FAQs

GENERAL

How do I get an appointment with an Orthopedic Surgeon?

You must be referred by a doctor, nurse practitioner, or certain physiotherapists in order to see an Orthopedic Surgeon.  The wait time to see a surgeon varies with the type of problem you have and the urgency of your condition.  Once a referral is sent on your behalf, it will be reviewed by one of our surgeons.  It will either be accepted and put on the waitlist or rejected.  If accepted, you and your referring party will receive a letter saying you are on the waitlist with the approximate wait time.  When the time comes, you will be called and we will schedule you in for an appointment.  If your referral is rejected, we will send a letter to your referring party – if this happens it is usually because we do not treat your problem at our clinic.

Can I choose my surgeon?

Yes, you can choose your surgeon. You should choose at the time the referral is made so your doctor can indicate in the letter that you want to see a specific surgeon.  However, not all surgeons treat all conditions. The surgeon you request may not treat your problem. If this is the case, you will be put on the waitlist for the most appropriate surgeon.  Also, the waitlist for each surgeon varies so you may have to wait longer than average to see the surgeon you have specifically requested.

If I have already seen a surgeon, can I see him or her without a new referral?

Yes, if you have seen your surgeon within a year.  You can contact your surgeon’s assistant to arrange an appointment.  If it has been one year or longer since you have seen your surgeon, you need a new referral from your doctor.  If it is a follow-up for the same type of problem you were seen for before, have them put that in the referral letter.  The wait time for a follow-up appointment is typically shorter than for a new consultation.  If you want to see the same surgeon for a new problem, you need a new referral. Your surgeon may not see patients with your new problem. You must have your doctor write a new referral letter.  You will then be placed on the waitlist for the most appropriate surgeon.

Do I need an MRI to be seen?

No, you do not typically need an MRI to be seen. When your doctor sends in a referral, if you do not have enough imaging done, we will either contact them and ask for a specific test or have you see one of our musculoskeletal (MSK) physicians.

How come it’s so difficult to get a hold of someone in the office?

We have a busy office. Our receptionists receive hundreds of telephone calls per day. This is on top of checking in a hundred or more patients per day. They do their best to answer the telephone, but can’t always get to every call.  

Our assistants also receive many telephone calls and messages per day.  They are often not at their desks during the day as they run clinics for the doctors.  If you leave a message, they will get back to you within 2-3 business days.  

All our staff can be contacted either by telephone or via email.  Because email is more readily accessible, you may receive a faster response.  However, we cannot guarantee the privacy and security of email messages.  Be aware that when using an employer's or other third party’s email system, these parties may have the right to access the email communications.  Emails sent from the third party's computer system may also be at risk of being disclosed in the context of an access request, privacy commissioner or College investigation. They may also be subject to disclosure in the context of litigation. For this reason, we strongly discourage discussing sensitive medical information via email.  If email must be used to communicate sensitive personal matters, consider using a personal email account accessed from a computer you personally control rather than a computer that is shared with others.  Email is not always instantaneous; an email message can arrive hours or even days after it is sent.  Email may, therefore, be a poor method for exchanging time-sensitive information.  Emails may be triaged to facilitate timely responses.  

The content and context of messages can indicate the expected turnaround times, and responses can be prioritized accordingly.  If you think you need urgent medical attention, do not leave a message – we probably won’t be able to get back to you in time.  Either phone HEALTHLink Alberta at 1-866-408-5465 or seek medical attention at the nearest Urgent Care Clinic or Emergency Room.

REFERRALS, APPOINTMENTS AND SURGICAL DATES

Why am I seeing a musculoskeletal (MSK) physician?

Our MSK physicians are family doctors with an interest in musculoskeletal disorders.  If you are seeing a MSK physician, it means you were triaged to that clinic when your consult was reviewed by an orthopedic surgeon.  Referrals are triaged to the MSK clinic when there is a lack of information such that your diagnosis is not clear from the referral letter, if you have not had all the required tests, or if you have not tried any non-operative treatments, when appropriate, for your condition.  Being seen by an MSK physician allows them to assess your condition, order tests if needed, and start non-operative treatments for your condition. For most conditions, non-operative treatment works quite well and no surgery is necessary.  If you still need to see an orthopedic surgeon, you will not have lost your place on the waitlist. In fact, by better knowing what your problem is, we can make sure you get to a surgeon that treats that condition. It actually may speed up having surgery because when you do see your surgeon, you will already have had all the required tests and non-operative treatment.

I have just been referred to an orthopedic surgeon.  How long do I have to wait before my appointment?

Your wait time will depend on the type of problem your have and the urgency of the referral.  If you have been referred for a broken bone (fracture), you will be seen in a timely fashion. Your doctor will have spoken to one of our surgeons to arrange an appointment. Your doctor will then tell you when you should be seen.  If you have been referred for something other than a fracture, then the wait times vary.  It may be anywhere from several months to more than two years.

