How do you choose a surgeon?

Recent progress in surgical medicine means patients now often have much greater choice. Because of this, your doctor may invite you to be involved in choosing your surgeon. Your choice can determine the way your surgery is done and how quickly you recover, so it is worthwhile taking the time to get all the information you need.

Factors to consider

When choosing a surgeon, there are several things to consider, the most important being the advice of your doctor. Your doctor can advise you whether it is possible to have your surgery done in a public hospital (free of charge for New Zealand residents).

Your doctor will also indicate that the surgery can be done privately where you (or your medical insurer) will pay for it: the surgeon will explain any medical insurance rebates available to you.

Factors your doctor will consider before making this recommendation are the type of operation you need, your age, general health, what support is available to you, whether you are employed, the type of work you do and your level of income and the waiting time for surgery.

A surgeon has trained in general and maybe specialist surgery for six to eight years after qualifying as a doctor. Different surgeons usually deal only with certain parts of the body and have special names to identify their area of expertise. An orthopaedic (bones and joints) surgeon will not take out your appendix. That’s done by a ‘general surgeon’ who deals with the abdomen, thyroid glands, varicose veins, etc.

Surgery at a public hospital

If you and your doctor decide you need to visit a public hospital for surgery you will be sent to a hospital clinic and allocated a surgical team that will consist of a surgeon, heading the team, and one or two senior doctors training to be surgeons. You are unlikely to be able to choose your surgeon or the exact date or time of your operation.

The hospital surgical team is well qualified, in fact many surgeons work both in hospitals and in private clinics, so the level of expertise should be equal.

Going private

If you decide to have your surgery done privately, you and your doctor can choose the best surgeon for your needs.

Important things to ask surgeons (private or public)

• what type of surgery do they perform?
• what specialist surgical training and how much experience do they have? (Surgeons who frequently perform your type of surgery may give better results.)
• what results have they had with patients like you - how much pain or recovery time should you expect?
• who do they work with (anaesthetists, nurses, physiotherapists, etc.) and what is their experience?
• where are they located and what costs are involved - will any insurance you have cover all or some of this?
• care after the operation - what follow up is offered?

Do not hesitate to ask a surgeon such questions. A confident surgeon with good results is proud of his or her work and will be pleased to discuss it with you. If you are still unsure, it is quite acceptable to approach another surgeon; your doctor can arrange this.

Types of surgery

Open (traditional) surgery
The skin and muscles are cut and pulled back to gain access to the affected body part. The size and place of the cut vary depending on the operation.

Laparoscopic (keyhole) surgery
A tiny (1cm) camera on a long, thin rod (laparoscope) is inserted into the body through a small cut. The surgeon then passes the ends of long, thin instruments through other small cuts and performs the operation from the outside, using the video images shown on a TV screen for guidance. A laparoscopic surgeon can work in any surgical field but training in laparoscopic technique is essential.

Original material provided by UBM Medica (NZ) Ltd. Reviewed in January 2002 by Robert J Fris.