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Be Informed: Questions to Ask Your Doctor BEFORE
You Have Surgery
Are you facing surgery? You are not alone. Millions of
people have surgery each year. Most operations are not emergencies. This
means you have time to ask your surgeon questions about the operation
and time to decide whether to have it, and if so, when and where.
The information presented here does not apply to emergency surgery.
The most important questions to ask about elective surgery are why the
procedure is necessary for you and what alternatives there are to surgery.
If you do not need to have the operation, you can avoid any risks that
might result. All surgeries and alternative treatments have risks and
benefits. They are only worth doing if the benefits are greater than the
risks. Your primary care physician, that is, your regular doctor, may
be the one who suggests that you have surgery and may recommend a surgeon.
You may want to consult another independent surgeon to get a second opinion.
Overview
Following are 12 questions to ask your primary care doctor and surgeon
before you have surgery, and the reasons for asking them. The answers
to these questions will help you be informed and help you make the best
decision. Sources are listed at the end of these questions to help you
get more information from other places. Your doctors should welcome questions.
If you do not understand the answers, ask the doctors to explain them
clearly. Patients who are well informed about their treatment tend to
be more satisfied with the outcome or results of their treatment.
1. What operation are you recommending? Ask
your surgeon to explain the surgical procedure. For example, if something
is going to be repaired or removed, find out why it is necessary to do
so. Your surgeon can draw a picture or a diagram and explain to you the
steps involved in the procedure. Are there different ways of doing the
operation? One way may require more extensive surgery than another. Ask
why your surgeon wants to do the operation one way over another.
2. Why do I need the operation? There are many
reasons to have surgery. Some operations can relieve or prevent pain.
Others can reduce a symptom of a problem or improve some body function.
Some surgeries are performed to diagnose a problem. Surgery also can save
your life. Your surgeon will tell you the purpose of the procedure. Make
sure you understand how the proposed operation fits in with the diagnosis
of your medical condition.
3. Are there alternatives to surgery? Sometimes,
surgery is not the only answer to a medical problem. Medicines or other
nonsurgical treatments, such as a change in diet or special exercises,
might help you just as well or more. Ask your surgeon or primary care
physician about the benefits and risks of these other choices. You need
to know as much as possible about these benefits and risks to make the
best decision. One alternative may be "watchful waiting," in which your
doctor and you check to see if your problem gets better or worse. If it
gets worse, you may need surgery right away. If it gets better, you may
be able to postpone surgery, perhaps indefinitely.
4. What are the benefits of having the operation?
Ask your surgeon what you will gain by having the operation. For example,
a hip replacement may mean that you can walk again with ease. Ask how
long the benefits are likely to last. For some procedures, it is not unusual
for the benefits to last for a short time only. There might be a need
for a second operation at a later date. For other procedures, the benefits
may last a lifetime. When finding out about the benefits of the operation,
be realistic. Sometimes patients expect too much and are disappointed
with the outcome, or results. Ask your doctor if there is any published
information about the outcomes of the procedure.
5. What are the risks of having the operation?
All operations carry some risk. This is why you need to weigh the benefits
of the operation against the risks of complications or side effects. Complications
can occur around the time of the operation. Complications are unplanned
events, such as infection, too much bleeding, reaction to anesthesia,
or accidental injury. Some people have an increased risk of complications
because of other medical conditions. In addition, there may be side effects
after the operation. For the most part, side effects can be anticipated.
For example, your surgeon knows that there will be swelling and some soreness
at the site of the operation. Ask your surgeon about the possible complications
and side effects of the operation. There is almost always some pain with
surgery. Ask how much there will be and what the doctors and nurses will
do to reduce the pain. Controlling the pain will help you be more comfortable
while you heal, get well faster, and improve the results of your operation.
6. What if I don't have this operation? Based
on what you learn about the benefits and risks of the operation, you might
decide not to have it. Ask your surgeon what you will gain--or lose--by
not having the operation now. Could you be in more pain? Could your condition
get worse? Could the problem go away?
7. Where can I get a second opinion? Getting
a second opinion from another doctor is a very good way to make sure having
the operation is the best alternative for you. If you get one, make sure
to get your records from the first doctor so that the second one does
not have to repeat tests.
