Medically reviewed by John Costouros, MD | Reviewed July 2026

Choosing a shoulder surgeon is an important decision you may make for your long-term function and quality of life. I have spent my entire career focused exclusively on the shoulder, and I can tell you that not all surgeons who perform shoulder procedures have the same depth of training, volume of cases, or access to advanced techniques. Patients who do a little homework before choosing a shoulder surgeon tend to ask better questions, understand their options more clearly, and feel more confident going into treatment. This post is designed to help you know what to look for and which questions to ask.

Key Takeaways

• Shoulder surgery is highly specialized, and the shoulder is the most complex joint in the body. A surgeon who focuses exclusively on the shoulder will typically have more relevant experience than a general orthopedic surgeon.
• Volume matters – studies have demonstrated improved outcomes, lower complication rates, and improved patient satisfaction in patients undergoing shoulder surgery with high-volume specialists. Ask how many procedures of your specific type the surgeon performs each year.
• Academic affiliation or faculty experience, research involvement, and peer-to-peer reputation are meaningful indicators of expertise.
• The right surgeon will explain your options clearly, discuss realistic expectations, and make you feel heard and understood.

What I See in My Patients

Some of the patients that I see in my Menlo Park and Fremont offices have already seen another doctor before reaching me. Sometimes they were told they needed surgery but weren’t given much detail about why, or which type. Sometimes they tried a treatment that didn’t work and weren’t sure what to do next. And sometimes they simply weren’t sure whether the surgeon they had seen was the right fit for their condition.

That uncertainty is a common reason why patients choose to obtain additional opinions. Shoulder problems can be complicated, especially if prior surgeries were not successful. Conditions like rotator cuff tears, shoulder arthritis, and shoulder instability each require a different approach, and the overlap between them adds another layer of nuance. A surgeon who sees a high volume of these cases or has undergone additional fellowship training develops an understanding that goes beyond what can be learned in textbooks or a general orthopedic residency.

I have dedicated my entire career to treating shoulder disorders of all types, from straightforward rotator cuff repairs to complex shoulder conditions. I have travelled around the world in order to share knowledge with others while also learning about new techniques that may not yet be available in the United States. That focus is intentional. The shoulder is, in my view, the most technically demanding joint in the body, and it rewards specialization.

Why Specialization Matters

Orthopedic surgery covers a broad range of joints and conditions. The shoulder has enough complexity that dedicated subspecialty training can make a real difference. Many shoulder-focused specialists pursue fellowship training specifically focused on the shoulder and elbow after their general orthopedic residency. In my case, I was able to pursue additional fellowship training at Harvard and the Massachusetts General Hospital as well as in Zurich, Switzerland from two of the giants in our field. That additional focused training exposes a surgeon to a much higher volume of shoulder cases and a wider range of pathology than they would encounter in a general program.

Beyond fellowship, you can also look at what the surgeon has continued to do. Have they published research on shoulder conditions? Have they been involved in clinical trials? Have they developed new devices or surgical techniques? Do other surgeons refer difficult cases to them? These are signals. In my own career, I have led multiple FDA clinical trials, trained surgeons from around the world, serve as a resource for other orthopaedic surgeons to refer complex cases, and remained deeply involved in developing new approaches to shoulder replacement and other procedures. That ongoing engagement keeps my practice grounded and at the forefront of the newest technologies which allow for optimal care.

Questions Every Patient Should Ask

When you sit down with a surgeon, a good consultation is a two-way conversation. You should feel comfortable asking direct questions, and the surgeon should answer them directly.

How many of these procedures do you perform each year?

A surgeon who performs a specific procedure dozens of times per year tends to develop a level of technical fluency that comes from repetition. Ask specifically about your procedure, whether that is a rotator cuff repair, a total shoulder replacement, or a reverse shoulder replacement, not just about shoulder surgery in general.

What are my options, and what do you recommend and why?

A skilled surgeon should be able to walk you through the full range of treatment options relevant to your condition, including non-surgical approaches if they are indicated, and explain why they are recommending one path over another. My own approach is to be clear about what non-surgical care can realistically accomplish and when it makes sense to move forward with an operation. In some cases, optimal outcomes and results occur with immediate surgical treatment.

What would you do if this were your shoulder?

A confident, experienced surgeon will generally give you a direct answer and back it up with evidence. It also signals whether they are treating your situation on its own terms rather than applying a one-size-fits-all protocol.

What does recovery look like, and what can I realistically expect?

Recovery from shoulder surgery is rarely a straight line, and realistic expectations matter enormously for patient satisfaction. Ask specifically about timelines for your procedure and your goals, whether that means getting back to overhead work, a sport, or daily activities.

My Approach to Evaluating Patients

When I see a new patient, my first goal is to understand what is actually going on and what matters most to them functionally. I spend time taking a thorough history, doing a careful physical examination, and reviewing imaging studies before I discuss any treatment options. I also think it is important to be direct about what surgery can and cannot accomplish. Not every shoulder problem requires an operation. Many rotator cuff tears, for example, can be managed effectively without surgery, depending on the size, the patient’s age, activity level, and overall shoulder function.

When surgery is the right answer, I believe patients deserve to understand why, what we are specifically trying to accomplish, and what the recovery process looks like in concrete terms.

Good communication between a surgeon and patient is important. It is a meaningful predictor of how well a patient understands their treatment, complies with rehabilitation, and ultimately does with treatment.

When to Seek Out a Shoulder Specialist

There are situations where I believe seeing a dedicated shoulder specialist is worth seeking out specifically. Those include cases involving irreparable rotator cuff tears, complex fractures, instability problems with significant bone loss, previous shoulder surgery that did not go as planned, or any situation where shoulder replacement is being considered. These are cases where a surgeon’s depth of experience with the shoulder, not just with orthopedics broadly, tends to make a meaningful difference in outcomes.

Summary

Choosing a shoulder surgeon is worth treating as an active decision rather than a passive one. Ask about subspecialty training, fellowship background, annual procedure volume, and how the surgeon approaches the specific condition you have. Pay attention to how thoroughly your options are explained and how well you feel listened to during the consultation.

If you are dealing with a shoulder problem and are not sure whether you have the right care team, I would encourage you to request a consultation. A second opinion or a first conversation with a shoulder-focused specialist can clarify a great deal, and it is always a reasonable step to take.

Frequently Asked Questions

How do I know if a surgeon is experienced enough for my procedure?

Ask directly. A surgeon who is experienced will be comfortable telling you how many procedures like yours they perform each year and giving you a sense of their outcomes. Research publications, involvement in clinical trials, and academic and teaching experience can also provide context.

What should I bring to a shoulder surgery consultation?

Bring any imaging you have had done, including X-rays and MRI scans, along with the reports if available. If you have had surgery before, providing the operative reports are very useful as they detail what the previous surgeon saw and did during your prior operation. The more information your surgeon has up front, the more specific the conversation can be.