Bad shoulders are no fun. I have two of them. One I had surgery on and it's about 95%. The other I've managed to hold together with exercises, conservative paddling and no hole play.
If you're on the front range, I can recommend a great ortho doc (in Boulder) who has substantial experience with shoulder injuries/repair. I can also recommend a great physical therapists, which you'll need if you have the surgery. PM me if you want the name/number of either. If you do have surgery, it's a bitch but well worth it.
The biggest concern, in my opinion, is that if you don't have your shoulder repaired, you'll always be running a significant risk if you run remote rivers. Once your shoulder is out, even if you can get it back in, you're done. You won't be able to paddle out.
Additionally, as someone already mentioned, if your shoulders keep popping in and out, you can do more damage. I let mine pop in and out too many times over the years and ended up with painful bone spurs on the humeral head which had to be filed down when I had surgery.
Get it fixed and get back in the boat. Good luck.