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Considering Surgery?
Have you been told that you need to have surgery? If so, you are not alone. Millions of older Americans have surgery each year.
Most surgeries are not emergencies. You have time to find out as much as possible about the surgery, think the matter over, and review other options. You also have time to get a second opinion.
Questions to Ask
Deciding to have surgery can be difficult, but an informed decision may be easier to make once you know why surgery is necessary and whether there are other treatment choices. Your surgeon can help. Talk with your surgeon about your condition and the surgery recommended.
Don't hesitate to ask the surgeon any questions you might have. For example, do the benefits of surgery outweigh the risks?
Your surgeon should welcome your questions. If you don't understand something, ask the surgeon to explain it more clearly. The answers to the following questions will help you become informed and make the best decision.
What surgery is recommended?
Why do I need surgery?
Can another treatment be tried instead of surgery?
What if I don't have the surgery?
How will the surgery affect my health and lifestyle?
Are there any activities that I won't be able to do after surgery?
How long will it take to recover?
How much experience has the surgeon had doing this kind of surgery?
Where will the surgery be done - in the hospital, the doctor's office, a special surgical center, or a day surgery unit of a hospital?
What kind of anesthesia will be used? What are the side effects and risks of having anesthesia?
Is there anything else I should know about this surgery?
Choosing a Surgeon
Your primary care doctor may recommend a surgeon to you. You also may want to identify another independent surgeon to get a second opinion.
One way to reduce the risk of surgery is to choose a surgeon who has been thoroughly trained to do the type of surgery you need and who has plenty of experience doing it. Be sure to ask about your surgeon's qualifications. For example, you may want to find out if your surgeon is certified by a surgical board that is approved by the American Board of Medical Specialties (such as the American Board of Orthopaedic Surgery, the American Board of Colon and Rectal Surgery, or other national surgical board). Surgeons who are board-certified have successfully completed training and passed exams for their specialty.
The letters "FACS" after a surgeon's name tell you that he or she is a Fellow of the American College of Surgeons. Fellows are almost always board-certified surgeons who have passed a test of their surgical training and skills; they also have shown their commitment to high standards of ethical conduct. Don't hesitate to call the doctor's office and ask for this information. Your State or local medical society and the hospital where the surgeon operates also should be able to verify his or her training. Try to choose an experienced surgeon who operates regularly (several times a week) and who has treated a problem like yours before.
Getting a Second Opinion
Getting a second opinion from another surgeon is a good way to make sure that having surgery is the best choice for you. Many people are uneasy about seeking another opinion. They worry that they might offend their doctor. However, getting a second opinion is a common medical practice. Most doctors encourage it.
Getting a second opinion is a good way to get additional expert advice from another doctor who knows a lot about treating your particular medical problem. In addition, a second opinion can reassure you that your decision to have surgery is the right one.
Don't be afraid to tell your surgeon that you want another opinion and that you would like your medical records sent to the second doctor. This can save time, money, and possible discomfort since tests that you've already had may not need to be repeated if the second doctor has the results.
When getting another opinion, tell the second doctor your symptoms, the type of surgery that has been recommended, and the results of any tests you've already had. Ask the second doctor the same questions you asked the first one about the benefits and risks of surgery.
Medicare and many private health insurance companies will help pay for a second opinion. Most Medicaid programs also pay for a second opinion. If the second doctor agrees that surgery is needed, he or she usually will refer you back to the first doctor for the surgery. If the second doctor disagrees with the first, you may feel you have enough information to decide what to do, you may wish to talk again with the first surgeon, or you may wish to see a third doctor. Your primary care doctor also may be able to help you decide what to do.
Informed Consent
Before having surgery, you'll be asked to give consent. It's important to discuss all of your concerns about your condition and the surgery with your surgeon before you sign this form. In most cases, your surgeon will volunteer a great deal of information, but don't hesitate to ask any questions you still have. Your doctor should be willing to take whatever time is necessary to make sure that you are fully informed.
Paying for Surgery
Before your surgery, ask about your surgeon's fees. Many surgeons volunteer this information; if yours doesn't, don't hesitate to ask. You can find out about hospital rates from the hospital business office. Your doctor should be able to tell you how long you can expect to be in the hospital. Today, many types of surgery can be performed without hospitalization. Your surgeon will be able to decide if that's possible in your case.
In addition to surgeons' fees and the costs of hospitalization, you also will be billed for the professional services of others involved in your care such as the anesthesiologist and medical consultants.
You may want to check your health insurance plan to see what portion of the costs you'll have to pay. You probably will need approval from your health insurance plan before surgery. If your insurance plan will not pay all of the anticipated costs and you cannot afford the difference, discuss this situation frankly with your surgeon.
Most people 65 and older have Medicare health insurance, which has two parts: Part A (hospital insurance) and Part B (medical insurance). Medicare Part A helps pay your hospital bill. It covers a semiprivate room, meals, general nursing, and other hospital services and supplies. It does not pay for private duty nursing, a television or telephone in your room, or a private room, unless medically necessary. For more information about Medicare coverage, call the toll-free helpline at 1-800-MEDICARE (1-800-633-4227).
For More Information
The American College of Surgeons (ACS) has information for the public. When You Need an Operation answers many questions that patients have about surgery. Frequently Performed Operations is a series of brochures on specific types of surgery such as hysterectomy, hernia repair, gall bladder surgery, and others. For free copies, contact the ACS at 633 North St. Clair, Chicago, IL 60611; telephone 312-202-5399. The ACS website address is http://www.facs.org.
Free booklets on what you should know about anesthesia are available from the American Society of Anesthesiologists at 520 Northwest Highway, Park Ridge, IL 60068-2573; telephone 847-825-5586. The website address is http://www.asahq.org.
For more information about health and aging, contact the National Institute on Aging Information Center at 1-800-222-2225 or 1-800-222-4225 (TTY). The website address is http://www.nih.gov/nia. The NIA distributes a number of other free Age Pages, including "Hospital Hints" and "Choosing a Doctor."
National Institute on Aging
U. S. Department of Health and Human Services
Public Health Service
National Institutes of Health
February 2000
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