Asking the right questions is essential to preparing for surgery; see which

When a member of my family was recently advised by the doctor to have minor surgery, I felt fear and uncertainty. How can we be sure the surgery was necessary? Should we seek a second opinion, or should we trust the doctor who recommended the procedure? What should we do in preparation?

My family is one of many who have found themselves in this situation recently. According to the American College of Surgeons, 15 million Americans undergo surgery every year. To figure out how best to reflect on the situation, I turned to three doctors who study medical decision-making and the knowledge patients have about their own health.

For Susan Pitt, a surgeon at the University of Michigan Center for Health Outcomes and Policy and a scholar of how patients and doctors make decisions about treatments, the first thing a patient should do is take a deep breath.

Facing an operation is no small thing to process in your head. If the doctor has not yet explained why he recommends surgery, ask why the procedure is necessary. Also ask if medical guidelines generally recommend this procedure for the problem you have.

Consider asking if you can record the conversation with the doctor on your phone so that you can hear the information again later when you are calmer. That’s a recommendation from Harlan Krumholz, a cardiologist who directs the Center for Research and Outcome Evaluation at the Yale School of Medicine.

Even if your doctor makes a compelling case for surgery, you may have other options. Pitt suggests that you ask if there are any non-surgical options or other, less invasive surgeries. Specify that you are interested not only in the alternatives your doctor can offer you, but also in treatments that may be available from other doctors.

Don’t forget to ask what can happen if you don’t do anything, recommended Pitt. Perhaps the worst-case scenario isn’t all that bad.

For Krumholz, you should ask your doctor about the potential benefits of any procedure. Doctors often perform surgery to increase the patient’s chances of feeling well or to avoid future risks. But, according to the professional, some surgeries do not achieve these goals.

When he and his colleagues interviewed adult American candidates for elective angioplasty — a procedure to open blocked arteries — 70% said they believed the procedure would prolong their lives or prevent future heart complications, although that’s not usually the case. (Usually the surgery just relieves chest pain.)

Some procedures are not even necessary and may not help. In a 2017 survey of more than 2,000 American doctors, they estimated that 11% of medical procedures, including surgery, are unnecessary.

According to Pitt, it is also essential to be informed about the potential risks of surgery. If what the doctor tells you is not clear, ask for a better explanation.

(For complex surgical decisions, you can ask if the hospital has patient advocates or patient care nurses. They can accompany the patient to appointments and help him understand what he is being told.)

Ask how recovery from surgery will be. How long will it take? What will you or will you not be able to do? How many people never fully recover?

“This is crucial information that the patient must understand,” Krumholz said.

Also ask what costs will be on your account. “A lot of people don’t understand that they’re going to have a big bill to pay,” he said, even if they have health insurance.

It can also be helpful to get a second opinion from a different doctor, said Glyn Elwyn of the Dartmouth Institute for Health Policy and Clinical Practice. This is especially the case if the first doctor did not suggest any other alternative to surgery. Elwyn recommended that the patient seek a second opinion from a general practitioner, who may be more knowledgeable about alternative nonsurgical options.

When my relative’s doctor did not mention any alternative to surgery, my relative sought a second opinion from a different surgeon. He explained that there were actually several non-surgical options.

He suggests that you ask the doctor how many such procedures he has performed in the last 12 months and over the course of his professional career, and how this compares with the threshold associated with positive outcomes in the practitioner’s field.

“If the doctor says he doesn’t know, that will be revealing,” Krumholz said, and it may be the case that you look for another surgeon.

You can also ask what the surgeon’s effectiveness and complication rates are for this type of surgery compared to other surgeons.

“Surgeons should know where they stand relative to the national average,” Pitt said.

There is no national registry where patients can access this information. That’s why it’s best to ask the doctor directly.

If your doctor performs surgery at a teaching hospital, ask if there is a possibility that a junior doctor will be in charge of performing the procedure and, if so, how much experience he has and what the hospital does to ensure optimal patient care.

To Elwyn, if the doctor is annoyed that you’re asking so many questions, take that as a warning sign.

After my relative sought a second opinion and discovered that there were other treatment options, he opted for a less invasive procedure with an easier and faster recovery. His symptoms have improved tremendously. It is possible that surgery will still become necessary one day, but maybe not.

“There are a number of ways people are tricked into thinking that surgery is necessary and that there is no other option, when in reality there are almost always other options,” Krumholz said.

Translation by Clara Allain