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Doctors & Hospitals
by Carolyn M. Clancy, M.D., A.H.R.Q., AARP Bulletin, April 7, 2010
If you need surgery, there’s a better-than-average chance that you’ll have it and go home the same day. That’s good news for several reasons, but same-day surgery does require some planning on your part.
Thanks to advances in technology and anesthesia, nearly six of every 10 surgeries performed at hospitals are done as outpatient procedures, which means you go home the same day you have your surgery. Almost 35 million such surgeries are performed each year in the United States.
For example, most eye and ear surgeries are performed as same-day surgeries, and so are some skin procedures. In some cases, you can have your gallbladder removed at 7 a.m. and be home by noon. Many of these surgeries are done at surgery centers or in doctors’ offices.
This shift to same-day surgery can result in lower costs. For some patients, same-day surgery is more convenient and safer than staying in the hospital. But no surgery is risk-free. Same-day surgery means that you, or the people who help take care of you, may have to change your bandages or manage your pain medicines.
There are several steps you can take to increase your chances for a successful surgery. My agency, the Agency for Healthcare Research and Quality (AHRQ), offers a free guide, “Having Surgery? What You Need to Know,” that provides advice and resources to help you prepare for surgery.
Some surgeries must be done right away. But many are not urgent, which means you have time to talk with your doctor and decide what course is best for you. Before your surgery, you should:
• Ask questions. Do I need this surgery? Is there some other way to treat my condition? What are the benefits if I have this surgery? What are the risks or side effects? What will happen if I don’t have the surgery? My agency has an online tool to help you create a list of questions.
• Learn about the surgery and its possible benefits and risks. The first step in learning about your surgery is asking questions. The next step is finding trusted sources of medical information at your library or on the Internet, including Healthfinder. You may also benefit from a growing area of research that compares different treatments for your condition. This is called comparative effectiveness research, and it is designed to help patients make good decisions. For example, it can help you learn about the pros and cons of certain types of surgery.
• Check the qualifications of any facility you’re considering. Call your health plan or visit the facility to find out:
1. Whether your health plan will cover your care there.
2. Whether it is licensed. Also check to see whether the facility is accredited by either the Joint Commission or the Accreditation Association for Ambulatory Health Care. The accreditation certificate should be posted in the facility.
3. How well-trained and experienced the facility’s health care professionals are.
4. Whether the facility is affiliated with a hospital. If it is not, find out how the facility will handle an emergency that might happen during your visit.
If you decide surgery is right for you, take the following steps to improve your chances of a successful surgery and full recovery:
• Make sure your surgeon, other doctors and nurses know about the prescription medicines, supplements and over-the-counter medications you take and any allergies you have. Bring a list of your medicines with you to your visits before the operation and on the day of your surgery. Once you’re home, make sure you understand what medicines you are—or aren’t—supposed to take and for how long. Do not assume that if you have already answered the questions once that the information has been shared with all members of your health care team.
• Ask about potential complications with your surgery. It’s important to know what to look for and whom to call if problems arise. In addition, ask whether you should schedule follow-up appointments—such as physical therapy—before surgery.
Research shows that patients who ask questions and are informed about their surgeries typically work better with their doctors in making the best decisions about their care. Being prepared before having surgery will help ensure that you have a smooth recovery.
I’m Dr. Carolyn Clancy, and that’s my advice on how to navigate the health care system.
Carolyn M. Clancy, a general internist and researcher, is an expert in engaging consumers in their health care. She is the director of the U.S. Agency for Healthcare Research and Quality.
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