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Wednesday, January 30, 2008 9:00 AM

Navigating Health Care: What You Need to Ask Your Doctor Before Your Next Elective Surgery

Rand: Every year, more than 15 million Americans have surgery. The good news is that most operations are not emergencies. They are considered elective surgery which means you have time to prepare. In this segment of Navigating the Health Care System, AHRQ Director Dr. Carolyn Clancy is here to talk about what to ask your doctor before you undergo surgery. Dr. Clancy, welcome.

Dr. Clancy: Thank you.

Rand: Dr. Clancy, why is it important to prepare for surgery?

Dr. Clancy: Surgery is a big deal no matter what kind of operation you’re having. It’s very important that you ask as many questions as possible so that you can be an informed and active participant in your own health care.

Rand: Well, what type of questions should we ask before we undergo surgery?

Dr. Clancy: Before having surgery, it’s almost impossible to have too much information. The types of questions someone should ask about a procedure before having it include: the exact name of the procedure; why it’s being recommended; what are the risk and benefits of having this done; the alternatives - what happens if I just wait and see or take medicines; what kind of doctor will be doing the procedure; how many times the surgeon or other physician has done that procedure, and what kinds of outcomes that person has had; where the procedure will be done and what kind of anesthesia will be used; what recovery will be like; and how much it will cost, and if your insurance will cover it.

Rand: Usually if we’re going to have surgery, there’s more than one doctor involved in our care. Are there different types of questions that I should ask for, say, our primary care physician versus our surgeon?

Dr. Clancy: When you’re seeing a primary care physician who recommends that you have surgery, you’re going to be wanting to discuss why you need surgery and are there any other alternatives that wouldn’t be surgery. Once the decision to have surgery has been jointly made with your primary care doctor and you are referred to a specific surgeon, you’d want to be asking the primary care physician - what’s your experience with this individual been; how do his or her patient’s do; do you have a long track record or is this someone new that you don’t know very well either? The surgeon, on the other hand, you’re going to want to know quite specifically from that individual what’s the recovery time like; what are the complications; what kind of anesthesia am I going to have; is it likely that you might change your mind when the surgery starts, you know, are there unanticipated circumstances that might arise where you’d do a slightly different procedure than that you’re telling me today, and does it matter, and so forth.

Rand: Do you recommend that people get a second opinion before they decide to actually have surgery?

Dr. Clancy: Getting a second opinion can be very helpful in terms of reassuring you that you’re making the right decision. So if you have any doubts, a second opinion is a great idea. Most doctors would welcome a second opinion, particularly if there is any debate or controversy about what is the logical next step.

Rand: Are there other sources of information available to us?

Dr. Clancy: The really good news about having surgery is, for many procedures, groups have developed specific brochures that talk about that procedure, so it’s very important to ask the doctor and/or the nursing staff where I can get more information.

Rand: Well AHRQ has developed a brochure, called "Having Surgery? What You Need to Know," it’s available online at ahrq.gov/consumer. The publication is part of a series of health care resources from AHRQ to help people be more active in making informed decisions, and more satisfied with their treatment. Dr. Clancy, thanks for joining us.

Dr. Clancy: It’s been a pleasure. Thank you.

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