I wanted to work with Dr. Castello because he has an excellent reputation as a surgeon and he was highly recommended.
On my first appointment, I had fallen, severing the ACL in my left knee, tearing both menisci, and fracturing my tibia. I had severe chronic knee problems, multiple previous surgeries, and instability (which caused the fall). I said that I'd been told I would need total knee replacements within a few years, and that I wanted him to do the surgeries.
He glanced at the MRI and asked if I wanted him to surgically repair the damage from the fall. I asked his opinion. He shrugged. He suggested I return for a steroid shot to manage the pain, and left without examining my knees. I was in his office for about 5 minutes. Disappointing.
I returned for the steroid shot. Once again, he didn't examine my knees, and he was in the room just long enough to administer the injection.
Three years later, my knee pain had grown progressively worse, so I returned. It was time to consider knee replacements, and I had questions regarding a couple of new surgical procedures I'd read about. I'd also gained a few pounds during Covid, but I didn't want to worsen my knee pain, so I wanted his OK on my exercise plans. In addition, I wanted to ask about a referral to his colleague, Dr. Blackburn, as I had serious, ongoing spine issues, as well.
On this third visit, new x-rays were taken. He glanced briefly at the x-rays, and said my knees were bad and it was time to think about replacement surgery. He briefly answered one question I had about replacements. Then, before I could ask my other questions, his hand was on the doorknob and he was talking over his shoulder.
I said that I had a couple more questions, and he replied, "I'm behind." I said I would be brief. I had my questions on a note card, because I knew I would need to get right to the point. He tried to rip the note card out of my hand! I pulled it back and repeated that I'd be brief. I asked him if it would be OK to ride a bike with my knee issues, and he walked out, yelling as he strode down the hall, "Join Weight Watchers!"
Weight Watchers has an 11% long term success rate. It was a lazy non-answer. So because he was "behind," my allotted time was less than four minutes?
The fact that he couldn't take time to answer my questions cost him two knee replacement surgeries, and cost his colleague a referral. I've since found an orthopedic surgeon for my spinal condition that I'm impressed with. My initial visit lasted around two hours-- he asked me questions and listened to the answers, as well as doing an exam. The contrast to Dr. Castello was striking!
I'd decided to change knee surgeons at that point, but I receive a small benefit from a Long Term Disability Insurance company, and I have to update my medical information periodically, so a few days later I dropped off a form and paid the $25 office fee for them to fill it out. I crossed my fingers, because I knew Dr. Castello had no idea what was wrong with my knees-- 1) my problems weren't on his x-rays; 2) he'd never examined my knees; and 3) he'd never asked about my knee function or listened when I'd tried to explain it.
When I picked up the form, his staff had written "osteoarthritis," and he'd signed it. That was all they filled out on a 2-page form. That's NOT what's wrong with my knees! Yes, I have some osteoarthritis-- like everyone over the age of 40! The actual diagnoses, which are listed in their records, weren't mentioned, nor were the functional knee issues that impact my mobility.
I asked for a copy of the office visit report, hoping it might provide more information that I could submit to the insurance company. I was shocked when I read it!
He thanked my Primary Care Doctor for referring me (she didn't, and she hasn't been my doctor in nearly a year). It explained his "findings." Everything in the report was from shared Dignity health records-- the work of my other doctors. Dr. Castello's office billed my insurance more than $300 for this 4-minute visit!
The report went on to say that the patient "denies this," and "reports that" for numerous symptoms. When did I do that? It listed many tests that he'd supposedly performed. Um, no! It concluded with a paragraph saying he'd discussed the various treatment options with me, and how we'd decided to proceed. Didn't happen.
I'm sure Dr. Castello is an excellent surgeon (two stars for that), but he's streamlined his practice to the point where the patient is no longer part of the equation. He makes the most money doing surgery, so if you aren't scheduling one that day, he's isn't interested.
Bottom line: If you are considering something as important as knee surgery, you deserve a doctor that does a complete evaluation, listens when you talk, keeps accurate records, and works with you to meet your needs, whether it's answering your questions or filling out an insurance form. I'm going to keep looking. read more
