Be prepared for wide range of patient questions

Patients more aware of credentials, experience

Ask questions. These words of advice are offered to patients, especially surgical patients, by accreditation organizations, medical societies, health care institutions, and individual physicians.

Web sites, brochures, and checklists offer suggestions about what patients should ask. The questions range from credentials, to experience, and to specific information about the proposed procedure. Add this information to the thousands of hits you get when you search for information on surgical procedures, and surgeons and surgery center staff must prepare for a wide range of questions, says experts interviewed by Same-Day Surgery.

"Today's patients are more educated about their procedures and the importance of credentials," says Sam Speron, MD, FACS, CEO of Park Ridge (IL) Center for Plastic Surgery. More questions lead to better communication, and this is good for surgeons and patients because it gives the surgeon the opportunity to make sure that patients understand the procedure and the potential outcome, he says. "Some people do not have realistic expectations for plastic surgery and it is better to be able to discuss expectations up front," Speron says. "Patients who have had their questions answered and who fully understand the procedure and what to expect after the surgery are generally more satisfied than patients who didn't get all of the information they needed."

Patients who are shopping for a plastic surgeon can find a list of questions they should ask any surgeon on Speron's web site. It is important to offer information and prompt questions when patients are looking for physicians, he says. "Patients don't ask me directly about my credentials or the accreditation of my facility, but they've usually visited my web site first, and all of the information is available on the site," he explains. "My staff and I also volunteer information about my credentials and accreditation of our facility."

Because many plastic surgery procedures are elective and may not qualify for reimbursement by the patient's insurance plan, patients shop around for surgeons and compare prices. "I encourage patients to ask about credentials and accreditation because they need to make sure that the physician and the facility staff is qualified to perform their procedure before they compare prices," Speron says. "It is a safety issue."

Allow time for questions

During the patient's initial consultation, Speron encourages the patient to "ask anything," he says.

"A consultation can last 30-45 minutes, with 10 minutes or more devoted to answering the patient's questions," Speron adds.

Even if the patient doesn't initially have questions, Speron asks open-ended questions about the patient's reason for seeking plastic surgery, takes a detailed history, and discusses options. Once he has finished that part of the consultation, the patient usually has some questions, he adds. "I never schedule patients for surgery immediately after the first visit," Speron explains. "I encourage them to go home and think about it, and contact me with questions before making their decision."

Although some physicians are reluctant to volunteer information about their credentials or accreditation of the facility in which they perform the surgery, it is in the best interest of everyone to make sure patients are well educated, says Speron. Make sure that staff members are prepared to answer questions as well, he suggests. "We make sure that all employees know how to answer questions that a patient may believe are too personal to ask the physician, such as training and experience, but we also teach staff members not to overstep the boundaries of their knowledge," he adds. "Although all members of my staff want to be helpful, they know that it is OK to say that they need to ask someone else for information and get right back to the patient."

Although most patient education begins in the physician's office, surgery center staff should not assume that patients have had all of their questions answered, points out Emilie M. Keene, MHA, interim administrator of the Columbia, SC-based Parkridge Surgery Center. "Our pre-op nurse calls patients two to three days prior to their procedure to confirm the day and time as well as the type of procedure," she says. "The nurse also describes our facility, our experience, and what they can expect during the day of their surgery."

Some patients have researched their procedure using less than accurate sites, so the nurse might have to answer some off-the-wall questions to reduce the patient's anxiety and provide accurate information, says Keene. "Luckily, we have a kindhearted pre-op nurse who is a very good listener as well as an experienced nurse," she adds.

Shonda Huggins, RN, BSN, the staff nurse at Parkridge who handles the pre-op calls, answers quite a few of questions about anesthesia. "Many people assume that arthroscopy is such a simple outpatient procedure that the only anesthesia needed is a local," she says. "I have to make sure they understand that they will need more than a local and that they understand that this is still surgery, even if we're not making a lengthy incision."

One of the most surprising questions came from a patient who had read a newspaper article about a case in Florida in which an outpatient undergoing plastic surgery died from malignant hyperthermia, says Huggins. "He asked if we had the medications needed to treat this condition in our operating rooms," she recalls. The patient was reassured to hear that the staff were prepared with the medications and the training needed to treat the condition, Huggins explains. "Even though he understood that this is not a common condition, he wanted to make sure we were equipped to handle any emergency during his surgery," she says.

Sources/Resources

For more information about handling patients' questions, contact:

  • Emilie M. Keene, MHA, Interim Administrator, Parkridge Surgery Center, Columbia, SC. Telephone: (803) 407-4940. Fax: (803) 407-4955. E-mail: emilie.keene@palmettohealth.org.
  • Sam Speron, MD, FACS, Chief Executive Officer, Park Ridge Center for Plastic Surgery, Park Ridge, IL. Telephone: (847) 696-9900. Fax: (847) 696-9913. E-mail: prplastic@yahoo.com. Web: www.drsperonplasticsurgery.com.

For materials and information that can encourage and guide patients' questions, contact:

  • The Joint Commission. The Joint Commission's Speak Up program publicizes the importance of patients taking an active role in their health care. For brochures and other materials that can be used to prompt patients' questions, go to www.jointcommission.org and select "Patient Safety" from the top navigational bar. Choose "Speak Up" to see materials available and find link to the Joint Commission Resources store to order materials. There is a charge for buttons and posters, but Speak Up brochures can be downloaded from the Speak Up page at no charge.
  • The Agency for Healthcare Research and Quality offers a free brochure titled Having Surgery? What You Need to Know. To find the brochure and a checklist of questions, go to www.ahrq.gov. Under the "Consumers and Patients" heading, select "Surgery."