Have a patient with an orthopedic problem. One doctor in one county says there is no way he'd operate as it would be of no benefit, and the patient has a 25% chance of losing one third of his strength in his arm if he did operate. The doctor is a highly respected surgeon.

Another doctor in the patient's home country said the first doctor was crazy and he has to operate. He is also a specialist.

The complicating factors are that the home country is Russia. Over the last four years I've had six patients from Russia insist on surgery, (one for a small fracture of the coccyx, another for a mid fracture of a clavicle). The doctors in my country say they would never operate for such things.

The patient has had two more opinions (Russian opinion) and they all think surgery is needed.

The patient has chosen surgery.

Bryn