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 or not 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 your surgery about elective surgery are why is the surgery necessary for you and are there treatment choices other than surgery. If you do not need surgery, then you can avoid any complications that may result. All surgeries and alternative treatments have risks and benefits. Treatments are only worth doing if the benefits are greater than the risks.
Your regular doctor, sometimes called a primary care doctor, may be the one to suggests that you have surgery and recommend a surgeon to you. If you want a second opinion, you will want to find a surgeon other than the one recommended to you. Before getting a second opinion and having surgery make sure you understand what your health insurance will pay for and what you must pay for. Medicare will pay for a second opinion if you are eligible for Medicare.
Your doctor will probably not be able to answer your questions regarding your insurance coverage.You should talk with your health insurance company or your employee benefits manager about payment of medical services you receive.
Below are 12 questions you can 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 allow you to make a better decision. Resources for more information are listed at the end of these questions.
Your doctors will probably welcome your questions. If you do not understand his answers, ask the doctor to explain in a way you will better understand. Some people learn with pictures, others learn by reading. 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 part of you is to be repaired or removed, ask why. Your surgeon can draw a picture explaining the steps involved in the surgery.
Ask if there is more than one way to perform the surgery? One way may require more extensive surgery than another. Ask your surgeon why he has chosen a one way over another.
2. Why do I need the operation?
There are many reasons for surgery:
Pain relief or pain prevention to reduce symptoms
Improve a body function
Diagnosis of disease
To save your life, now or at some later time
Your surgeon will tell you the reason for the procedure. Make sure you understand how the operation will affect the outcome of your medical condition.
3. Are there alternatives to surgery?
Surgery is not always the only treatment for medical problem. Medicines or non-surgical treatments, such as a change in diet or special exercises, might help you just as well or more than surgery. Ask your surgeon or primary care doctor about the benefits and risks of these other choices. Learn as much as possible about the benefits and risks of making a choice other than surgery.
An alternative to surgery may be “watchful waiting”. Watchful waiting is when your doctor and you follow your problem closely to see if it gets better or worse. If it gets worse, you may need surgery right away. If it gets better, you may be able to postpone or not have the surgery.
4. What are the benefits of having the operation?
Ask your surgeon to describe the benefits of having surgery. For example, a hip replacement may mean that you can walk without pain.
Ask how long the benefits are likely to last. For some procedures, the benefits may last only a short time. There might be a need for a second operation later. For some procedures, the benefits may last a lifetime.
When learning about the benefits of the operation, be realistic. You may expect too much and be disappointed with the results. Ask your doctor if there is any written information he can give you about what you can expect from the procedure.
5. What are the risks of having the operation?
All operations carry some risk along with the benefits. This is why you consider the benefits against the risks of complications or side effects.
Complications can occur before, during or after the operation. Complications are unplanned events, such as infection, too much bleeding, reaction to anesthesia, or accidental injury. You may have an increased risk for problems if you have other medical conditions, such as diabetes, heart disease or high blood pressure.
Also, there may be side effects after the operation. Side effects can often be anticipated. For example, your surgeon will know to expect some swelling and some soreness at the site of the operation.
Ask your surgeon about all of the possible complications and side effects of the operation. There is almost always some pain with surgery. Ask how much there will be and how will your pain be controlled. Controlling pain will keep you more comfortable while you heal which will help you heal faster and get better results from 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 may decide not to have it. Ask your surgeon what you will gain–or lose–by not having the operation now. Will you be in more pain? Will your condition get worse? Will your problem go away without surgery?
7. Where can I get a second opinion?
Getting a second opinion is often a good way to ensure that having the operation is the best choice for you. Some health insurance plans require patients to get a second opinion before they have certain non-emergency operations. If your plan does not require a second opinion, you may still want to have one. If you are expecting your insurance company to pay for a second opinion, be sure to ask BEFORE you get the second opinion. If you get a second opinion, be sure to take your records from your first doctor so that you may not have to retake some of the 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 does the surgery often. Ask your surgeon about his or her recent record of successes and complications with this procedure. You may feel more comfortable for talking with your regular doctor about the surgeons’ qualifications.
