This has turned into a great discussion. I mentioned that IMO a patient bears some of the responsibility of choosing a doc that meets his or her needs in an earlier post. The reason I stated some and not all of the responsibility is that many people have no choice. They are restricted by their insurance or geographical location or other reasons. Unfortunately some folks can't shop around or leave if they are not satisfied. In those cases, I don't hold the patient responsible.
I think you should consider changing this to "the patient bears most of the responsibility of choosing a doc that meets his or her needs". While there may be some cases where the patient has limited options, by and large those limitations are put on themselves. The convenience of going out of town, or expense of going out of town, etc.. is largely more powerful than their desire to get better care. They tell themslves, "I MUST see this local doctor because he's the only one who treats this condition" whereas they DO have the choice of inconveniencing themselves (time, money, etc..) to go out of town. It's not that they do not have a choice, but they're choosing to stay local for the convience.
I don't have a problem with them making that choice, but nobody should say that they do not have a choice. They do, they just don't like that choice so they say they have no choice.
I'm in no way diminishing your outcome or that of anyone else. Post-surgery outcomes cannot be guaranteed by ANY doctor. Any doctor who guarantees a particular outcome is blinded by their own gawdliness and you should run for the hills if ever given that kind of guarantee.
For example, there are many Canadians that have been disatisfied with the speed of treatment in Canada, so they come to a doctor in the US. Another example is that many people travel across the country to get treated at House and other institutions because they felt it was right for them. Luckily, my doctors were local and were extremely good in my mind so I didn't have to travel. If they weren't, you bet your patooty that I'd find someone in the country that I was comfortable with doing my surgery and I'd travel there to have it done. Luckily, I wasn't faced with that choice.
I agree that this is a good discussion. One that merits us having it. I simply disagree that the patient has NO or SOME of the responsibility for their own choices. Rather, I feel they bear MOST of the responsibility for choosing their doctor and location for treatment. There are things that are out of their control (bad outcomes happen to patients of the best doctors for example) and they shouldn't be "blamed" for that, but neither should the doctor.