Questions to Ask Before 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 physician prior to surgery. Ask your physician 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 and bring a tape recorder to help them review the information discussed before making a final decision.
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 physician 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/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 physician 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 non-surgical treatments, such as lifestyle changes, may be as helpful in improving a condition as surgery. Your physician 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 physician 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 physician 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 physician 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 physician to outline the possible complications, such as infection and bleeding, and possible side effects that could follow the procedure. 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 now require patients to obtain a second opinion before undergoing elective surgery. Your physician 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 physician's experience in performing this procedure?
You can minimize the risks of surgery by choosing a physician who is thoroughly trained and experienced in performing the procedure. You may ask the physician about his/her experience with the procedure being performed, including the number of times he/she has performed it, and his/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 care centers. This lowers the cost of these procedures since you are not paying for a hospital room. Certain procedures still need to be performed on an inpatient basis. Be sure to ask your physician why he/she recommends either setting.
- What type of anesthesia will be administered?
Your physician 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 physician 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 upon discharge. 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.
It is important to communicate your feelings, questions, and concerns with your physician prior to having surgery. The following suggestions may help to improve communication between you and your physician:
- If you do not understand your physician's responses, ask questions until you do.
- Take notes, or ask a family member or friend to accompany you and take notes for you. You can also bring a tape recorder, so you can review information later.
- Ask your physician to write down his/her instructions, if necessary.
- Ask your physician where you can find printed material about your condition. Many physicians have this information in their offices.
- If you still have questions, ask the physician where you can go for more information.
It is important to have confidence in the physician who will be performing your surgery. Whether this is someone you have chosen yourself, or a physician/surgeon you have been referred to, you can make sure that he/she is qualified to perform this operation. This may include any/all of the following:
- Ask your primary care physician, your local medical society, or health insurance company for information regarding the physician/surgeon's experience with the procedure.
- Ask about the physician/surgeon's credentials and whether he/she has any additional certifications that make him/her more experienced in performing the procedure.
- Make certain the physician/surgeon is affiliated with an accredited healthcare facility. When considering surgery, where it is performed is often as important as who is performing the procedure.
Before you have surgery, discuss with your physician his/her fees, as well as other fees you will incur. These may include, but are not limited to, the following:
- the surgeon's fee for surgery
- hospital fees (if you require hospitalization)
Check with the hospital's business office regarding these rates; your physician/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 physician prior to the surgery.
Asking another physician/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 non-emergency 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 physician or hospital can provide you with names of qualified physicians. Be sure to get your medical records from your first physician 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.