What to ask your surgeon

Having surgery is a scary proposition for most patients and most patients are hesitant to have a frank conversation with their surgeon for any number reasons including fear, an unwillingness to confront the doctor with difficult questions, time constraints and generally lacking an understanding of confusing medical terms.

When it comes to improving patient understanding of medical information, there are lots of roadblocks:

1. The information is not standardized or delivered the same way by doctors or other medical staff

2. The language is difficult to understand 

3. Patients are not emotionally prepared to make a decision. How much can you really process after you've been told you have cancer?

4. Patients are asked to sign forms under duress, like just before they go to surgery

5. Patients learn different ways. Some are visual, some are lingual

6. Patients ofen want to share the decision with other family members and can't when the form is staring them in the face.

7. There is little or no opportunity to get more information to make the decision at the point of care

8. Almost every consumer facing inustry uses marketing and sales techniques based on customer realationship management. Look at Amazon or Zappos.

9. There are few ways to include video, graphics or personal websites to education and inform

10. There are few ways to engage patients after their treatments to assure medically appropriate follow up , particularly when they move or relocate. But, if I have your cell number, that is probably more valuable than your Social Security Number when it comes to tracking you.

Here are some questions you should ask your surgeon. You should bring someone with you to take notes during the visit since the terms will be confusing and you will have follow up questions. Here are some others:

 Others: 

1. Will you be staffing more than one operation at a time?

2. Will the anesthesiologist stay for the entire case or will there be a hand off?

3. Where is the best facility (ASC or hospital based) to have my procedure and why?

4. If I have the procedure in an ASC and I need to be hospitalized for some reason post operatively, where will I go?

5. Where can I find a third party determination of the results of your surgical procedures? 

6. How do your outcomes compare to other surgeons for this particular operation

7. How much will I have to pay? How do your charges compare to other surgeons and why?

8. Which one of your patients can I talk to ?

9. Have you ever had a disciplinary action taken against you?

10. Do you have any conflicts of interest? For example, will you be using an implant from a company in which you have a financial interest?

11. Will the surgeon prescribe non-opioid analgesics for postoperative pain?

12. Are there other materials you can review, like educational or instructional videos, explaining your operation in terms you can understand?

13. Where would you recommend I go for a second opinion?

14. Will you take care of me if I decide to to somewhere else to get surgery that might be out of the state or country?

15. What kind of medical information system do you use in case I need to access my records?

If you are scheduled for surgery, be sure to do your homework and come prepared with answers to your questions. Researchers noted that only 36% of patients met the criteria for an informed patient-centered decision. Informed patients were significantly more likely to report being extremely satisfied with their treatment. People who were informed and received their preferred treatment also tended to do better, although it wasn’t clear why patients who actively participated in treatment decisions had better outcomes. It could be they have more realistic expectations or are more motivated to follow through with their treatment.

Seek to understand and share in the decision making process, not just consent. Joining an online community could save your life.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs and Co-editor of Digital Health Entrepreneurship