyday’s operation in 2009. An expert report then noted certain shortcomings in the singer’s care.
Without prejudging the procedures currently being considered, this news above all reminds us of a reality: when an operation is scheduled, the choice of surgeon deserves to be thought about… even if it is known. So how can you be reassured?
First reflex: ask your doctor for advice
In most cases, the patient does not have to find the name of a surgeon on their own.
Your treating doctor or the specialist who monitors your pathology is a particularly useful first contact. He knows the medical file, can explain the different options and direct him to colleagues whose practice he knows personally.
“The first person you should trust is your treating doctor and/or your referring specialist.”explains a surgeon and former ordinal advisor whom we interviewed.
Dr. Guillaume Pourcher, full member of the National Academy of Surgery, shares this approach: “We choose it thanks to our attending physician or the medical team we trust.”
This recommendation obviously does not prevent the patient from finding out for themselves. It simply allows you to start from medical advice rather than research based solely on the Internet.
Check the surgeon’s qualifications
Once a name has been obtained, some objective verifications are possible.
The first instinct is to consult the directory of the National Council of the Order of Physicians. In particular, it makes it possible to verify the identity of the practitioner, their RPPS number, their specialty and their qualifications.
The learned societies of each specialty also constitute an interesting source. They sometimes offer directories of their members.
“This allows you to be sure that you are dealing with real doctors.”underlines our expert.
It is then necessary to look at whether the surgeon regularly performs the type of intervention envisaged. Without trying to establish a ranking, it is perfectly legitimate to ask him what his experience of this operation is.
The right questions to ask in consultation
The preoperative consultation is precisely done to allow the patient to understand what will be proposed to them.
A few questions may be particularly helpful:
- Why is this intervention necessary?
- Is there another solution?
- What are the main risks?
- Which ones are specific to my case?
- How long will recovery take?
- In which establishment will the intervention be carried out?
- How will the follow-up take place after the operation?
- What happens in the event of a complication?
On this point, our experts are cautious: a surgeon does not have to promise that everything will go perfectly. Surgery always carries some risk.
“All surgeons have already experienced complications in their career”recalls our interlocutor. The challenge is therefore less to find someone who promises a “risk-free” intervention than someone capable of clearly explaining this risk and the way in which it will be taken care of.
“Surgery is a magnificent profession, but it remains an artisan’s profession” reminds the surgeon again.
Renowned surgeon: a good criterion?
But should we trust and look for the “high profile” side to approve surgery? This is one of the pitfalls of notoriety, and today of visibility on the Internet. A well-publicized surgeon, followed by thousands of people or known for having operated on celebrities, can naturally inspire confidence.
“Someone who is famous, a priori, is someone serious. He wouldn’t be here without anything”says Dr. Pourcher.
But notoriety does not constitute proof of medical competence. “Lnotoriety, it depends in what field and in what context we practice”underlines the surgeon interviewed.
In other words, a large number of patients or subscribers may be a clue, but certainly not a skill ranking.
Social networks, for their part, must therefore be considered with hindsight. They show ability to communicate, visibility or popularity, but not necessarily the quality of care provided.
What about reviews on the Internet?
They can help make a first impression, but they should never decide for the patient.
Online testimonials are by definition subjective. A positive or negative experience alone does not measure the technical quality of a surgeon.
“Be careful of the Internet which can also make you make mistakes”warns Dr. Pourcher.
For her colleague, the problem is also that of social networks, where the quantity of “likes” or views can easily be confused with a form of expertise.
It is therefore better to use the Internet to check precise information about the practitioner than to search for “the best rated surgeon”.
The relationship and the feeling also count
Finally, the patient’s feelings should not be ignored. On the contrary, the two doctors interviewed insist on the importance of the relationship that is created during the consultation.
“The moment of consultation, this moment of trust, it is very important for me”believes Dr Pourcher for his part.
The patient must be able to ask questions, express their fears and obtain understandable answers. He must also feel that the surgeon takes his particular situation into account.
This feeling obviously does not replace objective verifications. But if there is significant discomfort, it deserves to be heard.
When to ask for a second opinion?
This is precisely what the second opinion is for: when the patient hesitates, when an important intervention is proposed or simply when he wishes to compare two approaches.
And there is no reason to consider this approach an affront to the first surgeon.
“If in doubt, we recommend it ourselves”says our expert.
Dr. Pourcher also notes that patients are using it more and more.
This second opinion can also perfectly confirm the first proposition. In this case, the patient simply has an additional element to make his decision.
The treating physician can also play a vital role in helping to find another specialist.
If something bothers you, take the time
An operation is never a trivial act, even when it is presented as common.
It is therefore possible to take a few days to think, to ask for additional explanations or to consult another practitioner when the situation allows.
Before giving consent, the patient should ideally have obtained answers to three main questions: Why this operation? Why this surgeon? And what will happen if a complication arises?
If the answers are clear and dialogue is possible, the conditions are met to move forward more calmly.
And if doubt persists, asking for a second opinion is not a lack of confidence: it is a way of taking part in your own medical decision.
Ultimately, there is no method for determining “the best” surgeon. The choice is based on a set of objective and human elements: qualifications, experience, medical recommendations, quality of explanations and confidence felt during the consultation.
As Dr. Pourcher summarizes: “If we don’t feel confident, I think we need to think a little more.”