Being a Patient - things to ask

 When we buy a car we spend a lot of time looking for the car that suits us, we then look for the best manufacturer and dealer. We might want a sharp, sporty model or family wagon, but we always look for a reliable car that has good dealer support. The same applies to any other important purchase we undertake. Do we apply the same when choosing a surgeon or therapist?

More and more people are doing so these days. Patients realise that when it comes to getting the information they need, and when making good decisions based on that information the responsibility falls squarely on their shoulders.

Some people find it more comforting to rely on their doctors and therapists to know whats best. But it's your body and your health. The issues are rarely so clear cut that an "objective" professional can make the choice for you. Surgeons can supply you with all the technical information and statistics, but only you can make the judgements about what you really want.

Expectations can drive outcomes, and sometimes patients are expecting an "as good as new" result. However, realistically "better than before" is all that can be expected.
The techical outcome, as your doctor sees it, such as how your shoulder moves and how strong it is, does not neccessarily correlate with your functional improvement as you see it. The result: happy surgeon, unhappy patient.
It is important that your surgeon understands exactly what you expect from the treatment and you understand exactly what they can achieve. Not all doctors are good at spelling these things out up front and you need to persist until everything is clear.

Patients are often nervous and hearing the word "surgery" add an additional level of stress. It is therefore difficult to absorb and recall everything discussed at the consultation.
Here are a few questions that patients often want to know, but don't always ask:

  •  Is this a pain I can live with, or am I going to harm myself further if I don't get it fixed?
  • Is the procedure necessary, or is it advisable?
  • Are there other alternatives to surgery?
  • How much will it improve me - a little or a lot? Ask for a percentage.
  • Can it wait, what will happen if I do wait?
  • What is the recovery time?
  • How long will I be off work? How long will I be off sports and leisure activities?
  • How much physiotherapy will I need afterwards?
  • Are there regional variations in techniques? How often is this procedure done?
  • Is this really the best surgeon for the job?
  • How many procedures does he/she do per year?
  • What is his/her results? Does he/she know, and how? 
  • What are the potential complications? How common are they?

It is unlikely you will recall everything discussed with your doctor. Your doctor might give you some additional reading and reference material. If not, ask for some. If you still have questions afterwards don't be afraid to contact your surgeon and ask. It is often helpful to write your questions down beforehand.

When choosing your surgeon for a particular procedure, you should know that the best results are associated with the doctors and hospitals that do that procedure every day, week after week. This means that you will probably look for shoulder & elbow specialist. The same applies to your physiotherapist. Shoulderdoc keeps a directory of therapists with an interest in the shoulder and elbow.

Your surgeon may be able to put your body back together, but your final outcome also depends on you. After your surgery you will need to follow the rehabilitation programme strictly. Doing the exercises might seem boring and it might be difficult to allocate time to do them, however you cannot achieve the best results without them.

Shoulder and elbow surgery is advancing rapidly and outcomes improving all the time. With more procedures done through smaller incisions and via the arthroscope complications are much less and recovery rates quicker with greater likelihood of returning to a full active lifestyle. You are an integral player in your healthcare team, and if you participate in your own care, things go better.

Ask questions, discuss your expectations, look for information and you will be on the road to recovery.   

 L Funk, 2005 - Based on the book: Framework by Nicholas A. DiNuble, MD. 

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