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Beyond the Hammer and Nail: Exploring Alternative Treatments Before Considering Surgery

Deborah Westergaard, MD

Pain Experts




In the realm of medical care, there's an old saying: "If all you have is a hammer, everything looks like a nail." This adage, often evoked in various professional fields, is particularly pertinent in the context of healthcare and surgery. As a physician with nearly three decades of experience, I've seen a myriad of cases where patients were steered towards surgery as the first and only option. However, in my practice, I've always believed in exploring all avenues before resorting to surgical interventions.



Over the past 30 years, I've had the privilege of working alongside many exceptional surgeons. These professionals, masters in their field, share a common preference: they would rather see patients who genuinely require surgical intervention. This isn't out of a mere preference but out of a recognition of their specialized skills and the significant impact surgery has on a patient's life. Surgeons take pride in their work, and rightfully so, but they are also the first to acknowledge that surgery isn't always the best or necessary path.

It's not uncommon for orthopedic surgeons' offices to be inundated with patients who, upon evaluation, do not require surgical treatment. This scenario often leads to the employment of physician extenders to manage the high volume of non-surgical cases. The result? A bottleneck effect where surgical candidates might face delays, and non-surgical patients might be delayed in receiving the focused care they need for their specific conditions.


In my practice, I don't have a hammer, and my patients are not nails. Instead, I have at my disposal advanced diagnostic tools like X-rays, MRI, CT scans, EMGs, vascular testing and ultrasound machines, which help in accurately assessing and understanding a patient's condition. My focus is on finding a solution that addresses the root cause of the problem, ideally without the need for surgery.


In orthobiologic medicine, a field in which I have come to love and embrace, I have not considered resorting to the proverbial hammer. Orthobiologics offers a multitude of non-surgical options. These treatments aim to help heal injuries or alleviate pain for extended periods, often months or years. The goal is to provide patients with relief and improved quality of life without the risks and recovery time associated with surgery.



Of course, there are cases where surgery is the best option, and for those patients, I work with a network of highly skilled surgeons ready to provide the necessary care. However, my commitment to my patients is to explore every possible avenue to treat their pain and address their conditions effectively and safely, without immediately resorting to surgery.


In conclusion, I advocate for a comprehensive, patient-centered approach. Let's look at your problem together, understand it thoroughly, and explore all possible solutions. If surgery is the path forward, rest assured you'll be in good hands. But, if there are other viable options, we'll explore them first. Remember, you're not a nail, and I'm not wielding a hammer. We're partners in your healthcare journey, seeking the best possible outcome for your unique situation.

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               Deborah Westergaard, MD

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