Healthcare Advocate: Protecting a Loved One Before Surgery

Being a healthcare advocate for a loved one before surgery is an important job. Some surgeries are planned, and in that case, there is time to research ahead of time.  The patient and their healthcare advocate deserve to be well-informed about the procedure to secure the best possible outcome.  Advocating after surgery is just as important, but that’s a topic for another time.  This blog discusses the process of selecting a surgeon and pre-op preparedness.

Before Surgery:  Most often another physician has referred the patient to a surgeon who specializes in the type of procedure needed.  Research the surgeon.  Your loved one is a customer of the healthcare system and has the right to select a surgeon of their choice.  Review the surgeon’s medical training and professional history.  Check their state credentials and certifications.  Read reviews and ask others to share their experiences about the surgeon.  

Identify the hospitals where the surgeon has privileges and ask your loved one if they are comfortable with those hospitals.  Teaching hospitals are excellent, but not everyone likes the large number of students in their care team.   Healthcare advocates can check also look at the Centers for Medicare & Medicaid Services to compare physicians and hospitals. 

Attend the initial surgical consultation as your loved one’s healthcare advocate. You can gather a lot of information during this appointment.  Everything from the surgeon’s bedside manner to their skill set.  Ask questions.  A lot of questions. Surgeons who have a compassionate approach to care and who are confident in their abilities won’t mind the entourage of questioning.  They will be interested in developing a relationship of trust and comfortability with their patients.  There is no harm having a second consultation with another surgeon to be sure you have secured the right one.

As a healthcare advocate, here are questions to ask during the initial consultation:

Has the surgeon reviewed the patient’s medical history and any test results that led to the reason for surgery (CT scan, MRI, biopsies, etc.)?

What does the surgery involve?  Is it performed under general anesthesia, local anesthesia or something else?  Ask for as much detail you are interested in receiving.  You can ask general questions such as the length of the surgery or you can ask about the clinical details about how the procedure will be performed.

What are the benefits and risks of the surgery?  Do the benefits outweigh the risks?

What are the possible adverse effects? What is the most common possible complication?

What is the expected length of stay (is the procedure inpatient or outpatient)?

What is the expected recovery time? 

What precautions or restrictions are needed after the surgery? 

Is post-surgical treatment needed (physical therapy, skilled nursing, wound care, etc.)?

What pre-op work is needed (lab studies, EKG, physical, etc.)? 

How many times has the surgeon performed this surgery?  Do they consider themselves an expert in the procedure?

Is the surgeon actually performing the surgery or is a resident?  Do they have a second surgeon in the operating room during the procedure?  

Prior to Surgery:  

If pre-op lab studies or other testing is needed, be sure the results have been reviewed by the surgeon, and they have confirmed them to be within normal limits, making surgery safe.

Obtain clear pre-op instructions.  Does any medication need to be held for a number of days before surgery? When is the last time the patient can eat or drink before surgery?  What medication should be taken or not taken the morning of surgery?  Can medication be taken with a small sip of water?  Are there any special preparations for surgery?  What time should the patient arrive for surgery?  Confirm the address for surgery. What personal items should the patient bring along?  Ask about care partner policies and COVID restrictions for visitors.  

Day of Surgery:  

Accompany your loved one as their healthcare advocate.  Assist with the check-in process and review documents to be signed. Your loved one may be nervous and not able to fully concentrate on these details so having another person verify the information is helpful.

Be at the bedside before surgery to speak with the nurse, the anesthesiologist, and the surgeon.  Ask questions. Review the procedure to be performed.  If a particular site is being operated on, watch the surgeon mark the body.  Ask again about benefits and risks.  Make sure the patient’s prior surgical and medical history has been reviewed by everyone on the surgical team.  They should verify what medication has been taken on the day of surgery.  The team should ask about any allergies to medications or adverse effects to anesthesia.  Ask how updates during the surgery will be relayed to you.  How often will you receive those updates?  How long should the surgery take? 

Any surgery can be worrisome for the patient and their loved ones.  Being a well-informed healthcare advocate allows you to offer support during a stressful time and having the details of what to expect ahead of time reduces the fear of the unknown for everyone.  Everyone should have a healthcare advocate and your loved one will thank you for all of your efforts if they have chosen you for the role.