Questions to Ask Before Surgery

Do you need surgery? Do you know what questions to ask before surgery? There’s a lot to consider, and worry about, before a surgical procedure. It’s scary to think about going under anesthesia, and it’s scary to think about a doctor cutting you open! And it’s really scary to think about the possibility of something going wrong.

But instead of putting your head in the sand, it’s important to ask the right questions so you can have the best outcome possible. However, surgeons can be intimidating, and many patients don’t know what questions to ask. And “you don’t know what you don’t know”. So, prepare yourself using our questions to ask before surgery.

What do other doctors think?

If time allows, it’s always a good idea to get a second opinion. Preferably with a surgeon from a different hospital than your initial surgeon. Not all surgeons use the same techniques or have the same success rates.

Therefore, whenever possible, it is worth your time to meet with a few surgeons before scheduling a procedure. To make sure you remember all the questions to ask before surgery, write our questions in a notebook or print out this post before you meet with prospective surgeons.

What will the operation entail?

It’s important for you to know your options before scheduling an operation. Even in an emergency, there is usually time for questions before the procedure begins.

Ask these questions to understand your options:

• What are the surgical or procedural options?
• What is the least invasive option?
• How often is the least invasive method used by you? By other surgeons?
• What will happen if the surgery or procedure is not performed?
• Will I need to stay in the hospital for recovery? Under what circumstances? If so, for how long?
• Will local or general anesthesia be required? Are there options?
  • For general anesthesia, will a board-certified anesthesiology doctor be giving and monitoring the anesthesia?
• How long will the procedure take? Who will update my family?

What outcome can you expect?

Before you consult with a surgeon, you can use the Surgical Risk Calculator (created by American College of Surgeons National Surgical Quality Improvement Program) to determine your relative risk of a surgical procedure. After you can enter your age, sex, weight, chronic and acute health issues, and other pertinent factors, you will receive a statistical assessment of your chance of success as well as any possible downsides.

Then you can use this information when making decisions about your surgical plan with prospective surgeons.

Because not all surgeons have the same results, it’s a good idea to learn about expected outcomes for each surgeon you consider. And realize no matter what you hear, there are no guarantees in medicine.

Ask prospective surgeons:

• What are the expected outcomes?
• What do you consider a successful outcome?
• What’s your success rate?
• What are all the possible risks and complications for my situation? Do the risks decrease with a less invasive option?
• What kinds of complications have you experienced with similar patients?

How experienced is the surgeon?

It’s not only about how many years the surgeon has worked. The number of times a surgeon has performed the procedure you need is critical. In general, it’s best to use a surgeon who has performed your procedure hundreds of times.

However, If you have a rare condition, it will likely be impossible to find a surgeon who has performed hundreds of the procedures you need. In these situations, try to find a surgeon who has at least some experience with your condition and procedure.

Ask prospective surgeons:

• Are you Board Certified in Surgery?
• Do you have a F.A.C.S. (Fellows of the American College of Surgeons) designation?
• How many of these surgeries or procedures of this kind have you performed? How often do you perform this procedure?
• What kind of training did you receive in this procedure?

Additionally, visit the Zaggo Resource center to find websites where you can learn of a doctor’s credentials, as well as any previous judgments, complaints or restrictions.

Will your surgeon perform your entire procedure?

When you choose a surgeon, it’s easy to assume he/she will be performing the actual procedure. However, that is not always the case. Instead, other doctors, including those still in training, may perform all or part of your procedure. This scenario can occur for training purposes in teaching hospitals, or when doctors schedule more than one procedure at a time.

Training doctors at teaching hospitals.

Certainly, new doctors must learn the ropes by participating in procedures under the guidance of a more senior surgeon. Although it can seem scary to think about a less experienced surgeon operating on you, the close supervision of residents makes this practice relatively safe for patients.

Importantly, research suggests that while operations tend to be slightly longer when trainees take part, they are generally equally successful, with no significant impact on surgical outcomes.

For instance, a 2011 study investigated 600,000+ surgeries performed at 234 US hospitals between 2006 and 2009. The surgical complication rates were slightly higher in hospitals where residents participated in the procedures, but mortality rates were slightly lower when residents were involved.

Interestingly, experts believe many surgeons at teaching hospitals – perhaps even most – do not tell their patients when trainees will be performing part, or even most, of the procedure.

But, you have the right to know who will perform your procedure – so ask!

Surgeons may schedule simultaneous procedures.

In some cases, particularly in teaching hospitals, surgeons simultaneously work on 2 or 3 patients, going between operating rooms? There are two categories for this practice:

• Overlapping – In most overlapping cases, the patient is prepped before the surgeon arrives, the surgeon performs the procedure, and then leaves the “closing” to a trainee or other staff, with a brief overlap at the start and end of cases. However, in some overlapping surgeries, the primary attending surgeon leaves to perform a second procedure before finishing the key or critical elements of the first procedure. When this happens, the primary surgeon should immediately assign another attending surgeon to finish the first procedure.
• Simultaneous or Concurrent – More concerning, a surgeon schedules 2 or 3 surgeries to occur simultaneously, working on patients in one operating room, while patients in the other room either wait while anesthetized or have procedures performed by residents (doctors still in training). The American College of Surgeons considers this practice inappropriate. Simply put, it should never occur.

Importantly, the American College of Surgeons “Statements on Principles” requires surgeons to notify patients if they will perform overlapping procedures. However, doctors are not legally required to report overlapping surgeries. Therefore, you should ask about this issue.

