Jim,
My surgeon had no problem with the procedure(NA) if that is what someone wanted. He was also very aware of collagenase and had sent two or three patients to Stanford for trials.
The problem, as we have discussed previously, is that there is no training for NA in the U.S. Dupuytren's is generally a small part of a good hand micro-surgeon's practice. They are generally, much busier reconstructing hands from accidents or more serious hand diseases. There is just not the incentive to take time off from their practice to learn NA. Remember, surgery is the standard practiced in most countries in the world. There are only a few countries that will allow NA to be done. Most of Europe still considers surgery as the procedure of choice, so it isn't just the U.S.
It just comes down to an individuals choice as to what type of procedure they would want. NA and a fasciotomy have (by most studies) have a higher recurrence than a limited fasciectomy, but they are less invasive, and that is appealing to some people.
It is my opinion that Segmental Aponeurectomy is the preferred procedure, but it is not available (to my knowledge) in the U.S. or most of the world.

Jim,
What was meant was that he had no problem with people choosing NA. He didn't care what type of procedure that a person wanted. He mainly does limited fasciectomies, but if a person wanted to go to France for NA he didn't care.

I concur. The USA NA procedure is a dead end. A better use of time would better spent acquiring a passport for a trip "over there". JIM