Here are questions to ask and issues to think about when you face surgery.
Since the publication of the first parts of our Quantity of Care investigation, many readers have asked for advice on how to navigate the world of surgery.
It’s a daunting moment in patients’ lives, with high-stakes decisions made difficult by jargon, uncertainty and a lack of public information that could help determine the best path.
In conversations with doctors, nurses and independent patient advocates, The Times has gathered advice to consider when you face surgery.
Is the surgery necessary?
Some doctors are more aggressive about recommending surgery than their peers, and sometimes there is reasonable disagreement about the best approach. If you are not facing an emergency situation, consider seeking a second opinion from a doctor at a different medical facility. It’s common practice, so don’t worry about offending your doctor. (If they are offended, that may be a red flag.)
And be sure to ask both doctors questions to help you assess whether to pursue surgery: What are the consequences of not doing surgery? What alternatives could be explored first? What are the risks of surgery? What is the ideal outcome? How long will the recovery take? What rehab will be necessary? What are the odds of a complete recovery? Doing your own research can help, too. Before surgery, you may also want to ask what you can do to prepare, including exercises that could make the surgery or rehab go more smoothly.
Is your doctor the right one?
It can be difficult to assess whether your doctor is the right expert for your condition. If you know someone in the medical community, they might have suggestions based on conversations with colleagues. When you do speak to your doctor, ask about their experience. How many times have they done the procedure? What percentage of patients had complications? Can I speak to a former patient? Who will be assisting during the surgery? Does the surgeon have plans to leave town in the few weeks after the surgery?
A SEATTLE TIMES SPECIAL REPORT
- Investigators find ‘numerous’ issues related to patient safety at Cherry Hill site
- Swedish Health largely bans overlapping surgeries
- Swedish CEO Tony Armada resigns
- Top Swedish neurosurgeon resigns
- U.S. Attorney’s Office launches investigation
- Providence CEO Rod Hochman apologizes
You can check online reviews for your doctor, but they are often anonymous and may be unreliable. You should check the state Department of Health to see if your surgeon has had any enforcement actions against them. For facility-wide issues, such as infections, be sure to check your hospital at the federal Hospital Compare site. Some organizations, such as The Leapfrog Group, also rate hospitals.
A few organizations are using medical data to try to compare the surgical outcomes of individual doctors. You can try ProPublica’s Surgeon Scorecard or a site run by Bellevue-based startup MPIRICA Health.
Also: Be sure to check with your insurance company to make sure your surgery will be in-network, and ask the hospital to make sure the anesthesiologist who will serve you will be in-network, too, because sometimes they are not.
Will your doctor really be the one doing the surgery?
As we’ve reported, some surgeons regularly run multiple operating rooms at the same time. And even if they’re not juggling other cases, some will delegate portions of the surgery to an assistant while they attend to other work, such as meeting patients in a clinic.
If this concerns you, ask your doctor whether they will be the one performing the entire surgery. Ask them what role their assistants will play and how they will be supervised. And ask whether your surgery will overlap at all with another case. Beware: If a doctor says they will be “present” for the whole case, clarify whether that means they will be present in the operating room or just somewhere nearby. But also be realistic: If you’re going to a teaching hospital, you can expect assistants will likely play some role in your surgery. And if your operation is going to last many hours, you can expect your surgeon to take breaks to use the bathroom and to eat.
How do you get what you need after surgery?
Patients sometimes find it difficult to get the attention they need after surgery. Nurses often have overwhelming caseloads and may need to deal with something that’s urgent before getting to you. Advocates suggest being respectful and appreciative to build a positive relationship with your care team. But you may need to be assertive at times to get attention on a critical issue. Sending a friend or relative to speak with the charge nurse could help. And be sure to ask what to do once you are discharged — What would be a sign of infection? What pain can be expected? — and whom to call if you have a problem.
Don’t go it alone
It can help throughout the process to have someone at your side and have questions in writing. Navigating a surgery can be overwhelming. Even during an office visit, anxiety and uncertainty can make you forget the questions you wanted to ask. It can be helpful to have another person to help ask questions, remember instructions and take notes. And ask your doctor how much assistance you’ll need once you get home, and for how long.