Before You Have Surgery, Read This

When your doctor recommends that you have elective surgery, it’s important to gather information before you say yes.

Always be sure to have your doctor (or the surgeon you’re considering) explain the details of the procedure; why he or she thinks you need it; the benefits and possible risks; the alternatives; and what may happen if you don’t have the surgery.

You’ll also want to know which anesthesia will be used and whether the procedure will be done on an inpatient or outpatient basis.

Here, four more important questions to ask. Getting the right answers to these may reduce the likelihood of pre-op and post-op problems.

1. How Experienced Are You?

The surgeon should have recent and significant experience with your procedure. Research has found that the more often a surgeon has performed a particular surgery, the lower the risk of complications—and even death.

However, the right number varies from surgery to surgery. When it comes to hip or knee replacements, for example, you ideally want a surgeon who has done at least 50 such procedures in the previous year and has a complication rate of 3 percent or less. For laparoscopic hysterectomies, surgeons may have a learning curve for the first 100 procedures, according to recent research. 

If you aren’t satisfied with what the surgeon tells you, ask your internist to recommend another surgeon for a second opinion.

2. How Safe Is Your Hospital?

About 650,000 people develop an infection while in a hospital each year. Pneumonia and surgical-site infections are the most common of these.

Because many surgeons have operating privileges at multiple hospitals, you may be able to choose the facility you prefer—and infection rates are one important factor in making that choice.

Your surgeon may be unable to provide infection-rate information, but you can see how Consumer Reports rates your hospital on the prevention of five types of infections, along with other measures of patient safety.

3. Do I Really Need That Pre-op Test?

Between the X-rays, blood tests, and stress tests your doctor may recommend, getting ready for a scheduled procedure can take longer than recovering from the operation itself.

People with certain medical conditions or illnesses do need preoperative tests to make sure that they’re in good enough physical condition for surgery. However, the practice of pre-op testing has been broadly adopted for healthy patients, too, even though studies have found that it’s unnecessary.

You probably don’t need a chest X-ray unless you’re a smoker, you have symptoms or a history of heart or lung disease, or you’re having major surgery, especially in the chest or upper abdomen.

Blood tests aren’t needed if you’re undergoing an elective procedure that’s considered to be low-risk, such as cataract surgery.

Having a heart stress test before surgery may also be unnecessary. Seven medical specialty societies, including the American College of Cardiology, advise against pre-op stress testing for people scheduled to undergo low- or intermediate-risk noncardiac surgery.

Choosing Wisely, a campaign to get people and their healthcare providers to talk about tests and treatments that are unnecessary, includes procedures such as breast biopsy, and eye, hernia, and skin surgery among these.

4. Are There Costs That Might Surprise Me?

You probably already know it’s important to ensure that your primary surgeon accepts your health insurance. But healthcare providers who aren’t in your insurance network may also become involved in your care during and after a procedure.

These are often providers you have no role in selecting, such as assistant surgeons, anesthesiologists, pathologists who review biopsies, and radiologists who read your imaging test results.

Such out-of-network consulting specialists may be able to bill you separately—and charge a much higher rate than those who contract with your health insurer. The bills you may get as a result are called surprise medical bills.

Although more than 20 states are currently working toward or have already enacted protective measures, millions of people are still vulnerable to surprise medical bills.

Ask your surgeon to make sure those involved in your care are in your network. He or she can take this into consideration when selecting a surgical team. And before you’re admitted to a hospital, ask whether pathology and radiology providers are in your network.