Helping Patients Facing Surgery

Over the last several years, there has been an trend toward patient participation in medical decision-making. Known as “shared decision-making’, this model puts emphasis on involving the patient in their treatment decisions with input from the physician. However, when the patient is faced with the prospect of an invasive medical produce, many feel nervous and anxious; they may have a harder time thinking of questions to ask their provider or surgeon about the procedure and their options.

If one of your patients is scheduled to have surgery or another medical procedure, one way to help them relieve their anxiety about it is to help them learn all they can about the procedure. The following list of questions is based on information from Questions to Ask Your Doctor page on the Agency for Healthcare Research and Quality website. The AHRQ provides basic questions as well as a question generator that patients can use to print a personalized question list.

Encourage patients to use a list of questions like this. They may also benefit from having a family member or a friend at their doctor’s or surgeon’s appointment. Such ones can help speak for your patient and may also be able to help them remember all of the information the doctor or surgeon provides.

Patient Questions
Why do I need surgery?
Find out the purpose of the surgery and how it relates to the diagnosis of your condition. For example, is the procedure designed to relieve pain? Reduce symptoms? Improve function?

What type of surgery are you recommending?
Often, there are different types of surgery available for a given condition. Ask your surgeon to explain the procedure and describe to you exactly what is going to be done. Ask if any instrumentation (hardware such as screws, plates, stents, or cages) will be used and how large your incision will be.

Your surgeon may be able to draw a picture, show you a diagram, give you written information or refer you to other resources such as books, videos, or websites that can help you better understand the procedure.

Are there alternatives to surgery?
For some musculoskeletal conditions, surgery is considered only after conservative, or non-surgical, treatments have been tried. Talk to your surgeon about other options to see if there is any reason to try a different treatment option first or to just postpone surgery. If you have tried various conservative treatments, tell your surgeon about them and why they did or did not help your condition.

What are the benefits of having the operation?
Find out what you will gain from the surgery. Ask how long the benefits will last or if you will need another operation at a later date.

What are the risks of having the operation?
All surgeries carry a risk of complications, such as infection, excessive bleeding, reactions to anesthesia and injury. Be sure you understand all of the possible complications before you agree to have any surgical procedure. Also, talk to your surgeon about any side effects after the surgery, such as swelling, soreness, and pain and how these will be managed. What will my capacity for activity be like?

What if I choose not to have this operation?
After you have learned about the risks, ask your surgeon what would happen if you chose not to have the surgery. Will your condition get worse? Will you have more pain?

Where can I get a second opinion?
Getting another doctor’s opinion about whether or not to have surgery is a great way to ensure you are making the right decision. Many health insurance plans cover getting a second opinion. Call your insurance company to see if your plan will pay for a second opinion.

What has been your experience with this procedure?
Ask your surgeon how many of these surgeries they have performed. Get a feel for their experience with your condition. Ask your surgeon if they can refer you to someone who has also had this operation.

Where will the operation be done?
Most surgeons work out of more than one hospital. Find out where your procedure will be performed. If you have a choice, choose the facility that has the most experience and the highest success rate in treating your condition. Talk to your doctor about whether or not your procedure will require you to stay in the hospital and for how long.

Asking these straight forward questions empowers patients to make collaborative decisions with their caregivers. Empowered patients tend to have better outcomes from any treatment, especially in the case of a major surgery.