I won’t be able to make it to my appointment.  What should I do?

Please phone us as soon as possible to reschedule your appointment. If you do not call to cancel or reschedule your appointment more than 24 hours prior to your appointment, you will be charged $100 to reschedule another appointment.

I have just been scheduled for surgery.  How long will I have to wait?

The wait time for surgery is usually at least 3 months. It does depend on the type of surgery you need, who your surgeon is and any medical problems you may have.  If you have medical problems that make surgery more risky, then you will have to have a pre-operative consultation with an Internal Medicine doctor. This doctor may send you for more tests, which will make the wait for surgery longer.  We do not have a cancellation list per se. However, if you are available at short notice, tell your surgeon or their assistant and we will contact you if there is a cancellation.

SURGICAL QUESTIONS

How long will I be in the hospital?

This depends on the type of surgery you are having and whether you have any underlying medical conditions.  The typical stay for a joint replacement (hip, knee, shoulder, ankle) is three days.  For most other shoulder elbow, wrist, knee and foot and ankle surgeries you will be going home the same day as your surgery (Day Surgery). For more information on your specific surgery, see our information package for your procedure.

Will I need crutches/a cast/a sling after surgery?

This depends on the type of surgery you are having. Most lower extremity surgeries require a period of non-weight bearing following surgery.  This is best discussed with your surgeon.

Will I need antibiotics after surgery?

For most operations, you will receive one dose of antibiotics just before your surgery. Depending on the type of operation you will be having, you will receive from one to three doses of antibiotics before going home.  For most operations, you do not need any antibiotics once you leave the hospital.  If you think you have an infection, contact your surgeon’s office to either speak with one of our nurses or arrange a follow-up appointment. If this is not possible or you are ill, go to the nearest emergency room for medical care.

How long will I be off work?

This depends on the type of surgery, your post operative weight bearing status, and the type of work you do.  Please discuss your expected time off work with your surgeon.

Will I need physiotherapy after surgery?

You will usually need to do some sort of rehabilitation after your surgery. However, physiotherapy is more important after certain procedures.  Please discuss your anticipated need for physiotherapy post surgery with your surgeon.

Can I fly after my surgery?

We do not usually recommend you fly right after surgery. In the first two weeks after surgery, you will feel tired – like you are getting over the flu and you will have pain from your surgery. This will make travel uncomfortable.
Travel can also increase your risk of certain complications like:

• Deep vein thrombosis (DVT) or a blood clot in your legs. You are at increased risk of a DVT if you:
• Have had hip or knee surgery
• Are wearing a cast or splint on your leg
• Have previously had a blood clot
• Someone in your family has had a blood clot

If you are planning to travel, we recommend you drink plenty of water and walk around as much as possible on the airplane. If you have any of the above risk factors, contact you surgeon – they may recommend you take a blood thinner.

• Post spinal headache

This is a severe headache that can happen up to seven days after receiving a spinal anesthetic.

• Breathing difficulties

Because of the blood loss after surgery (which decreases the amount of oxygen your blood can carry), the effects of anesthesia on your lungs (there is usually some collapse of part of your lungs) and the effects of flying at altitude, your body may not get enough oxygen to its tissues. This can be a problem if you already have coronary artery disease, lung problems or other serious medical conditions.  

Also, if you are leaving the country, your surgery will be considered a pre-existing condition and your travel insurance will not cover any medical expenses resulting as a complication of the surgery. This usually includes any medical complications or interactions with any new medications your may be on (pain medications, etc). If you will be leaving the country, check with your insurance company.  Check with your airline before travel. Some may require a medical clearance note.  If you have a cast or splint on your leg, you may also need to purchase extra seats if you cannot bend your leg and fit in a seat.  If you are planning to travel after your surgery, let your surgeon or your surgeon’s assistant know.  We strongly recommend you attend your two-week and as well as any other follow-up that is scheduled.

References:
http://www.asma.org/asma/media/asma/TravelPublications/Medical%20Guidelines/Surgical-Conditions.pdf

Can I fly with my cast on?

Most airlines will not allow you on board with a cast that has been put on in the 48 hours before your flight without being bivalved. This is because you can have severe swelling in the cast that can cut off the blood supply to your limb. We can bivalve (cut) a cast to allow you to fly. However, cutting your cast in this way may lead your bones to shift out of alignment.  If you have been in your cast for more than 2-3 days, it should not be a problem.  Please note we do not recommend you get your cast wet, especially with ocean, river or lake water as that may cause infection. Sand also tends to collect in casts and under the padding, it acts like sandpaper wearing away your skin. This can lead to serious skin ulcers.

