Considerations in choosing a surgeon
Picking a surgeon is a very personal issue. It depends on what surgery and why, where you will have surgery, and of course who will perform it. Not being afraid to ask questions is really important.
Why are you having surgery?
Obviously, the first question one has to ask is: "Why do you need a surgeon?" For this hub, I am assuming you are having elective surgery. Elective surgery means that it is scheduled weeks or months in advance, and that you have time to shop for your surgeon. True emergencies such as life-threatening injuries suffered from motor vehicle accidents do not allow you time to choose. If your life is in imminent danger, you must rely on the surgeon who is immediately available (on-call).
Elective surgery can be as small as having wisdom teeth extracted to as big as an organ transplant. Choosing the right surgeon for you is extremely important. The surgeon best for you may not be the best surgeon for your friend or relative. Why is that? It comes down to a number of factors including personality, experience (both yours and the surgeons), and insurance. In addition, you should also consider where the surgeon has privileges (ie., what hospital) and whether the surgeon is board certified or not.
The personality of the surgeon should pair well with yours. If you feel uncomfortable before surgery, will you be comfortable calling his office afterwards? A surgeon who spends little time with you and doesn't answer your questions when you first meet them is unlikely to be very helpful in your postoperative period. This does not mean that friendly surgeons are necessarily better in the operating room, but it does mean that if there are problems afterward, they will more likely help you navigate the complications. This is very important, since everyone that has surgery believes that complications are something that happens to someone else. Unfortunately, even in the best of hands, complications are common.
Question the surgeon
How does he or she respond to questions? Write down as many as you can before you meet the surgeon so that you can utilize your time wisely. Are they irritated if you ask how many of the procedures they have done? Are they evasive in answering how often complications occur? Ask them if they have plans for how to deal with those complications and how often they will see you afterwards.
Second opinions are good here. For any significant procedure, it is wise to get at least one second opinion. But ask each surgeon how they would feel if you do go for another opinion. Those surgeons who are irritated by such requests are probably best avoided. You want to choose someone who is comfortable with their decision enough to have another specialist review the information and give an independent opinion.
Your surgeon's experience may be hard to gauge. A younger surgeon may have less years of experience but may have more with a newer procedure. Their knowledge of the newer techniques may overshadow the lack of grey hair. On the other hand, the older surgeon likely has more experience in dealing with complications. While this sounds less important than having the best technician, dealing with the aftermath of problems is really where doctoring comes in.
Does the surgeon have special training in the particular procedure? Where did they get the experience? How many do they do a year? Remember, there are some procedures that are very uncommon even in the busiest of surgical practices. You must keep this in mind and the surgeon should be able to tell you as such.
And your experience matters as well. If you have had surgery in the past, how well you did will likely affect your choice of surgeon. Perhaps you had a surgeon of the same or opposite sex that made you feel more (or less) comfortable during the treatments.
Don't be afraid to ask others about your surgeon. Ask your primary care doctor, and don't be afraid to pull a nurse aside and ask her or him. You can try looking on-line on sites such as www.Healthgrades.com or www.vitals.com.
You can go to the state medical board website and look up your surgeon. This will give you basic information and may provide information on complaints and lawsuits. Remember, lawsuits themselves are very common and do not mean that the surgeon isn't qualified, but numerous lawsuits may be a harbinger of problems.
Is the surgeon covered by your insurance or are they cash only (in which case you will need to pay up front and apply for reimbursement from your insurance company)? Some surgeons have stopped taking insurance because of the hassles in getting paid by the insurance companies (each has different paperwork requirements and reimbursement rates). By charging cash, the surgeon makes his life easier but puts the onus on the patient.
Know your insurance. Even if the surgeon accepts your insurance, they are very unlikely to know the details of what it covers. It is your insurance and your responsibility. Call the insurance company to ask if the surgeon is covered, what percentage of the charges they will cover, and whether they cover the hospital where the procedure will be performed.
Is your surgeon board certified? The ABMS oversees 24 medical specialties in producing standards and certifying physicians. Not all surgeons are certified by their medical board. This does not mean they are not qualified, especially if they are recently out of training (residency). Many of the boards require a few years in practice before a surgeon is eligible. In addition, some foreign medical graduates may not be eligible. However, someone who has been practicing for many years and is not board certified can be an issue.
Where will your procedure be performed? Is it a major medical center or university hospital, or a community hospital or even a surgery center? Surgery centers are commonly used for low risk procedures such as arthroscopy, and generally run very efficiently. On the other hand, very complex and major procedures frequently need additional support of other departments such as radiology, intensive care, and others. Thus, these types of procedures are better performed at a medical center. Small community hospitals fall in between. They may be very good for certain procedures but are unlikely to have full coverage of all specialties. In addition, certain insurance companies have preferred hospitals which may save you some out of pocket money.
The governments reports on the Centers for Medicaid and Medicare Services may be the most useful. In addition, other sites such as US News and World Reports and Consumer reports rate hospitals.
This is a critical piece. Who will be doing the anaesthesia? Is the anaesthesiologist board certified? Do they routinely do anaesthesia for the procedure you will undergo? If it is a child having anaesthesia, are they pediatric specialized? Kids are not small adults and have certain issues that differ from adults.
Other things to consider
The examination: Most surgeries whether they be orthopaedic, general, urological, gynecologic, or neurosurgical will require a thorough examination by the treating physician. Did the surgeon perform an examination carefully and thoughtfully, or was it his assistant that examined you? Did the surgeon explain what they are examining and why, and go over all studies with you? Did they provide you with any written information or provide a drawing of what they will do at the time of the surgery?
The pre-surgical discussion: Can the surgeon articulate exactly what they are going to do? The surgeon should know exactly what they are going to do at the time of the surgery, and also be able to explain fall-back plans if they encounter problems. This gives you an indication of their readiness and confidence in what they are proposing.
So there are many factors that you must consider when choosing a surgeon for an elective procedure; training, board certification, facility, and who will perform the anaesthesia. Remember, it is your body and your operation. Ask questions and investigate. And good luck.
- HealthGrades > Find a Doctor | Doctor Reviews | Hospital Ratings
HealthGrades, the leading independent health care ratings company. Research hospitals, doctors, nursing homes, and more.
- Doctor Reviews and Doctor Ratings | Compare & Find Doctors | Vitals
Find a doctor and book an appointment online. FREE access to two million doctor reviews and ratings. Find doctor appointments by insurance.
American Board of Medical Specialties
- Welcome to ABMS: Improving healthcare quality through board certification
The American Board of Medical Specialties (ABMS) is a not-for-profit organization that oversees 24 approved medical specialty boards in setting standards for the ongoing evaluation and certification of physician specialists.
Centers for Medicare & Medicaid Services
- Centers for Medicare & Medicaid Services
US federal agency which administers Medicare, Medicaid, and the Children's Health Insurance Program. Provides information for health professionals, regional governments, and consumers.
US News and World Reports
- U.S. News Best Hospitals 2011-12
Ranks hospitals by specialty based on reputation, safety, and other factors.
- Hospital Ratings By State -Consumer Reports Health
Get Hospital Ratings with this helpful tool that compares hospitals by city and state from Consumer Reports Health.