9. Where will the operation be done?
Most surgeons practice at one or two hospitals. Find out where your operation will be performed. 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 the hospital where you will have surgery. If the hospital has a low success rate for the kind of operation you are considering, you can ask to have surgery at another hospital.
Until recently, most surgery was performed in the hospital and patients stayed in the hospital for a few days. Today, most surgery is done on an outpatient basis in a doctor’s office, at a special outpatient 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 if your operation will be done in the hospital, in the doctors office, or in an outpatient surgery center. If your doctor recommends inpatient surgery for a procedure that is usually done as outpatient surgery, or 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 is usually done with 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 asleep, or unconscious, if you have general anesthesia.
Anesthesia during surgery is quite safe for most patients and is administered by an anesthesiologist or nurse anesthetist. Both are highly skilled and are 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 about their qualifications and training. Ask about the side effects and risks for you when having anesthesia. Be sure to tell him or her if you have other medical problems 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. Ask if you will need special supplies, equipment, or help when you return home.
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 like “too much” a week after your operation, but it may be. Follow your surgeon’s advice to recover fully and as soon as possible.
12. How much will the operation cost?
Health insurance coverage will depend on your health plan. There may be costs you will have to pay. Before you have surgery, call your insurance company to find out how much insurance will pay and how much you will have to pay.
Surgical fees may include several office or hospital visits after the operation. You also will be billed by the hospital for inpatient or outpatient care, by the anesthesiologist, and possibly others providing care related to your operation.
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 a review by surgeons in their surgical specialty.
For More Information
The American College of Surgeons (ACS) has a free series of pamphlets on “When You Need an Operation.” For copies, write to the ACS, Office of Public Information, 55 E. Erie Street, Chicago, IL 60611, or call 312-664-4050. Pamphlets in this series range from those providing general information about surgery to those explaining specific surgical procedures.
For a free brochure on “Medicare Coverage for Second Surgical Opinions: Your Choice Facing Elective Surgery,” write to Health Care Financing Administration, Publications, NI-26-27, 7500 Security Blvd., Baltimore, Maryland 21244-1850. Ask for Publication No. HCFA 02173.
To get the name of a specialist in your area who can give you a second opinion, ask your primary doctor or surgeon, the local medical society, or your health insurance company.
Free booklets on what you should know about anesthesia are available from the American Society of Anesthesiologists (ASA) or the American Association of Nurse Anesthetists (AANA). For copies, write to ASA at 520 North Northwest Highway, Park Ridge, IL 60068, or call 708-825-5586; or AANA at 222 S. Prospect Avenue, Park Ridge, IL 60068-4001, or call 708-692-7050.
“Pain Control After Surgery: A Patient’s Guide” is available free from the Agency for Health Care Policy and Research (AHCPR). For a copy of this consumer version of the AHCPR-supported clinical practice guideline and for information on other patient guides, write to the AHCPR Publications Clearinghouse, P.O. Box 8547, Silver Spring, MD 20907, or call toll-free 800-358-9295.
For almost every disease, there is a national or local association or society that publishes consumer information. Check your local 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.
Some of these issues are covered in greater detail in a guidebook and video program, “PREPARED for Health Care: A Consumer’s Guide to Better Medical Decisions,” by J.C. Gambone, D.O., and R.C. Reiter, M.D., Copyright 1993, Great Performance, Beaverton, Oregon. For information on obtaining copies, write to Great Performance, Inc. at P.O. Box 91400, Portland, OR 97291-0400.
For further information you may also wish to see “The Savvy Patient: How to Be an Active Participant in Your Medical Care,” by David R. Stutz, M.D., Bernard Feder, Ph.D., and the Editors of Consumer Reports Books, Copyright 1990, published by Consumers Union of U.S., Inc., Yonkers, NY, 10703.Tags: Allergies, Agency for Health Care Policy and Research, doctor questions, questions to ask doctor, Health insurance coverage