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How To Choose A Surgeon

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All surgery has the potential for lifethreatening complications.

In order to choose a surgeon with the best chance of a positive surgical result, it is advisable to take the following steps (If you are considering surgery for colorectal cancer, click here):

Step 1: Create a list of possible surgeons who accept your insurance if you have health insurance. If you do not have insurance, choose one you can afford.  Also check to see if you qualify for Medicaid. For additional tips for paying for surgery, see, Uninsured. 

Step 2: Ideally, look for a doctor who:

  • Is board certified. If the surgery in question is a sub-specialty, the certification should be in the sub-specialty. For information about board certification, click here.
  • Operates regularly, has performed the procedure a lot in the past few years, and particularly in the past month, on people like you (such as people of your age and/or with your medical situation.) To accomplish these goals, you can start by looking at https://data.cms.gov offsite linkwhich will show you how many time a doctor did a particular service as well as his or her average charges. (Click on "Medicare Physician and Other Supplier Look-Up Tool to find the doctor.) Then consider asking the surgeon you are thinking of using::
    • About the number of times he or she has performed this surgery in the past year (including the last month), his or her recent record of success and complications with this procedure. There is no magic number to look for. For a complicated, rare procedure, 4 or 5 times in a year may be a lot. For a more common procedure, the number may be hundreds a year. Your primary care doctor can give you guidance in this area.
    • How often the doctor has performed the procedure on people like you. For instance, people of your age.
    • How often the doctor has performed the procedure on people with your medical situation. For example, if you have diabetes, the condition may increase the risks when undergoing certain surgical procedures.
    • If it is more comfortable for you, you can discuss the topic of the surgeons' qualifications with your regular or primary care doctor.
  • Has a high success rate with respect to this operation.
    • The areas to consider are success rate and complication rate. The better the success rate, the more likely your procedure will have a successful outcome.
      • The complication rate shows the percentage of complications the doctor has had relating to performing the particular operation.
      • In both cases, you will have to rely on the doctor's truthfulness.
    • ProPublica and Consumers' Checkbook both have websites where they rate surgeons and provide this information for a variety of common surgeries based on Medicare data. Both sites take into account that some doctors take on sicker or more frail patients.
      • ProPublica offsite link - look for the directory of local hospitals, the procedure in which you are interested, and the surgeon that performs it. 
      • Consumers' Checkbook: see SurgeonRatings.org. offsite link
  • Has not been subject to propfessional reprimands.
    • You can check for medical malpractice claims through your state medical board.  You can find a link to your state website  through the Federation of State Medical Boards: www.fsmb.org/policy/contacts offsite link
  • Keeps up-to-date on the latest procedures and alternatives, particularly if it has been a while since the surgeon left medical school. 
    • Some doctors do not want to work past their comfort zone. There may be new ways of performing a procedure that are more successful and less difficult for the patient. There may be new alternatives.
    • In addition to asking whether a doctor keeps to date, you can also ask how.
  • Works with a reputable hospital that has a low infection rate and good back-up in other specialties if something goes wrong.
    • For starters, the facility should be one which is accredited. Accreditation means that the hospital or surgical center is committed to providing high quality health care and that it has demonstrated commitment to meeting high patient safety standards. 
    • Hospitals are accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAH0). You can find out if a hospital is JCAHO accredited at www.qualitycheck.org offsite link
    • Surgical centers are accredited by the Accreditation Association for Ambulatory Health Care (AAAH) and JCAHO. You can find out if a center is AAAH accredited at www.aaahc.org/eweb/StartPage.aspx offsite link.  Click on the heading "Search for Accredited Organizations."
      • With respect to cancer operations, Cancer Treatment Centers are approved by the Commission on Cancer (CoC). You can find an approved cancer center by going to www.facs.org/cancerprogram/howto.html offsite link. Look for: "Find a CoC Cancer Program Near You."
    • Ideally, look for a facility:
      • In which the procedure is performed a lot, and with a good success rate. The hospital or other facility can tell you their experience.
      • There is a low infection rate. Infections found in hospitals can be drug resistant and very dangerous.
      • In which there are specialists in a wide variety of areas in case something goes wrong during the surgery.

Step 3: Interview the doctor to be sure you are comfortable with him or her.

  • Ask the questions described in Questions To Ask Before Surgery
  • Be sure that you understand the answers. If you do not, ask the doctor to repeat them in words you can understand, or draw you a diagram. To be sure you understand, repeat your understanding to the doctor.

Step 4: Check to see if the doctor has been the subject of complaints or disciplinary actions. It's not easy to check a doctor's record because the great majority of states do not publish this information. However, there are some available sources. To learn more, see: Has A Doctor Been Subjected To Disciplinary Action?

NOTE:

  • For most procedures, a surgeon's age is not an important predictor of operative risk. For some complex procedure, surgeons older than 60 years, particularly those with low procedure volumes, do have higher operative mortality rates than their younger counterparts.
  • If additional aspects are important to you, such as a doctor's bedside manner, review Choosing A Specialist .
  • If you need advice about which of a few candidates to choose, speak with your primary care doctor. Ask him or her who he or she would recommend to his or her child or other loved one.

Before agreeing to a treatment, ask all questions of concern to you. For a list of suggested questions, see:


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