Important questions to ask before having surgery
Millions of Americans will undergo surgery each year. It is important for patients to be informed about the surgery being recommended, particularly if it is elective surgery (an operation you choose to have performed), rather than an emergency surgery (also called urgent surgery). All surgeries have risks and benefits which you should familiarize yourself with before deciding whether the procedure is appropriate for you.
The following are important questions you should review with your doctor prior to surgery. Ask your doctor to explain the answers clearly and ask for further clarification if you are having trouble understanding an explanation and/or any medical terms. Some patients find it helpful to write their questions down ahead of time.
It is important to remember that a well-informed patient tends to be more satisfied with the outcome or results of a procedure:
What is the operation being recommended?
Your doctor should clearly explain the surgical procedure, explaining the steps involved and providing you with illustrative examples. You should ask if there are different methods for performing this operation and why he or she favors one way over another.
Why is the procedure necessary?
Reasons to have surgery may vary from relieving or preventing pain to diagnosing a problem to improving body function. Ask your doctor to specifically explain why this procedure is being recommended for you and make sure you understand how this may improve your medical condition.
What are my alternatives to this procedure? Are there other treatment options available based on my current medical condition?
In some cases, medication or nonsurgical treatments, such as lifestyle changes, may be as helpful in improving a condition as surgery. Your doctor should clearly explain the benefits and risks of these options so that you can make an informed decision about whether or not surgery is necessary. Sometimes "watchful waiting" is indicated, in which the doctor will monitor your condition over a period of time to observe changes and the progression of a disease. You may still need surgery, or if your condition improves or stabilizes, you may be able to postpone surgery. After a period of "watchful waiting," it may be determined that surgery is still the best option.
What are the benefits of the surgery and how long will they last?
It is important that your doctor outline the specific benefits of having surgery for you. You should also ask how long the benefits typically last. Some benefits only last a short time, and could possibly require a second operation, while others may last a lifetime.
Also, ask your doctor about published information regarding the outcomes of the recommended procedure. This will allow you to make an informed decision and have realistic expectations about the surgery.
What are the risks and possible complications of having the operation?
Surgery always carries some risks, so it is important to weigh the benefits against the risks before surgery. Ask your doctor to outline the possible complications, such as infection and bleeding, and possible side effects that could follow the procedure. Be sure to understand when you should notify your doctor or seek immediate medical attention for complications. You should also discuss pain and ways to manage any pain that may follow the procedure.
What happens if you do not have the operation?
If you decide, after weighing the benefits and risks of the surgery, not to have the operation, what will happen? You need to know whether the condition will worsen or if there is a possibility that it may resolve itself.
Should I obtain a second opinion?
Many health plans may require patients to obtain a second opinion before undergoing elective surgery. Your doctor should be able to supply you with the names of qualified individuals who also perform the procedure. For more information on second opinions, see the Preoperative Management section of this module.
What is the doctor's experience in performing this procedure?
You can minimize the risks of surgery by choosing a doctor who is thoroughly trained and experienced in performing the procedure. You may ask the doctor about his or her experience with the procedure being performed, including the number of times he or she has performed it, and his or her record of successes, as well as complications.
Where will the surgery be performed?
Until recently, most surgery was performed in hospitals. Today, however, many procedures are done on an outpatient basis or in ambulatory surgical centers. This lowers the cost of these procedures since you are not paying for a hospital room. Certain procedures may still need to be performed on an inpatient basis. Your overall health is also considered when making a decision as to where the operation will be performed. Be sure to ask your doctor why he or she recommends either setting.
What type of anesthesia will be administered?
Your doctor should tell you whether a local, regional, or general anesthesia will be administered and why this type of anesthesia is recommended for your procedure. You should also ask who will be administering the anesthesia (such as an anesthesiologist or a nurse anesthetist; both of whom are highly qualified to administer anesthesia) and ask to meet with that person before your operation. For more about anesthesia, see the Preoperative Management section of this module.
What can I expect during recovery?
Ask your doctor what to expect in the first few days following surgery, as well as in the weeks and months that follow. You need to know how long you will be hospitalized, what limitations will be placed on you, and if there are special supplies or equipment you will need when discharged. Knowing ahead of time what to expect will help you to cope and recover more quickly following the surgery.
What are the costs of this operation?
Because health plans vary in their coverage of different procedures, there may be costs you will be responsible for. You will need to know what the specific costs of the operation will be and how much your insurance or health plan will cover. This information is not typically available to the doctor.
Tips for communicating with your doctor
It is important to communicate your feelings, questions, and concerns with your doctor prior to having surgery. The following suggestions may help to improve communication between you and your doctor:
If you do not understand your doctor's responses, ask questions until you do.
Take notes, or ask a family member or friend to accompany you and take notes for you.
Ask your doctor to write down his or her instructions, if necessary.
Ask your doctor where you can find printed material about your condition. Many doctors have this information in their offices.
If you still have questions, ask the doctor where you can go for more information.
Learning about your surgeon
It is important to have confidence in the doctor who will be performing your surgery. Whether this is someone you have chosen yourself, or a doctor or surgeon you have been referred to, you can make sure that he or she is qualified to perform this operation. This may include any or all of the following:
Ask your primary care doctor, your local medical society, or health insurance company for information regarding the doctor or surgeon's experience with the procedure.
Ask about the doctor or surgeon's credentials and whether he or she has any additional certifications that make him or her more experienced in performing the procedure.
Make certain the doctor or surgeon is affiliated with an accredited health care facility. When considering surgery, where it is performed is often as important as who is performing the procedure.
Determining the costs of the procedure
Before you have surgery, discuss the costs with someone from the finance department at your doctor's office. These costs may include, but are not limited to, the following:
The surgeon's fee for surgery
Hospital fees (if you require hospitalization) or Ambulatory Surgical Center fees (for outpatient services). Check with the hospital's business office regarding these rates; your doctor or surgeon should be able to give you an approximate idea of how long you will be in the hospital.
Separate billing for other services. You will also be billed separately for the professional services of others who might be involved in your care, such as the assisting surgeon, anesthesiologist, and other medical consultants.
Check with your health plan prior to surgery to be certain of what portion of the costs you will be responsible for. If your anticipated costs present a problem, discuss other financial solutions with your doctor prior to the surgery.
Obtaining a second opinion
Asking another doctor or surgeon for a second opinion is an important step in ensuring that this particular procedure is the best option for you. A second opinion can help you make an informed decision about the best treatment for your condition and can help you weigh the risks and benefits against possible alternatives to the surgery.
Several health plans now require and will pay for patients to obtain a second opinion on certain nonemergency procedures. Medicare may also pay for patients to obtain a second opinion. Even if your plan does not require this, you still can request a second opinion.
If you decide to get a second opinion, check with your health plan to see if it is covered. Your primary care doctor or hospital can provide you with names of qualified doctors. Be sure to get your medical records from your first doctor so that the second one does not need to repeat tests and procedures.
Remember, in the case of emergency surgeries, the surgery should be performed as quickly as possible and, most likely, there will not be time to obtain a second opinion. The necessity of getting a second opinion should always be weighed against the severity and urgency of the medical condition.