If you’ve been living with a sore shoulder, a cranky knee, or a back that just won’t settle down, there’s a good chance someone has told you, “You’ve hit your deductible — get it done before the end of the year.”
It’s one of the most common things I hear in November and December. And I understand it. Healthcare is expensive, and it makes sense to want to use the benefits you’ve already paid for.
But as an orthopedic surgeon, I want to offer a different way to think about it. A calendar date is a reason to have a conversation about surgery. It isn’t, on its own, a reason to have surgery.
Why Does Everyone Rush to Schedule Surgery in the Fall?
For many insurance plans, your deductible and out-of-pocket maximum reset on January 1. If you’ve already had a costly year, a procedure done in December may cost you far less out of pocket than the same procedure in February.
That’s a real financial factor, and I never want to dismiss it. The problem is when the deadline starts driving the decision instead of the diagnosis. Surgery is a big commitment: time off work, weeks to months of rehab, and a recovery that asks a lot of your body. It deserves more than a rushed decision in the busiest, most stressful season of the year.
What Should You Ask Before You Say Yes?
Whether you’re seeing me or another surgeon, these are the questions I’d want you to have answers to before you sign a consent form:
- What exactly is causing my pain? Imaging shows structure, but it doesn’t always explain symptoms. Plenty of people have “abnormal” MRIs and no pain at all.
- What happens if I wait three to six months? For many conditions, waiting and working on it doesn’t close any doors. For some, it does. You should know which one you have.
- Have I truly tried conservative care? Not a few sessions of PT two years ago, but a focused, consistent plan built for your problem.
- What does recovery really look like? How long until you can drive, work, lift your grandkids, or get back to your sport?
- What are the realistic outcomes? What percentage of people like me are better a year later, and what does “better” mean?
What Does “Conservative Care” Actually Mean?
“Conservative” can sound like “doing nothing.” It’s the opposite. Good nonsurgical care is active, specific, and measured. Depending on your situation, it might include:
- Targeted physical therapy that addresses how you move, not just where it hurts
- Progressive strength training to build capacity around the joint
- Injection options like corticosteroid or PRP, when they fit the problem
- Hormone and metabolic factors, which can affect tendons, cartilage, bone density, and healing, especially for women in perimenopause and menopause
- Lifestyle pieces like sleep, nutrition, and daily activity that shape how your body recovers
This is exactly why I built Valivera Health inside a collaborative wellness community. When a surgeon, physical therapists, strength coaches, and functional medicine providers are all working on the same plan, conservative care stops being a box to check and becomes a real option.
I see this often with shoulders and knees. Someone arrives with an MRI showing a partial tear or arthritis and a surgery date already in mind. After a focused few months of strength work, physical therapy, and sometimes an injection, many of them are back to the activities they love, and surgery moves from “this December” to “maybe someday, if ever.”
When Is Surgery the Right Call?
I’m a surgeon. I believe in surgery, and I’ve seen it change lives. Sometimes it’s clearly the best path, and waiting only makes things harder.
Surgery may be the right choice if:
- You’ve done a real, consistent course of conservative care and still aren’t where you need to be
- Your pain or function is getting steadily worse, not better
- There’s structural damage that won’t heal on its own, like certain tendon tears or fractures
- You have weakness, numbness, or instability that puts you at risk
- Your joint is limiting the life you want to live, and you’re ready for the recovery
If that sounds like you, the end of the year may be a great time to move forward. My goal isn’t to talk you out of surgery. It’s to make sure that if you choose it, you choose it for the right reasons.
Already Scheduled? Use the Time Before Surgery Well
If your date is on the calendar, the weeks leading up to it matter more than most people realize. This is often called “prehab,” and it can make a real difference in how you recover.
- Build strength now. The stronger you go in, the easier it usually is to come back.
- Practice your recovery. Learn your home exercises, set up your space, and plan help for the first few weeks.
- Check your foundation. Blood sugar, vitamin D, protein intake, sleep, and hormone health can all affect healing.
- Line up your team. Know who your physical therapist is before surgery day, not after.
If I could give every surgical patient one piece of advice, it would be this: start physical therapy before surgery, not after. Even four to six weeks of prehab helps you learn the exercises while you’re still comfortable, builds strength around the joint, and makes those first weeks of recovery feel far less overwhelming.
Not Sure What’s Right for You?
There is not one right answer for everyone. The best decision is the one made with a clear picture of your body, your goals, and every option on the table.
If you’re weighing surgery before the year ends, or you’ve been told it’s your only option and you’d like a second perspective, that’s exactly the kind of conversation I love having. Let’s look at your imaging, your history, and your goals together, and figure out what makes sense for you, whether that’s surgery this December or a different path entirely.
You can book a free 15-minute discovery call with Valivera Health to get started.
— Dr. Elizabeth Dulaney-Cripe, Orthopedic Surgeon, Valivera Health
This post is for general education and isn’t a substitute for individual medical advice. Always talk with your provider and your insurance company about your specific situation.