Anyone who’s ever had surgery or helped a loved go through it knows it’s scary, even when the outcome is terrific. To help patients wrap their minds around a possible date in the OR, Dr. Edward H. Livingston offered advice in a recent issue of JAMA, “What to Ask Your Surgeon Before an Operation.”
Following these excerpts of his article are notes about a new public service video, “Speak Up: When You’re Having Surgery,” produced by The Joint Commission, the nonprofit that accredits and certifies more than 20,500 health-care organizations and programs in the U.S.
Livingston says all patients should ask their surgeons these questions:
1. Do I need surgery?
Before an operation, Livingston said, you should understand what disease or disorder you have and if there are ways to treat it without an operation. Find out if your problem is common, and if there’s anything unusual about your condition.
2. How do I know if the surgeon and hospital where the procedure is scheduled are a good match for me?
We must note that insurance coverage directs most patients toward certain facilities, so this isn’t an open-ended inquiry. Still, for the providers within your plan’s network, you should ask your surgeon about his or her training for your operation: Where did he/she learn how to do it, and how extensive was the training? How many times has he/she performed this procedure? How many patients with your problem does your surgeon treat? Who are the other doctors your surgeon will work with during your operation?
Physicians must be licensed to practice medicine in the state where they practice, and although they don’t have to be board certified or belong to professional organizations, it’s better if they have these credentials. So ask if your surgeon is board certified and, if not, why not.
If your surgeon plans to use a certain technology, such as laser or robotics, ask why it is better than conventional approaches to your problem and how much training and experience he or she has had with it. “Surgeons learning newer techniques may have learned them during a very brief course,” Livingston wrote, so “ask about this.” And see our blogs about robotic surgery.
Also, discuss your options for anesthesia with your anesthesiologist before the surgery, and make sure you understand the possible side effects, how long they should last and what you can do to minimize them.
3. What can I do before surgery to help get the best outcome?
Should you exercise? Stop smoking? Go on a diet? Achieve better control of your diabetes? Should you stop taking any of your regular medications? You might be advised to bathe the day before surgery with special cleansers to minimize the risk of infection. You might have to fast or cleanse your bowels before surgery.
4. What happens after the surgery?
Ask your surgeon how much pain you should expect, how it can be managed and who’s responsible for it. You should know that surgery often requires short-term restrictions in activity, driving and/or diet. Ask how long you will be unable to work (make sure the surgeon knows what type of work you do). Will you need help after the surgery? From whom? What resources are there to get help if you need it after the surgery?
What type of complications might occur? How often do they occur and what happens if you have some? If you have a problem after leaving the hospital, whom should you call and/or where should you go for help?
How available is the surgeon after the procedure? Can you contact him or her at night or weekend? If not, who’s available for emergency care and what is his or her experience taking care of patients like you?
In closing, Livingston advised patients to get more information from the American College of Surgeons.
The Joint Commission reinforces much of Livingston’s advice, and encourages patients to:
- Speak up if you have questions or concerns. If you still don’t understand, ask again. It’s your body and you have a right to know.
- Pay attention to the care you get. Always make sure you’re getting the right treatments and medicines by the right health-care professionals. Don’t assume anything.
- Educate yourself about your illness. Learn about the medical tests you get, and your treatment plan.
- Ask a trusted family member or friend to be your advocate (advisor or supporter).
- Know what medicines you take and why you take them. Medicine errors are the most common health care mistakes.
- Use a hospital, clinic, surgery center or other type of health-care organization that has been carefully checked out. For example, The Joint Commission visits hospitals to see if they are meeting The Joint Commission’s quality standards.
- Participate in all decisions about your treatment. You are the center of the health care team.