How to Avoid Surgery: The Advantage of Experience Amplified by New Technology
- cassis101
- Feb 2
- 3 min read
Deborah Westergaard, MD | Pain Experts | Dallas–Plano
The Problem: Why Many Patients Struggle to Avoid Surgery
As a specialist, I routinely evaluate patients who have already consulted highly skilled and respected surgeons. These physicians do extraordinary work, and I continue to refer to them when surgery is appropriate.
However, many patients seeking to avoid surgery arrive after consultations constrained by time which is an unavoidable reality of insurance-driven medicine.
Recently, I evaluated a middle-aged executive who was young for his age, active, and highly motivated. He sought a second opinion on orthobiologics as a strategy to delay or avoid surgery, specifically shoulder surgery. He arrived with a high-quality MRI arthrogram and a thorough radiology report. His prior evaluation was appropriate and professionally sound.
Yet critical questions remained unanswered:
How were the shoulder tendons functioning dynamically?
Were ligament structures stable during movement?
Were there subtle soft-tissue contributors to pain that static imaging could not fully capture?
These gaps were not due to lack of expertise but lack of time. And for patients trying to avoid surgery, those details matter.
How Precision Evaluation Helps Patients Avoid Surgery
To better understand the true pain generators, I personally reviewed the MRI images, performed a comprehensive physical examination, and followed this with a live diagnostic ultrasound of the shoulder.
For patients exploring options to avoid surgery, real-time ultrasound provides critical advantages including functioning almost like a dynamic MRI:
Tendons can be visualized in motion
Fluid collections are immediately apparent
Partial tears, ligament laxity, and soft-tissue abnormalities can be assessed dynamically
Subtle biomechanical contributors to pain become clear
This precision allows patients to see what is happening inside their own body, rather than relying solely on a written report. It also supports a more informed discussion about structural integrity, biomechanics, and whether non-surgical strategies may be appropriate.
After spending nearly an hour reviewing these findings together, the patient was understandably frustrated. Not with his prior physician, but with a system that rarely allows this level of evaluation for those trying to avoid surgery.
Advanced Imaging as a Strategy to Avoid Surgery
Modern medicine is evolving rapidly. Ultrasound is no longer just a procedural tool. It has become a powerful diagnostic extension of the physical examination.
I am encouraged to see younger orthopedic surgeons and pain physicians adopting these skills, not only to guide needles, but to diagnose with precision. When advanced imaging is combined with decades of anatomical understanding and clinical judgment, patient care is elevated, and opportunities to avoid surgery are more accurately identified.
The future belongs to physicians who integrate:
Experience
Advanced imaging
Time for thoughtful evaluation
Individualized, patient-specific decision-making
This approach is particularly important for active individuals who want to preserve joint function and delay or avoid surgery whenever clinically appropriate.
How Active Professionals Can Avoid Surgery with Strategic Care
If you are an active professional who values performance, longevity, and informed decision-making, your medical care should reflect those priorities.
A thorough evaluation, one that combines advanced imaging, functional assessment, and clinical experience can help guide intelligent, non-surgical strategies when appropriate and ensure surgery is pursued only when truly necessary.
Your joints are assets. Protect them with precision.
A thoughtful, technology-enhanced evaluation may help you avoid surgery, stay active, and continue moving forward—on your terms.
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