Surgery is often a major, life-changing event.
If you ask your surgeon, "do you guarrantee a good result?" and he says yes, turn and run away as fast as you can. No competent surgeon will ever do that, but they will give you a list of possible complications and the risk of each one.
Patients can be overwhelmed by the experience and sometimes do not ask their surgeons the best questions to understand the operation and to make sure they have good outcomes.
Before having an operation, you must understand what disease you have and if there are ways of treating the disease without an operation. You should find out if the problem you have is common and if there is anything unusual about your condition.
Ask your surgeon about his or her training for doing your operation. Where did they learn how to do the operation and how extensive was their training? Physicians must have a license to practice medicine in the state where they practice. They do not have to be board certified or belong to professional organizations, but it is generally better if they have these credentials. Ask if the surgeon is board certified and, if not, why not. Ask if the surgeon takes care of patients with your problem very often. How many times have they performed the operation they propose to perform on you as the surgeon in charge (attending surgeon)? Who are the other doctors the surgeon will work with to provide your care? Depending on your condition, it is often better to have a team of health care professionals involved with your care rather than a single doctor.
If a special type of operation or technology (such as laser or robotic surgery) will be used, ask about why it is better than conventional approaches to your problem. Ask the surgeon how much training and experience he or she has had with the usual approaches for your problem and with the newer techniques being proposed. Surgeons learning newer techniques may have learned them during a very brief course—ask about this.
Ask if the hospital has a special area and staff trained to take care of your specific medical problem. How many patients do they take care of with a problem like yours? You should discuss the various options for anesthesia care with your anesthesiologist prior to surgery.
Ask your surgeon about things you can do before surgery to improve the likelihood of having a good result. Should you exercise? Stop smoking? Go on a diet? Achieve better control of your diabetes? Should you stop taking any of your regular medications? Your surgeon may want you to bathe yourself the day before surgery with special cleansers to minimize the risk of infection. He or she may also ask you cleanse your bowels before surgery.
Ask your surgeon about how much pain you should expect and how it can best be managed. Surgery is often associated with short-term limitations in activity and/or diet restrictions. The amount varies with the type of operation and level of activity you have. Ask how long you will be unable to work and make sure the surgeon knows what type of work you do. Will you need help after the surgery? Who can provide the help? Are there resources for you to get help if needed after the surgery?
If you have a problem after leaving the hospital, who should you call or where should you go for help? Will the surgeons themselves be available at all times of the day, night, or weekend to provide care if needed? If not, who will provide emergency care and how experienced are they at taking care of patients like you?
Are there printed or online materials available so that you can learn more about your disease and surgical treatment?
- American College of Surgeons
www.facs.org/education/patient-education
To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA’s website atjama.com. Many are available in English and Spanish. A Patient Page on health care professionals and qualifications was published in the December 5, 2012, issue.
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.
Source: Unpublished survey of selected academic surgeons attending the 2015 Academic Surgical Congress
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