Patient Preferences When Selecting Their Total Joint Arthroplasty Surgeon: A Multicenter Survey Study

Area of Science:

• Orthopedics
• Health Services Research

Background:

• Surgeon selection significantly impacts patient satisfaction, outcomes, and access in total joint arthroplasty (TJA).
• Understanding patient preferences is crucial for enhancing trust, communication, and adherence in TJA practices.
• Limited multicenter research exists on how patients choose their TJA surgeon, despite the prevalence of referrals and word-of-mouth.

Purpose of the Study:

• To identify key decision-making factors influencing patient choice of total joint arthroplasty (TJA) surgeons.
• To analyze how these surgeon selection factors vary across different demographic groups.

Main Methods:

• Prospective, multicenter cross-sectional survey study involving patients undergoing elective total joint arthroplasty (TJA).
• Survey collected data on surgeon referral sources, consultation frequency, and importance ratings of various selection factors.
• Analysis of 808 participants' responses to identify demographic variations in surgeon choice criteria.

Main Results:

• Referrals (44.9%) and word-of-mouth (18.7%) were primary surgeon selection methods; online ads were cited by only 8.4%.
• Female patients prioritized surgeon gender, communication ease, and time spent more than males.
• Minority patients valued surgeon gender, race, bedside manner, time spent, and implant type more than White patients.
• Patients with lower-to-mid incomes prioritized insurance acceptance over higher-income counterparts.

Conclusions:

• Referrals and word-of-mouth dominate TJA surgeon selection, emphasizing the critical role of trust.
• Female and minority patients show a preference for specific surgeon attributes (gender, race, interpersonal skills), indicating a need for culturally responsive care.
• Enhanced primary care physician engagement and community outreach can foster trust and promote equitable access to TJA care.