Important questions to ask before having surgery

Millions of Americans will have surgery each year. It's important to be informed about the surgery being recommended. This is particularly true if it's an operation you choose to have done (elective), rather than an emergency surgery. All surgeries have risks and benefits. It's important to understand them before deciding whether the procedure is right for you.

These are important questions to review with your healthcare provider before surgery. Ask your provider to explain the answers clearly. Ask for further explanation if you are having trouble understanding an explanation or any medical terms. Some people find it helpful to write their questions down ahead of time.

It's 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 healthcare provider should clearly explain the surgical procedure, such as the steps involved and provide you with examples. You should ask if there are different methods for doing this operation and why he or she favors one way over another.

• Why is the procedure needed?

  Reasons to have surgery may vary from relieving or preventing pain to diagnosing a problem to improving body function. Ask your provider to specifically explain why this procedure is being recommended for you. Make sure you understand how this may improve your medical condition.

• What are my alternatives to this procedure? Are there other treatment choices available based on my current health condition?

  In some cases, medicine or nonsurgical treatments, such as lifestyle changes, may be as helpful in improving a condition as surgery. Your healthcare provider should clearly explain the benefits and risks of these choices so that you can make an informed decision about whether or not surgery is needed. Sometimes "watchful waiting" is indicated. This is when your healthcare provider will monitor your condition over 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 choice.

• What are the benefits of the surgery and how long will they last?

  It's important that your healthcare provider 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 need a second operation, while others may last a lifetime.

  Also, ask your healthcare provider 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's important to weigh the benefits against the risks before surgery. Ask your healthcare provider to outline the possible complications, such as infection and bleeding, and possible side effects that could follow the procedure. Be sure to understand when you should notify your healthcare provider or seek immediate medical attention for complications. 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 get a second opinion?

  In certain cases, some health plans may require patients to have a second opinion before undergoing elective surgery. Your healthcare provider should be able to supply you with the names of qualified people who also do the procedure.

• What is the healthcare provider's experience in doing this procedure?

  You can minimize the risks of surgery by choosing a healthcare provider who is thoroughly trained and experienced in doing the procedure. You may ask the healthcare provider about his or her experience with the procedure being done. Ask about the number of times he or she has done it, and his or her record of successes, as well as complications. Ask if there will be additional healthcare providers in the room during surgery and what are their roles.

• Where will the surgery be done?

  Until recently, most surgery was done in hospitals. But today, many procedures are done on an outpatient basis or in ambulatory surgical centers. Some of these are located within a hospital. This lowers the cost of these procedures since you are not paying for a hospital room. Certain procedures may still need to be done on an inpatient basis. Your overall health is also considered when making a decision as to where the operation will be done. Be sure to ask your healthcare provider why he or she recommends either setting.

• What type of anesthesia will be used?

  Your healthcare provider should tell you whether a local, regional, or general anesthesia will be given and why this type of anesthesia is recommended for your procedure. You should also ask who will be giving the anesthesia. Is it an anesthesiologist or a nurse anesthetist? Both of these providers are highly qualified to give anesthesia. Ask to meet with that person before your operation.

• What can I expect during recovery?

  Ask your healthcare provider what to expect in the first few days after surgery, as well as in the weeks and months that follow. You need to know how long you will be hospitalized. Ask what limitations will be placed on you, and if there are special supplies or equipment you will need when discharged. Knowing ahead of time what to expect will help you to cope and recover more quickly following the surgery. You should also ask about the typical length of time it takes for a full recovery to resume work and your everyday activities. 

• 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. This information is not typically available to the healthcare provider. But their office may be able to help, or you may need to call your health insurance company. 

Tips for communicating with your healthcare provider

It's important to communicate your feelings, questions, and concerns with your healthcare provider before having surgery. These suggestions may help to improve communication between you and your healthcare provider:

• If you don't understand your healthcare provider's responses, ask questions until you do.

• Take notes or ask a family member or friend to come with you and take notes for you.

• Ask your healthcare provider to write down his or her instructions, if needed.

• Ask your healthcare provider where you can find printed material about your condition. Many healthcare providers have this information in their offices.

• If you still have questions, ask the healthcare provider where you can go for more information.

Learning about your surgeon

It's important to have confidence in the healthcare provider who will be doing your surgery. Whether this is someone you have chosen yourself, or a healthcare provider or surgeon you have been referred to, you can make sure that he or she is qualified. This may include any or all of the following:

• Ask your primary healthcare provider, your local medical society, or health insurance company for information about the healthcare provider or surgeon's experience with the procedure.

• Ask about the healthcare provider or surgeon's credentials and whether he or she has any additional certifications or experience in doing the procedure.

• Make certain the healthcare provider or surgeon is affiliated with an accredited healthcare facility. When considering surgery, where it's done is often as important as who is doing the procedure.

• Ask if your surgeon is board certified in their specialty area.

Determining the costs of the procedure

Before you have surgery, discuss the costs with someone from the finance department at your healthcare provider's office. These costs may include the following:

• The surgeon's fee for surgery

• Hospital fees(if you need hospitalization) or ambulatory surgical center fees (for outpatient services). Check with the hospital's business office about these rates. Your healthcare provider or 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 before 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 healthcare provider before the surgery.

Getting a second opinion

Asking another healthcare provider or surgeon for a second opinion is an important step in making sure that this particular procedure is the best choice 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 get a second opinion on certain nonemergency procedures. Medicare may also pay for patients to get a second opinion. Even if your plan doesn't require this, you still can ask for a second opinion.

If you decide to get a second opinion, check with your health plan to see if it's covered. Your primary healthcare provider or hospital can provide you with names of qualified healthcare providers. Be sure to get your medical records from your first healthcare provider so that the second one doesn't need to repeat tests and procedures.

Remember, in the case of emergency surgeries, the surgery should be done as quickly as possible. Most likely, there will not be time to get a second opinion. The necessity of getting a second opinion should always be weighed against the severity and urgency of the medical condition.