In an attempt to begin answering my own question I found some good explanation of the differences in laymans words on the website called 'The Face and Body Center' under the section for labeled FAQ (Frequently Asked Questions).

Anyone want to add more?

What Is a Certificate of Added Qualifications in Surgery of the Hand?

Hand Surgery is a specialized field of medicine that
includes the investigation, preservation, and restoration by medical, surgical, and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist.

In 1982, the American Boards of Orthopaedic Surgery, Plastic Surgery, and Surgery were asked by the American Association for Hand Surgery and the American Society for Surgery of the Hand to consider special recognition of those Diplomates of these Boards who had demonstrated special qualifications in
Surgery of the Hand.

The three Boards applied to the American Board of Medical Specialties (ABMS) for authorization to offer a Certificate of Added Qualifications in Surgery of the Hand, which was granted. The ABMS intends the Certification in the Subspecialty of Surgery of the Hand for only those surgeons who, by virtue of additional fellowship training, practice characteristics reflecting a major commitment to Hand
Surgery, and through contributions to this field, have demonstrated qualifications in hand surgery that deserve special recognition.

To qualify for Certification in the Subspecialty of Surgery of the Hand, a surgeon must, among numerous other requirements, have been in the active practice of hand surgery for at least two years following the completion of formal training, have as his major professional activity the field of plastic surgery, hold full operating privileges in an accredited hospital and have successfully passed all examinations prescribed by the Joint Committee on Surgery of the Hand of the American Boards of Orthopaedic Surgery, Plastic Surgery, and Surgery.

Candidates who enter a fellowship in Surgery of the Hand (as of 1999 or later) must enter and satisfactorily complete a one-year fellowship accredited by the Accreditation Council for Graduate Medical Education (ACGME). Hand surgery fellowship and plastic surgery residency requirements must be fulfilled, with submission of a list of at least 125 Surgery of the Hand cases, fulfilling at least six of the nine following categories, managed during a consecutive twelve-month period. (Bone and Joint, Nerve, Tendon and Muscle, Skin and Wound Problems, Contracture and Joint Stiffness, Tumor, Congenital, Microsurgery Vascular, and Non-operative)

Plastic & Hand Surgery Associates are proud of the fact that multiple surgeons in their practice have been awarded Certificates of Added Qualifications in Surgery of the Hand through either the American Board of Orthopaedic Surgery or the American Board of Plastic Surgery.

To anybody interested I had nothing but certified hand surgens. The worst was a plastic surgen he made a mess. I found these wnderful doctors in R.I. both came with great qualfations. In Boston now at New England Baptist have a doctor with a very great certificaton and record. He did say I have a very agressive DC problrm. He also said he could treat 5-7 people and everyone could tun out different. He also said a few years ago he wouldn't have touched a hand that had been operated on 2 times already. He is trying to get my skin back on my palms thats all the fingers are wrecked. Al good and certified recomended etc. I am just a poor candidate for regular fascietomy. And now NA.

As a layman, I am in complete agreement with Dr. Pess. NA is a "blind procedure", in that the hand is not opened up when NA is performed. For this reason alone, it seems to me that one would desire a physician who is completely familiar with hand anatomy and function to perform NA. That is someone with specialization in hand surgery.

Steve

Randy -

Point well-taken. But for me personally, when it comes to messing with my body, I always want the best-trained, most qualified person to do so. A dermatologist on the faculty at the University of Wisconsin examines me for unusual lesions that may turn into skin cancer; I am sure my family physician or my car mechanic could be trained to do the examination, but I'll take the dermatologist.

Steve