> the risk of a botched repair was permanent loss of hand function - why risk that with a mediocre doctor? You make an excellent point, and I will point out a

> the risk of a botched repair was permanent loss of hand function - why risk that with a mediocre doctor? You make an excellent point, and I will point out a related anecdote. A plastic surgeon in my wife's practice fell into a glass table severing a number of nerves and tendons in his dominant wrist & arm. Basically a potential career ending injury. Short of an amputation that is one of the worst injuries for a surgeon. He did not go to any regular hand surgeon, or plastic surgeon that may have done a fellowship in hand. Nope. He got driven to Hopkins where they have one of the best teams in the Mid-Atlantic for complex, nerve involved hand & arm related injuries. A year or so later and he is completely recovered. Some of the other leading honor roll hospitals [1] like Mass General, Cleveland Clinic, Mayo, etc - they have leaders in their field, and collections of gurus needed for really complex injuries where best outcomes are critical. Regular surgeons refer the super hard cases to them, because they are often times the best care possible in the US. [1] https://health.usnews.com/health-care/best-hospitals/articles/best-hospitals-honor-roll-and-overview https://health.usnews.com/health-care/best-hospitals/article...