If you’ve been diagnosed with a condition and the recommended treatment is surgery, there are proactive steps you can take to lower the risk of post-surgical complications and improve the likelihood of a good outcome. First, before deciding to undergo surgery, which always carries some risk, seek a second opinion from a physician who has experience treating the specific diagnosed condition. In most non-emergency cases, undergoing surgery immediately after diagnosis is not essential, so the short pause to get a second opinion is not likely to affect your outcome.
There are several ways a second opinion can help you make a more informed decision about treatment. It can confirm your diagnosis and treatment plan, giving you peace of mind as you move forward with surgery. It may also change your diagnosis and treatment options and may open the door to effective, non-surgical treatment options.
If you decide to pursue surgery, learn as much as you can about your surgeon’s experience performing the required procedure. Several studies and data analyses reveal that physicians and hospitals that do not perform a procedure frequently have higher rates of complications and deaths related to these surgeries. This holds true for surgeries that are performed frequently in the U.S., like joint replacement, as well as surgeries performed to treat less common conditions like spinal deformities and pancreatic cancer.
A U.S. News & World Report data analysis found that at hospitals that performed very few elective hip and knee replacements, knee replacement patients had a 50 percent higher risk of death and a 25 percent higher readmission rate for complications. Hip replacement patients also fared poorly, with a 77 percent higher risk of death and a 25 percent higher risk of readmission. They found similar increased risks for heart failure, heart bypass, and COPD patients at low-volume hospitals.
Another study published in the Journal of Neurosurgery also found an association between surgeon experience and outcomes. For adult patients who underwent a complex surgical procedure to correct a spinal deformity, as surgeons logged more years of experience performing the procedure, their overall complication rates and the rates of post-surgical neurological deficits decreased. And for patients undergoing a Whipple procedure to treat pancreatic cancer, the data showed a similar association between experience and outcomes. In the study in JAMA Surgery, the data linked more surgeon experience and higher procedure volumes at a given hospital with lower complication rates.
Questions to ask before choosing a surgeon
As a patient, you have an important role to play when choosing a surgeon. While your referring physician may recommend a particular surgeon, don’t make an immediate decision. Talk with that surgeon and gather as much information as you can about his or her experience with the specific surgery, complication rates, outcomes, and the full range of appropriate treatment options for the condition, including non-surgical options.
By asking the following ten questions, you can gather information that can help you decide whether you want to undergo surgery and whether this surgeon has the skills and experience required.
1. Are you board certified and did you complete fellowship training in your specialty?
2. What are your areas of surgical expertise? For example, some orthopedists focus on joint replacement while others focus on spine surgery.
3. How many times have you performed this specific procedure over the course of the past twelve months?
4. For how many years have you been performing this surgery and how many times have you done this surgery overall?
5. How frequently do you perform this surgery at this hospital?
6. What are your complication and death rates for this procedure?
7. Am I at an increased risk for complications or poor outcomes due to my health or other factors? If so, what can I do to decrease my risk before surgery?
8. Is there a minimally invasive option? What are the risks and benefits of this approach compared to an open surgical procedure?
9. How experienced is the anesthesiologist who will be involved in my surgery?
10. Are there any risks associated with waiting or trying other treatment options before having this surgery? Would any treatments mean I can’t have the recommended surgery in the future?
Miles J. Varn is chief executive officer, PinnacleCare, and can be reached on LinkedIn.
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