Saturday, July 16, 2005

Inquiring Minds Want to Know......
In a comment to this post Azygos left this comment:
I realize this topic could be an entire post but what questions would you ask a surgeon before letting them operate on you?
Some I have thought of:
Are you currently board certified?
This assures that your surgeon has completed an accredited residency program and has undergone both written and oral examinations. The American Board of Surgery currently requires recertification every ten years. The ABS is moving to a "maintenance of certification" (MOC) program (see page 4) as the internal medicine board has done.

How many of (insert procedure here) have you done? How many have you done in the past year? Month?
With the increasing body of evidence that surgeon and hospital volume are very important predictors of complications, or the lack thereof. You not only need to ascertain total experience, but also make sure that the last time your surgeon did this operation was during the Bush 41 administration.

If you are having your procedure at an ambulatory surgery center (ASC):
What provisions are made for complications at the surgery center?
While most of the procedures performed at ASC's are simple and complications are rare, sometimes they can happen. You should make sure that plans for transfer to a full-service hospital are in place should you need it.

If I have a question or a problem at night or on the weekend who will be there to assist me?
Your surgeon may take calls on his own patients at all times or may participate in a call group on nights and weekends. In a group practice you may deal with whoever is on call. Every surgeon has his or her own way of doing things and one is not necessarily right or wrong, but you should know how things will be done.

If having a laparoscopic procedure:
How often do you have to convert to an open procedure? How many of the open procedures have you done?
The latter question is the more important of the two. The goal of any operation is to accomplish the goal (removing the gallbladder, repairing the hernia) in the safest way possible. The benefits provided by laparoscopy come in a distant second. A surgeon who tells you he "never" has to convert is either a liar or engages in very risky operative behavior, IMHO. Even the laparoscopic "gurus" have to open from time to time.

I'm sure there are more questions you may think of, feel free to post them in the comments.
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