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How can I find out if I was used as a case study at a medical conference
June 17, 2014 7:17 PM   Subscribe

I'd like to find out if my surgery/medical condition has been presented at conferences.

The day after my operation my surgeon told me that my situation was so unique that he would be using me as a case study in future conferences. I have googled his name and have found some blurbs but no full article. I guess I, as a layman don't have access? The surgery was 5 years ago and I don't want to contact him to ask about it for many reasons. The surgery was a failure and I want details regarding why my situation was such an unusual case. My surgeon is not THE guy in his field but he is in the top 5. He is an ortho surgeon if that matters at all. How can I find out more?
posted by futz to Health & Fitness (14 answers total) 4 users marked this as a favorite
Google Scholar?
posted by sebastienbailard at 7:25 PM on June 17

If you are willing to memail myself (or many other mefites who will probably soon volunteer) your surgeon's name and details of the surgery, I can check academic medical databases for relevant articles.

In addition, you can request a surgeon's "operative report." These are standard for any surgery; if the surgery was non-common, the report would be quite detailed. It'd be part of your patient file wherever the surgery occurred, and can be requested like any other report. I found the operative report for a surgery I had surprisingly readable and somewhat interesting due to a (very) minor complication that occurred.
posted by saeculorum at 7:35 PM on June 17 [7 favorites]

Yep. I got my report. Pictures, scans, ect.

It can create a return of the mental trauma of the surgery, so make sure you are ready to see that. I wasn't prepared to see the inside of my literally bloody head. No one should see their exposed facial nerves.

The scans were neat though. I turned them into a movie using open source software that took each scan and made it into a frame.

The report wa surprisingly way for me to read, but then I grew up in a medical household and have always had a side interest in health.

The best source would be the doctor, but if that's out try the hospital instead?
posted by cjorgensen at 7:42 PM on June 17 [1 favorite]

Here's the thing: conference presentations generally only exist as abstracts, with no article, so if you're looking at full articles, you may be passing over your case. They are often printed in the supplements of the journal published by the society that holds the conference, and, to make things really confusing, may not be indexed as widely as the articles in the associated journal. However, since this is limited to one corner of medicine, it shouldn't be hard to canvass the supplements/conference proceedings of the major journals, and it's very possible that the abstracts will be freely available online in some form.
posted by pullayup at 7:46 PM on June 17 [1 favorite]

I'll add that since it sounds like you don't want to get in touch with your surgeon (and quite understandably so), if you want a copy of your operative report, you should contact the medical records office (or equivalent) at the hospital or facility where you had the surgery. That should be your first stop.
posted by un petit cadeau at 7:47 PM on June 17

I'm a physician. If you don't ask him directly, there might not be any way of knowing if he did present your case at a conference. You might be thinking of 'conference' as necessarily being a regional or national conference or some kind of published forum. The thing is, in an academic medical center, each department has educational lectures for the residents at least several hours a week, and unusual cases or cases that did not go well are often presented there as part of the learning process. These can be part of a lecture on a specific topic (i.e. your surgeon is presenting on "Advances In Rotator Cuff Repair" and uses your case as a vignette to illustrate a point in the talk) or a lecture that's specifically meant to be a case conference, usually called an "M&M conference" (Morbidity and Mortality) - morbidity means the patient was harmed in some way but did not die.

There would be no google-able way to find out about the use of your case in an educational lecture like this. I suppose you could ask one of the residents in his program if you could not ask him directly, but usually not all residents attend every lecture or they might not remember it.
posted by treehorn+bunny at 8:14 PM on June 17 [2 favorites]

Thank you!!! I will memail you tomorrow.

Also, I have all of the medical records already but they don't indicate anything unusual as far as I can tell.
posted by futz at 8:14 PM on June 17

Treehorn+bunny, I understand what you are saying and you may be correct but that is not what I gleaned from my conversations with the doc. He made it quite clear that my case would be presented at major conferences. He was full of glee. I distinctly remember my dismay at his enthusiasm. I fought long and hard to convince many docs that I had a major problem and was dismissed by all. After my surgery he treated me like a meal ticket. I don't doubt for one nano second that I have been the topic of his conference rounds. I could be wrong of course...
posted by futz at 8:34 PM on June 17

futz, he may also be presenting your case as part of a lecture at a national conference but using it as a vignette to illustrate a particular point in the lecture which is a general one on the topic of that surgery. It is very common these days for medical lectures on any topic to start with a few slides of case presentation before presenting the general information, it's meant to help the general information stick in the audience's minds (as they consider how the information applies to the case). This is often done even 3 or 4 times during an hourlong lecture with different cases. What I'm trying to say is that even if you are able to find records indicating that your surgeon presented a lecture on the type of surgery you had - seems likely, if he's one of the top 5 surgeons specializing in this area - again, it might be very difficult to tell if your case was presented as part of that unless you talked to someone who was at the lecture.

