Posted by Bill Sandweg on 25 July 2022.

You have been referred to a surgeon and she has advised you that you need surgery.  What now?  There are certain steps you should always take when this happens.

What happens if I don’t get the surgery?

This is always an option.  Just don’t get the surgery.  Ask the surgeon what is likely to happen if you choose not to get the surgery.  Remember in all discussions with the surgeon who wants to do the operation that this is how the surgeon makes money.  There is an old saying, “When the only tool you have is a hammer, every problem looks like a nail.”  The surgeon doesn’t get paid, if you don’t get the operation.  The surgeon may be 100% right that you need this surgery and that it is important that you get it.  Just keep in mind that just because a doctor says it does not make it true.

What are the risks and benefits of the surgery?

This is a conversation you should always have whenever considering a surgical procedure or any type of medical care, for that matter.  It is how you give “informed consent” to the surgical procedure or the treatment.  If you don’t know what the risks and benefits of the proposed surgery are, how can you give informed consent?  Hint:  You can’t.

There is no free lunch.  Every medical procedure or treatment has risks.  What are they and how do they stack up to the benefits you are hoping to get?  Unless you have no other option, the benefits of the surgery should outweigh the risks.

How likely is the surgery to solve the problem?

It is one thing to know the risks of the surgery.  It is another to know how likely the surgery is to solve your problem.  Sometimes the surgery may be the only way to save your life.  Under those circumstances, you may have to accept even a low chance of success.  It is all you have.  On the other hand, if the condition the surgery is intended to fix is not critical and the risks are high, you may be better off passing on the proposed surgery.

Are there alternatives to the surgery?

In my reading, I have often come across articles which compare surgical outcomes with non-surgical ones for a given medical condition.  Sometimes the non-surgical treatment is just as effective as surgery and often has far less risk attached to it.  You should always ask if there is a non-surgical alternative and, if there is, how effective it is.

How often do you perform this surgery and what is your complication rate?

Regardless of how badly you need the surgery, you should be concerned about the experience of the surgeon who will be performing it.  The statistics are clear.  Surgeons who do your operation often get better results than surgeons who only do it occasionally.  The more often your surgeon does your procedure, the better.

If the surgeon who wants to operate on you does not want to talk about complications or her experience, you should find another surgeon.

Where do you plan to perform the surgery?

Some surgeries are complex enough that they should only be performed in hospitals where emergency services are available, if things go wrong or if your recovery will require an overnight stay.

Just as not all surgeons are equal, not all hospitals or surgical centers are equal.  The surgeon may be choosing this hospital because it is close to her office.  That is not much of a benefit to you.  Look up this hospital on the  web site where the government compares hospitals across a number of areas.  I have seen a lot of well-done operations screwed up by nurses or other health care providers at the hospital.  You don’t want that to happen to you.

Do I even need this surgery – Part 2?

Now that you have asked the surgeon who wants to operate whether you need this surgery and whether there are other alternatives, it is time to ask someone else who doesn’t have a financial interest in doing the surgery.  Find another surgeon and get a second opinion.  Don’t use someone recommended by the first surgeon or you may end up with their golf buddy, who may not give you an objective answer

Other questions.

There are probably lots of other questions you should be asking, depending on your particular situation.  Surgery is a big deal.  You don’t want to have someone cutting on you, if you don’t need to or if the risks outweigh the prospective benefits.  Think carefully about your situation and add some questions of your own to this list.

Good luck.