Ask prospective surgeons:

• Will my surgery be double booked? Or, will you leave my surgery before it is completely finished?
  • If so, who else will be operating on me?
  • What tasks will you perform and what tasks will the other doctor(s) perform?
  • What training and experience do the other doctors have?

For more information on this potentially dangerous practice, read Surgical Dangers – What You Need to Know.

Are you having a device implanted?

Will your operation include the implantation of a medical device, such as an artificial hip or knee or a cardiovascular implant? Surprisingly, medical devices can involve serious health risks.

If your surgery will involve implanting a medical device, ask your prospective surgeon these questions:

• Are there any steps you can take to avoid the device? Will a change in diet or exercise lead to ample improvements? Will physical therapy help? Other medical procedures?
• What kind of training did you receive for this device?
  • Did you watch videos?
  • Attend a training session led by the manufacturer?
  • Participate in surgeries led by more experienced surgeons? How many?
  • Other training?
• How many operations have you performed using this exact device in your career? How many in the past year? What were the outcomes for these patients?
• How long has the device been on the market? Importantly, new doesn’t always mean better. “New” means less time in use, which can lead to less thorough outcome results as compared to older devices. And don’t assume that all devices in a particular category are equally safe and/or effective.
• Have there been clinical trials for this specific device? If so, what did the results show?
• Is it possible to have the device removed if a problem arises?
• Will a medical device sales rep be present during my procedure? If so, what role will he/she play?

To learn more about medical device safety, read How safe are medical devices?.

Where will the operation take place?

Where you have the operation is almost as important as which surgeon you choose. Some hospitals have better safety records than others.

It’s important to note that there are serious safety concerns related to procedures at freestanding surgery centers. Therefore, before you schedule a procedure for a freestanding, non-hospital location, I urge you to read How Safe Are Surgery Centers?

Note: You can research prospective hospitals on the websites listed in the Zaggo resource center – but realize there are limitations with this data.

Ask these questions before scheduling an operation:

• Where will the surgery take place?
• Is the hospital accredited by the Joint Commission, a sign of a “gold standard”?  (Look up your hospital here.)
• How often do surgeons perform your particular procedure at this hospital?
• If I will be hospitalized after the surgery, will I be placed on a floor that specializes in my condition? How can you assure that will happen?
• If the surgery will take place in an outpatient (non-hospital) surgical center:
  • Is it accredited by the Joint Commission?
  • What is the emergency plan if something goes wrong?
  • How close is the nearest hospital?

Questions to ask before surgery relating to safety concerns.

All medical procedures, including surgeries, carry risks. Find out what steps your surgeon and hospital take to reduce the risk of issues during and after a surgery.

In addition to what you’ve learned from the questions above, ask these questions:

• Does the hospital enforce the use of surgical checklists?
• What hand hygiene and other infection control programs are in place?
• How does the hospital minimize the risk of hospital acquired infections, such as sepsis and MRSA?
• What are the infection rates for this procedure for you and for this hospital/surgical center?

Should you change your lifestyle before the operation?

Following your doctor’s pre-surgery advice will help you succeed. Ask the questions below, and follow the guidelines given. However, it’s important to be honest with your doctor. If the surgeon tells you to do something (like quit smoking) that you think you cannot achieve, tell him/her immediately.

Ask these questions:

• What can I do to help get the best result?
• Should I make changes in medications, diet, exercise and/or lifestyle (e.g., stop smoking or drinking alcohol) before the surgery? For how long?
• Should I donate blood for myself before the surgery?

Should you go to the dentist before your procedure?

In some situations, patients should have thorough dental exams before surgery to make sure there are no abscesses, infections or gum disease. Why? Because dental infections can cause bacteria in the bloodstream which in turn can cause bacteria in surgical areas.

This is particularly important for heart procedures, joint replacements, and organ or stem cell transplants. Furthermore, recent research showed that patients who had dental work before cancer surgeries were less likely to develop pneumonia after surgery and less likely to die within 30 days after surgery.

However, researchers also found risks associated with dental work too close to surgery, particularly for patients with heart conditions.

Talk to your surgeon and your dentist about the need for a dental examination and/or dental work before or after surgery.

Questions to ask before surgery about post-surgical expectations.

Knowing what to expect after your surgery will help your recovery go more smoothly.

Ask these questions so you can plan accordingly:

• Who will oversee my care after the surgery?
• Will I need to go to rehab facility? If so, for how long? What type of facility?
• What types of further treatment will I need after the surgery or procedure?
• Will I need antibiotics after the surgery? Are they necessary or a precaution?
• What changes will I need to make in medication, diet, exercise and/or lifestyle after the surgery? For how long?
• Will it be necessary to miss work? For how long?
• How much help with daily living activities (e.g., bathroom, eating, and dressing) will I need? For how long?
• Do I need any special equipment at our home for the recovery period? If yes:
  • How do I get it?
  • For how long?
  • How will I learn how to use it?
• How long until full activities can be resumed?

Learn more!

Surgery is a big deal. Your life might be at stake. In addition to using our questions to ask before surgery, educating yourself will help you get the best outcome possible. For more information and tips related to surgery, read these posts:

• You Can Improve Your Surgical Outcome.
• How to Recover Faster After Surgery.
• Surgical Dangers – What You Need to Know.
• What is the Best Time of Day for Medical Care?
• Questions Seniors Should Ask Before Surgery.

NOTE: I updated this post on 3-23-23.