Will I set off the metal detector at the airport?

Maybe. It depends on how much metal you have in your body, how deep it is and the sensitivity of the metal detector.  If you do set off the metal detector, you will usually have to show the security agent your scar and explain to them that you have had surgery with an implant. Please allow for extra time when you get to the airport to allow for this.  A note or medical clearance will not allow the security agency to waive the body search.

When can I start driving after my injury/surgery?

The decision to resume driving after orthopedic surgery is difficult for both patient and surgeon.  According to insurance companies and law enforcement agencies, patients are ultimately responsible for the decision to drive. Surgeons are expected to help patients make an informed decision and provide evidence-based recommendations for safe driving.  A patient may safely return to driving a motor vehicle once they are no longer affected by pain, under the influence of pain medications, able to fully weight bear on their right leg and foot, and are confident that they can react appropriately to stop the vehicle in an emergency situation. NOTE: For splints and slings, the restrictions are for the length of time your are required to wear. It does not matter if you remove the splint or sling to drive. The information below does not apply for commercial driving. The following are recommendations based on experimental studies that assess emergency braking reaction times on a simulator following orthopedic surgery:

References:

Marecek, GS and Schafer MF. Driving After Orthopaedic Surgery. J am Acad Orthop Surg. 2013;21:696-706.
CMA Driver’s Guide: Determining Medical Fitness to Operate Motor Vehicles. 8 th Ed. Toronto, ON, Canada. Canadian Medical Association, 2012.

Can I have a follow up appointment with my family doctor?

Usually not. Getting a good result from your surgery requires some specialized rehabilitation.  Your surgeon will want to see your incision and may need to take x-rays to look at your bones and joints. We also will guide you along your rehabilitation letting you know what you should and should not be doing. This requires specialized training and your family doctor is not usually able to provide this care.

FORMS AND MEDICOLEGAL

How do I get a return to work note filled out? Is there a fee for this?

You may ask your surgeon for a note or to fill out a return to work form at your next follow-up visit.  If you require a note prior to this, you may contact your surgeon’s assistant by telephone or e-mail. You may either need to come for another visit or the details of the return to work note may be discussed over the telephone.  This is an uninsured service and as such, fees apply. There is a fee of $50 to fill out a return to work note.

I need a form for my insurance filled out by my surgeon.  How do I get this done?

You may drop off your form at your appointment. Should you need the form sooner, you may drop off your form at the reception area during our business hours. You may also contact your surgeon’s assistant via e-mail or telephone to arrange to fax or e-mail us your form.
You must:

• Print your full name on the form
• Put your date of birth on the form
• Sign the release of information portion
• Provide us with a contact number or detailed instructions on how you want to receive your form

It is YOUR responsibility to ensure your form has the proper identification, the release of information is signed and we have a way to contact you once it is completed. Failure to do this means we cannot fill out your form.  We cannot guarantee the privacy and security of e-mail messages. Be aware that when using an employers or other third party’s e-mail system, these parties may have the right to access the email communications. Emails sent from the third party's computer system may also be at risk of being disclosed in the context of an access request, privacy commissioner or College investigation. They may also be subject to disclosure in the context of litigation. For this reason, we strongly discourage discussing sensitive medical information via email. If email must be used to communicate sensitive personal matters, consider using a personal email account accessed from a computer you personally control rather than a computer that is shared with others.  Email is not always instantaneous; an email message can arrive hours or even days after it is sent. Email may therefore be a poor method for exchanging time-sensitive information. Emails may be triaged to facilitate timely responses. The content and context of messages can indicate the expected turnaround times, and responses can be prioritized accordingly.

When will my form be ready?

The Alberta Medical Association and the College of Physicians and Surgeons of Alberta recommend forms be completed within four weeks.  You will be contacted when your form is ready and you must either pick it up or it will be sent to you if you have made other arrangements.

Is there a fee for filling out my form?

Yes. Filling out forms is an uninsured service and as such, charges apply. You are responsible for ensuring all fees are paid. We will not give you your form back or fax it until the fees have been paid in full. Your insurance company may cover some or all of the cost - you must check with them. However, you will need to pay the entire amount and request reimbursement from your insurer if this is the case. We accept cash, cheque, credit and debit cards.  The fee for filling out a standard form is currently $75. Please see our Uninsured Services page for a full list of fees as your form may require more time to fill out and may cost more. Link to uninsured services page.

Do I have to pick up my form?

You may pick up your form once you have been informed that it is ready. If you have made alternate arrangements, you do not have to come pick it up in person. It can be faxed or e-mailed to you.  It is your responsibility to get the form to the requesting party. We do not send the form to your insurance company. This lets you keep a copy and allows you to read your form before giving it to your insurer.