The Clinton Herald, Clinton, Iowa

Food & Health

January 2, 2014

Gynecomastia can be harmless; still needs more investigation

(Continued)

While I understand you might be taken aback by the question, many hospitals are moving toward arbitration as a means of reducing malpractice coverage costs. I personally don’t see it as a reason to be concerned about the surgeon. However, I spoke with an attorney, who advised not agreeing to arbitration, as it isn’t germane to your medical condition and may limit your options later.

DEAR DR. ROACH: I have arthritis in both knees, injuries from the past. My knees hurt when going up and down stairs, not level ground.

How do I go about finding a good orthopedic doctor to check out my knees? There are so many doctors who do knee surgery. — D.M.P.

ANSWER: Well, I must admit to some bias here as an internist. I would recommend starting with a rheumatologist, an expert in medical treatment of joint problems, or an internist, rather than going first to a surgeon. While orthopedic surgeons certainly have expertise in all kinds of treatment (both medical and surgical), I reserve the expertise of the orthopedic surgeons for the people with knee pain who, after a medical evaluation, I think might benefit from surgery.

Knee pain is such a common problem that any rheumatologist will be expert in diagnosing your condition.

There are many kinds of arthritis, each with different treatments and prognoses. It’s a good rule of thumb not to see a surgeon unless you think you need surgery, and you don’t know enough yet to make that decision.

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