I'm trying to decide on a doctor for NA procedure-both MCP & PIP joint involvement. I'm willing to travel because I really want the best with no complications although I'm closer to California. I've heard from several patients, a doctor and a physical therapist that of all the docs doing NA, Dr. Denkler is the most aggressive. AFAIK, no other docs will do more than one hand in a single day whereas Dr. Denkler has been known to do both hands and feet as well. I've also heard he has a higher complications rate possibly because he attempts things other NA docs won't.

I've not heard any complaints about Dr. Eaton and it seems he's more middle of the road, his patients love him, he has a wonderful success rate whereas a few other docs are even more conservative.

I'd really appreciate any comments about various docs and aggressive treatment, risks, etc.

Thanks

Dr. Eaton has been the pioneer for NA in the US and quite likely has the most experience. For a couple of years people from all over the US flew into Florida to be treated by Charles Eaton and patients were and are enthusiastic. As NA became more popular other doctors either got trained in France (where NA originated) or by Dr. Eaton (http://www.handcenter.org/visitors.htm) and so we now have a much longer list of clinics offering NA in the US http://www.dupuytren-online.info/NA_list_North_America.html. Both, Keith Denkler and Charles Eaton, are excellent doctors, both are research oriented and it's just great having them both available. And BTW both are surgeons, too, so they can advise what technique is best.

Wolfgang

I had been strongly advised to use Dr. Denkler's services. His office is about 2 hours from my home so I was willing to make the drive. When I called his office to verify my insurance I was in for a rude wakening. Dr. Denkler's office only bills Medicare. They do not bill any other insurance. I am not on Medicare. They told me that they expect you to pay for the procedure out of pocket and bill your insurance company yourself to get reimbursed. That stopped me cold in my tracks and for several reason s: 1) As a daughter of a well-respected surgeon, I have found that if a physician is not willing to bill your insurance, there is something else going on. 2) I'm having my HAND operated on; I won't be able to do the paperwork myself; 3) I didn't have upwards of $1300 out of pocket to plunk down.

The conversation I had with his receptionist rose so many red flags for me that I told her I'd check with my insurance to see if NA is even covered and get back to her. I never called her back.

Instead, I contacted my original orthopedic doctor and scheduled a surgery with him. He does not do the NA procedure as it's considered experimental (although I didn't check, I suspect my health insurance wouldn't have covered it anyway.). My doctor's name is Stefan Klein. He is with Dominican Hospital in Santa Cruz, CA. He is a Stanford med school graduate and he is VERY good. He also has an excellent "bedside manner." I recommend him in a heart beat.

centered:

So apparently the genius who wrote this particular insurance guideline has it such that *you* must pay to avoid Open Surgery while *they* are willing to shell out about $7,000 to have you cut open. Now that's cost effective :-). Just think how much improved this will be if health care is nationalized in the USA and some bureaucrat gets to make these rules instead! I'm sure the'll get it right. :-)

In my personal experience, I found Dr. Denkler and all of his office staff cordial, helpful and competent. Dr. Denkler was forthcoming in our discussion. He was confident that he could help my DC but never pushed at all. NA was completely successful for me. He did the full surgery, but when he found out about NA, he sees it as a first line of treatment. That doesn't sound to me at all like aggressive.
Larkspur/Marin County is a retirement area. It makes sense that he would bill Medicare. I don't have the information at hand, but the total was under $800 including ONLY ONE visit for less than an hour and I drove home. I'd think that more severe contracture would likely cost more. My Medicare paid and my Blue Cross supplemental paid the rest. I'd pay out of pocket for NA if I had to. I have the utmost confidence in Dr. Denkler based on my personal experience.