What's a Successful Surgery?

Hospital for Special Surgery Survey Shows Patients' & Doctors' Expectations Differ

New York, NY—February 20, 2003

Patients and their doctors often differ on what constitutes a successful surgery, according to a recent survey at Hospital for Special Surgery. To insure that patients are satisfied with their surgical results, doctors at HSS recently surveyed 100 patients coming in for shoulder repair about their expectations. After reviewing the results, doctors realized what they define as successful surgery may not match their patients’ expectations. Since pain relief seems like the obvious goal, doctors tend to assume they know what their patients want. However, the study found that while pain relief is an important goal, it is not the only one that patients use to measure the success of their surgeries. The study, which appeared in the Journal of Shoulder and Elbow Surgery and published in the December 2002 issue, found that patients often consider other types of physical improvements just as important - if not more so.

Patients were asked how they felt the surgical procedure would affect them both physically and psychologically. Through the 17-question survey, doctors learned that not only did 75% of patients expect relief of all daytime pain and 85% expect relief of all nighttime pain, but more importantly, 87% expected to be able to return to their lives as they were before their problem began. Specifically, 77% expected improvement in their abilities to perform household chores and to participate in recreational activities like playing with their grandchildren; 74% expected to improve their abilities to participate in sports, and another 69% expected to improve their abilities to wash and dress themselves.

“If a patient is living pain-free after a surgery, many doctors would consider that a success. This survey clearly shows that may not be enough for a patient to determine the surgery a success. For example, if patients expect to return to certain activities at 100% and are only able to function at 60-70%, they may very well consider their surgery a failure. Therefore, it’s important for me as a surgeon to know what it is that they expect to achieve by undergoing the surgery. You can’t provide the best patient care if you don’t understand the needs of the patient,” said Dr. Edward Craig, attending orthopedic surgeon at Hospital for Special Surgery and Past President of the American Shoulder and Elbow Surgeons.

The survey clearly shows that patients often make assumptions about their surgical recoveries that may be better or worse than what will actually occur. More importantly, it shows how crucial it is for patients and doctors to discuss expectations before undergoing surgery. While ambitious goals can often be reached, a misconception about what’s realistic can leave a patient frustrated and dissatisfied. This survey is an important tool for patient-doctor dialogues about realistic and unrealistic goals.

Questions to Ask Your Doctor

Patients should talk to their doctors about their surgery and what they should expect upon recovery. Often a discussion about what to expect can help calm any fears. Some questions patients should ask their doctor include:

How many of these procedures have you and your hospital performed?

Not all doctors are the same. So when you see a specialist, you should ask how many similar procedures your surgeon and the hospital have performed. The more procedures your surgeon has performed, the more comfortable and knowledgeable you should be.

What are the risks involved?

There is a natural fear that comes with surgery. While most surgeries may seem routine to the physician, as a patient you have the right to know what could possibly go wrong and how often problems do arise.

What are my options?

Often a patient may not think to ask what other forms of treatment are available. While it is wise to trust your doctor’s advice, it is always best to discuss all available options. You may even be able to avoid surgery if you are willing to commit to an aggressive rehabilitation program.

Will I be able to (fill in the blank)?

If you have specific tasks you want to be able to accomplish after surgery, you should talk to your doctor about them. The last thing you want is to undergo surgery and be disappointed with the outcome.

Could the condition return?

Surgery should repair your injury and leave you pain-free. However, a patient often requires surgery because of simple “overuse” injuries associated with life’s daily chores. Talk to your doctor about what caused your injury and the likelihood of it reccurring.

How long should I expect to be in the hospital?

While some surgeries are outpatient procedures, most are not. Upon leaving the hospital, make sure you know what you will need to do to ensure proper care at home.

How long will the rehab process take?

After surgery you need to strengthen the muscles and tendons affected by the operation. How aggressive and committed you are to your rehab program will have a direct impact on how quickly you recover.

About Hospital for Special Surgery
Hospital for Special Surgery (HSS) is the world’s largest academic medical center focused on musculoskeletal health. HSS is nationally ranked No. 1 in orthopedics and No. 2 in rheumatology by U.S. News & World Report (2016-2017), and is the first hospital in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center four consecutive times. HSS has one of the lowest infection rates in the country. HSS is an affiliate of Weill Cornell Medical College and as such all Hospital for Special Surgery medical staff are faculty of Weill Cornell. The hospital's research division is internationally recognized as a leader in the investigation of musculoskeletal and autoimmune diseases. Hospital for Special Surgery is located in New York City and online at www.hss.edu.


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