Become an Informed Healthcare Consumer

Purchasing a new or used car normally involves advance research on make, model, performance history, mileage, and resale value. We examine color options and accessories, visit showrooms or car lots, review consumer reports on the vehicle type, and peruse online feedback about the dealer or vehicle we’re considering. By the time we sit down with a salesperson, we’re reasonably well informed, know what we want, have figured out how we’re going to pay for it, and are ready to make a deal and write a check.

Now compare that process to preparing for surgery. Typically, patients listen to their physician’s advice, see the specialists he or she refers them to, complete any required pre-surgical preparation such as drawing blood, fasting or stopping certain medications, and then have their surgery. The more curious among us might do some research online at a variety of websites to learn more about our procedure, options or recovery tips. But most patients still rely primarily on information their doctor gives them, verbally or in print, and get advice from neighbors, family and work associates.

Apparently, we’re a relatively trusting lot when it comes to surgery. But when you consider the potential outcomes, costs, risks and long-term consequences, don’t you wonder why we are so much better informed and prepared to buy a car then to go under the knife?

Approximately 51 million Americans have elective or emergency surgical procedures performed in hospitals, outpatient surgical centers or their physician’s offices annually. That’s everything from cataracts and colonoscopies to angioplasty, caesarean sections, hysterectomies, knee and hip replacement, tissue removal and you name it . . . if you have a part that isn’t working properly, it can likely be removed, subdued, or improved!

But the psychology of obtaining surgery differs greatly from auto purchases, and three primary factors – trust, perceived boundaries and a lack of reliable, useful information – hinder our ability to be informed and properly engaged.

First, trust. We have confidence in our physician and the specialists, hospitals or clinical settings he or she sends us to. Typically that’s been established over years of visits and care, or is limited by cost or type of insurance. If our regular doc sends us to a specialist he or she knows and trusts, that’s good enough for us. And with the labyrinth of insurance issues our provider helps manage prior to a surgical procedure, we’re happy to leave it all in their hands and be compliant.

Second, boundaries. They’re the experts with years of medical school and training, we’re the patients. Many healthcare consumers lack the medical knowledge and chutzpah to ask tough, insightful or truly probing questions. We don’t want to be perceived as troublesome, annoying patients, or risk insulting our physicians with stupid, anxious or paranoid questions. It’s bad enough when an electrician or plumber treats us as though we’re an inconvenience – why risk feeling that way with a physician when your life is going to be in his or her hands?

And finally, there’s the lack of reliable, useful information. When it comes to specifics on doctors and hospitals, there simply isn’t much available data when it comes to quality, outcomes and performance histories. Hospital and medical rating systems managed by private, State and federal agencies exist for measuring provider and hospital performance, but they keep this information close to the vest. The data is used for addressing safety and medical errors, and for determining how the government reimburses hospitals and physicians, but it isn’t public knowledge.

This conspiracy of silence is endemic to the industry, and is driven, in part, by litigation and malpractice fears. There have been efforts to try and capture and publish some related metrics – items such as infection rates, “avoidable” readmissions to hospitals within 30 days, surgical errors – but this information is tightly guarded, and difficult if not impossible to access. Some government healthcare programs, like Medicare, make certain information available on specific procedures, but it’s not easy for the layperson to find or understand. And there aren’t any simple-to-understand, straightforward websites or annual reporting mechanisms available to consumers.

So what can you do to be a better medical consumer? Ask smart, direct questions, and do some research prior to meeting with the physician. Here are some examples of questions to ask before surgery:

  • How many times and how often have you done this procedure? This is important because high-volume practitioners have more experience and may be better able to deal with unexpected problems or emergencies.
  • How experienced is the team you will work with at the hospital or clinic? Chemistry and longevity in the operating room is an important variable, and good communication among surgical team members enhances outcomes.
  • Can the facility you’re considering for surgery handle unexpected complications? For example, if you experience a heart problem during surgery, does the facility have the staff onsite necessary to address this complication? Does the facility have a trauma center for adults or infants, or more comprehensive diagnostic imaging tools?
  • What are the potential side effects or outcomes?
  • What can I do to limit or control potential side effects, or to hasten recovery?
  • What are the exact costs or co-payments for this surgery? It’s important to understand exactly what the insurance provider, if you’re covered, will pay for and what you will be expected to contribute for your care.
  • Where can I get more information on this procedure? Ask the physician for specific web addresses or other sources of information that may be helpful.
  • Can this be done through less-invasive surgery, such as laparoscopy or robotics? Physicians practicing at some smaller hospitals may lack the experience for minimally invasive procedures, or the hospital may not be able to afford certain types of surgical tools and expensive equipment. The difference in recovery time, pain and potential complications can be significant, so it’s worth inquiring about before you proceed.
  • What will I require for post-surgical care? This may include physical rehabilitation, a short-term stay in a step-down unit, a variety of follow-up visits, home care assistance, medications and a comprehensive list of foods or activities to limit or avoid.
  • What forms and releases will I be expected to complete at the hospital or surgical center? Even though your physician will have you complete pre-surgical paperwork, most facilities ask you or your guardian to sign a variety of releases immediately prior to the procedure, often when you’re at your height of pre-surgical anxiety, and distracted. Asking in advance may help you pose intelligent questions and not feel pressured.

If your provider balks at these questions or offers ambiguous or evasive answers, you might consider another physician. Remember, you don’t want to be thinking about these issues as you’re lying on the gurney being rolled into surgery, and hindsight is always 20/20! The better you’re prepared and engaged in your care in advance, the better the experience for you and your medical team. It’s not just about competence – it’s about being an informed consumer, and making sure you know what you’re buying.

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Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!