8. What has been your experience in doing the operation?
One way to reduce the risks of surgery is to choose a surgeon who
has been thoroughly trained to do the procedure and has plenty of experience
doing it. You can ask your surgeon about his or her recent record of successes
and complications with this procedure. If it is more comfortable for you,
you can discuss the topic of surgeons' qualifications with your regular
or primary care doctor.
9. Where will the operation be done? Most surgeons
practice at one or two local hospitals. Find out where your operation
will be performed. Have many of the operations you are thinking about
having been done in this hospital? Some operations have higher success
rates if they are done in hospitals that do many of those procedures.
Ask your doctor about the success rate at this hospital. If the hospital
has a low success rate for the operation in question, you should ask to
have it at another hospital. Until recently, most surgery was performed
on an inpatient basis and patients stayed in the hospital for one or more
days. Today, a lot of surgery is done on an outpatient basis in a doctor's
office, a special surgical center, or a day surgery unit of a hospital.
Outpatient surgery is less expensive because you do not have to pay for
staying in a hospital room. Ask whether your operation will be done in
the hospital or in an outpatient setting. If your doctor recommends inpatient
surgery for a procedure that is usually done as outpatient surgery, or
just the opposite, recommends outpatient surgery that is usually done
as inpatient surgery, ask why. You want to be in the right place for your
operation.
10. What kind of anesthesia will I need? Anesthesia
is used so that surgery can be performed without unnecessary pain. Your
surgeon can tell you whether the operation calls for local, regional,
or general anesthesia, and why this form of anesthesia is recommended
for your procedure. Local anesthesia numbs only a part of your body for
a short period of time, for example, a tooth and the surrounding gum.
Not all procedures done with local anesthesia are painless. Regional anesthesia
numbs a larger portion of your body, for example, the lower part of your
body for a few hours. In most cases, you will be awake with regional anesthesia.
General anesthesia numbs your entire body for the entire time of the surgery.
You will be unconscious if you have general anesthesia.
Anesthesia is quite safe for most patients and is usually administered
by a specialized physician (anesthesiologist) or nurse anesthetist. Both
are highly skilled and have been specially trained to give anesthesia.
If you decide to have an operation, ask to meet with the person who will
give you anesthesia. Find out what his or her qualifications are. Ask
what the side effects and risks of having anesthesia are in your case.
Be sure to tell him or her what medical problems you have including allergies
and any medications you have been taking, since they may affect your response
to the anesthesia.
11. How long will it take me to recover? Your
surgeon can tell you how you might feel and what you will be able to do
or not do the first few days, weeks, or months after surgery. Ask how
long you will be in the hospital. Find out what kind of supplies, equipment,
and any other help you will need when you go home. Knowing what to expect
can help you cope better with recovery. Ask when you can start regular
exercise again and go back to work. You do not want to do anything that
will slow down the recovery process. Lifting a 10-pound bag of potatoes
may not seem to be "too much" a week after your operation, but it could
be. You should follow your surgeon's advice to make sure you recover fully
as soon as possible.
12. How much will the operation cost? Health
insurance coverage for surgery can vary, and there may be some costs you
will have to pay. Ask what your surgeon's fee is and what it covers. Surgical
fees often also include several visits after the operation. You also will
be billed by the hospital for inpatient or outpatient care and by the
anesthesiologist and others providing care related to your operation.
American Surgeons' Qualifications
You will want to know that your surgeon is experienced and qualified to
perform the operation. Many surgeons have taken special training and passed
exams given by a national board of surgeons. Ask if your surgeon is "board
certified" in surgery. Some surgeons also have the letters F.A.C.S. after
their name. This means they are Fellows of the American College of Surgeons
and have passed another review by surgeons of their surgical practices.
For more information on surgery, The American
College of Surgeons (ACS) provides Public
Information on their website (www.facs.org).
General
For almost every disease, there is a national or local association or
society that publishes consumer information. Check a U.S. telephone directory.
There are also organized groups of patients with certain illnesses that
can often provide information about a condition, alternative treatments,
and experience with local doctors and hospitals. Ask your hospital or
doctors if they know of any patient groups related to your condition.
Also, your local public library has medical reference materials about
health care treatments.
Information referenced from the American
College of Surgeons web site, www.facs.org.
Link to our list of medical resources
for more information about your condition.
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