The treatment we provide as hand surgeons is focused on making the correct diagnosis and then instituting effective treatment that frequently involves surgery. However, before surgery is recommended, factors aside from the organic pathology causing the problem should be considered, especially that of the emotional stability of the patient. Often, the emotional problem predominates and may be a contraindication for surgery. Another factor that should be considered is that the patient's complaints may be exaggerated or even falsified. Recognizing who these patients are and critically important and when they are identified, knowing what to do. When surgery is recommended, it is obviously important that the procedure will, in all likelihood, be effective. There are operations that have enjoyed popularity but do not give good results and should therefore be avoided. The faculty, with a collective clinical experience of more than 100 years, will give their insight into those patients we should embrace and those to avoid, as well as some operative procedures that should be avoided.