If you want to see whether your surgeon wrote about your surgery as a case report in the medical literature, I suggest searching his name as an author on PubMed as the best place to start. Anyone can see the search results in PubMed, you only need special access to read the articles. I'd also be happy to take a look for you if you wanted.

As a side note, you might have misread your surgeon's attitude about your case - I know very few doctors, particularly surgeons, who take delight in their failures. Surgeons tend to take failures particularly hard because their surgical success rates are compiled and compared across the specialty and a hit to their success rate can cause a number of problems for them. For this reason, surgeons have been known to turn down complex or difficult cases - if they only do easy cases, their success rates will appear better than others in the specialty. Sometimes physicians do get excited about treating rare conditions, certainly, and it's rather poor form to show excitement in front of the patient about what an interesting case they are, as no one wants to be an interesting medical case; but if we didn't get excited about treating rare conditions, we probably wouldn't be very good physicians, I suppose.
posted by treehorn+bunny at 9:41 PM on June 17 [1 favorite]

I've been to a lot of conferences and they're pretty awful at publishing anything remotely accessible online.

Think about the most dysfunctional organization you've ever belonged to, medical conferences are several tiers below that. Email attachments with a powerpoint are generally considered to be next-generation tech. Your average PTA conference is more google-able. And surgeons? Forget it. I'm not sure they even know about the internet yet. I ordered an advanced trauma life support textbook from the Americal College of Surgeons official website last week and it was like time-traveling back to 1995.
posted by hobo gitano de queretaro at 9:42 PM on June 17 [2 favorites]

Thanks all. t+b your insight is always welcome. You are a wonderful resource for the green. I misspoke when I said the surgery was a failure. It was a great success for approx 3 years and now I am back to square one. He doesn't know my current status. I finally get health ins in July! I am not opposed to seeing him again at all...i just want to know why my situation was so note worthy and why he felt the need to tell me so. This is a major sports med (NFL) ortho who told me that he had never encountered a case like mine.
posted by futz at 10:03 PM on June 17

Futz, if it helps I have had a neurologist lean forward and say this is such an interesting case! with real enthusiasm after I haltingly brought up brain damage symptoms. He meant well and I'm glad he's one of my doctors because he chose my case as it was weird, but it was disconcerting at the time. I think the kind of doctors and surgeons who take on puzzling cases are by selection the kind of people who want to share their enthusiasm for weird cases, even with patients.

Congrats on health insurance!
posted by viggorlijah at 11:39 PM on June 17

Was your surgeon affiliated with a medical school, or was he in private practice? If the former, it's possible your case might have been presented as part of grand rounds. This is sort of an internal lecture presented to the department of a medical school where an interesting (unique) case is presented, along with how it was treated and what the outcome was.

Patients are always (supposed to be) anonymized [and this is true at medical conferences and in journal publications too], so you won't be identified by anything could help narrow down that it's you. Presenting anything about you like name, birthdate, photos of you showing your face without the eyes blacked out, etc. would be a HIPAA violation, though it does happen in thankfully-rare circumstances.

At medical schools, grand rounds are usually just advertised by an email list. I sort of doubt you'd find anything online, but it wouldn't hurt to google your surgeon's name with the term "grand rounds" to see what comes up. If you wanted to be really thorough about finding out if your case had ever been presented, you'd probably need to find someone who was a resident or fellow in the orthopedic surgery department of that medical school during the year or so following your surgery, describe your case to them, and ask if they'd ever seen it at grand rounds.
posted by wondercow at 6:12 AM on June 18

Futz, since this will be something you potentially will need to look into for some time... IANAD, but I just finished a project, after 2+ years, requiring a lot of health care research, and I also got diagnosed with a continuing condition impacting my hormones, fertility, etc.

PubMed is available to you right now, with its million citations, and many journal articles are now completely available as part of Open Access journals. Easy to trace from your computer.

I traveled to the Texas Medical Center Library, and also used interlibrary loan to request certain academic articles. NNLM offers a list of regional medical libraries that might be closer to you. Even your local public library might be willing to help you with interlibrary loan, or they might be able to suggest a state-connected program - in Texas, for instance, there is TexShare.
posted by mitschlag at 11:26 AM on June 18

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