Deciding Which Option is Best

Learning to ask the right questions—and getting the right answers—is vital to helping you decide whether or not surgery is right for you. Being a responsible health care consumer starts with getting involved in decisions about your health. That way, you’re more likely to feel calm and confident about whatever course of treatment you choose.

When you have a health condition that may involve surgery, it is scary. That’s why doctors only perform 10 to 40 percent of elective surgical procedures—those a person can choose to have or not have. (Elective surgeries relieve conditions that are basically harmless or are causing only minor symptoms.)

So how do you decide about surgery? The first step is to find out whether the surgery your doctor is recommending is nonelective or elective.

Nonelective Surgery

When surgery is needed to save a person’s life (such as to remove a ruptured appendix) or must be done immediately to prevent permanent disability (such as to surgically repair a badly broken bone), it is considered nonelective. That means you have little or no choice but to have the operation. And you probably do not have time to explore other options. Fortunately, few surgical procedures are truly nonelective.

Elective Surgery

Most surgical procedures involve some degree of choice for the patient. In some cases, alternatives to surgery exist, such as medications or other ways of dealing with the problem. In other cases, surgery may be the only option for correcting a particular problem, but the symptoms don’t merit the risk of surgery. For example, many people who have gallstones have no pain, discomfort, or other symptoms and do not need treatment. Surgery is appropriate when it is needed to:

• Relieve or prevent pain
• Restore or preserve normal function
• Correct a deformity
• Save or prolong your life

Even if surgery is appropriate, it may not be the only choice of treatment. It’s always best to investigate all other options before choosing surgery.

Make an appointment with your doctor to discuss the Questions to Ask Before Surgery worksheet. Write down or record the answers. If you feel anxious or nervous, take a friend or relative along for moral support. Then assess the information and decide what you want to do.Make sure it’s your own decision. Don’t let yourself be pressured into having surgery you don’t need or want.

Asking for a Second Opinion

Getting more information can help when you’re deciding about surgery. One way to do this is to get a second opinion (also called a “review of treatment”). Some health plans require second opinions before they will cover certain procedures. But a second opinion can also help you make a more informed decision.

Although a second opinion isn’t needed in every instance, you would be wise to seek one if:

• The procedure is experimental or high risk, such as an organ transplant.
• Your symptoms aren’t severe and the outcome of surgery isn’t clear.
• The procedure has a reputation for being performed when not absolutely needed.

Don’t Be Timid

You might feel uncomfortable asking for a second opinion, but most doctors today are used to this and are very cooperative. A doctor who responds with anger or refuses to cooperate with such a request may not have your best interests at heart.

To find a second surgeon, ask your primary doctor, your health plan, or your local hospital for a recommendation. If you ask the first surgeon for a referral, you are less likely to get a truly objective second opinion.

Avoid the expense of repeating tests and procedures; bring your medical records and x-rays, if any, along with you. If this is not possible, you can have them sent to the second surgeon before your appointment by signing a records release form.

If the second surgeon disagrees with the first, find out why. You may find that one surgeon’s philosophy and reasoning fit with your own more than the other’s.

Questions to Ask Before Surgery

View Questions to Ask Before Surgery worksheet.