Wednesday, March 26, 2014
Your doctor tells you or a loved one that you need surgery and has helped you find a surgeon. You've read all you could find about the procedure. But here are 10 things your doctor may not have mentioned, and that you should be sure to do for yourself to be prepared and feel empowered.
1. You need the most experienced surgeon you can find. When it comes to surgeries, practice makes perfect — and so the more experienced the surgeon, the better the results are likely to be. Ask directly: How many of these surgeries have you done? Consider looking for someone who's been doing surgery for more than five years with over 30 surgeries each year. Compared to a surgeon who's immersed in patient care, the clinician researcher may be more involved in research than in day-to-day surgery, cautioned Alexander Marmureanu, MD, a cardiothoracic surgeon at the California Heart & Lung Surgery Medical Center in Los Angeles.
2. I might have been sued by former patients. Contact the state medical licensing board for your state, or the county clerk's office in your area to find out about medical malpractice lawsuit cases involving your surgeon (or any doctor). This is public information you have the right to know.
3. My hospital may not be up to snuff. Try this Medicare tool to compare hospitals based on their surgical records. You might discover that your hospital is better than average — or worse — for care before, during and after surgery. You can also check that your hospital provides high quality care at this site, and for surgical centers, this site to see that they're accredited organizations. This means a hospital or outpatient clinic meets strict patient quality and safety standards.
4. Schedule surgery during banking hours. You might think having surgery on a weekend or at night is a great idea. Wrong. These are off hours for regular healthcare staff who are essential for a successful surgery, including the most experienced nurses, a patient advocate or a social worker. For the best care, schedule your surgery during the week — Monday through Thursday — between 9 and 5, recommends Dr. Marmureanu.
5. I'm great...but you still need a second opinion. Do you really need surgery now? Always confirm the necessity to have surgery with more than one source. Unless you're having emergency surgery, you'll have time to weigh your options. Get the name of a second surgeon by asking your primary health care provider, the first surgeon, or a service like Grand Rounds. A second surgeon’s opinion — and even a third — will help you decide what’s best.
6. Don't mind my lousy bedside manner. You want a surgeon who's confident and great at his or her job, but you're not going to spend a huge amount of time with them. Clear communication and skills are more important than a great personality.
7. Ask me all your questions...and make sure you get answers. What are the risks and benefits of the surgery? How long will the benefits last? What are the alternatives to surgery? What if we skip the surgery? How long will it take to recover from surgery? If the surgeon doesn’t welcome questions, you should look around for someone qualified who will. Put questions in writing, and follow-up by asking the attending nurse.
8. Your incision size could be negotiable. Your condition may have surgery options that are less invasive and come with fewer risks. This can mean a shorter hospital stay, quicker recovery, and even lower cost for you. Ask about different ways to get the same end result. Minor surgery, like laparoscopic surgery, might work as well as major surgery.
9. Get a friend to take notes. Support of family or a friend when you discuss surgery options with the surgeon can make all the difference. Bringing an assertive companion with you for these visits — as your patient advocate — can help you raise your voice and be heard. They can ask questions and even take notes for you, recommends Carolyn M. Clancy, MD former Director of the Agency for Healthcare Research and Quality, AHRQ, Center for Outcomes and Effectiveness Research in Rockville, MD. But what about when you don't have that special someone to come along with you? Reach out to ask for a patient advocate from the hospital or hire one from a private service. A professional patient advocate may be a social worker, a nurse, or even a chaplain.
10. Forgo makeup and nail polish. It’s important to shower with antibacterial soap or medicated soap from your doctor before surgery. In addition, you’ll want to remove makeup and nail polish (even if it's clear polish) because clinicians look at your nails for clues to your oxygen levels while you recover.