I Need a… Surgeon

Our "I need a" series is a helpful guide to finding the care you need when you don't know where to start. Today, we're learning about surgery and how to find a surgeon when you need one.


So, you've got a diagnosis. You've talked to your doctor, met with your specialist, and now, you're exploring your options. Those options may include something that can be pretty unnerving: surgery.

And that means finding the best surgeon you can; after all, the most important element of any surgery is the skill of the person performing the operation. Of course, there are emergencies when you won’t have the chance to choose for yourself. But when the choice is yours, it’s a big decision. When you're picking a stranger to trust with your health—and possibly your life—how can you know you're making the right choice?

But it doesn't have to be overwhelming. Having a better understanding of what to look for, what questions to ask, and what matters most to you can reduce anxiety and help you feel more confident about your decision.

So, before you hit the internet in search of the right surgeon for you, let's answer some helpful questions.

What Type of Surgeon Will I Need?

To get started, it helps to know what kind of procedure you're looking for. Surgeons work hard to perfect their craft by specializing and training to perform specific procedures, so that's a good way to begin your search. 

Your primary doctor and any specialists you're working with can help you understand what procedures might help your condition. They may even be able to recommend a surgeon you can contact, but feel free to find your own. Depending on your insurance, you may need a referral; if so, make sure to ask your doctor for one.

Practice Makes Perfect

If you know the specific procedure you're looking for, the most important criteria may be experience. Studies have shown that, in general, surgeons who have performed a procedure many times offer better outcomes.

If you don't have the name of a specific surgery for your search, you can start with a broad category and work from there. These categories include:

  • Breast Surgeons
  • Cancer Surgeons
  • Cardiothoracic Surgeons (heart, lungs, esophagus, and organs within the chest)
  • Colorectal Surgeons (colon, rectum, and anus)
  • Endocrine Surgeons (glands like the thyroid, parathyroid, and adrenal)
  • General Surgeons (esophagus, stomach, gallbladder, spleen, and intestines)
  • Gynecologic Surgeons (female reproductive organs)
  • Hepatobiliary and Pancreatic Surgery (liver, pancreas, bile ducts)
  • Neurosurgeons (brain, spine, and nervous system)
  • Ophthalmic Surgeons (eyes)
  • Oral and Maxillofacial Surgeons (mouth, jaws, and facial structures.)
  • Orthopedic Surgeons (bones, joints, ligaments, tendons, and muscles)
  • Otolaryngologic (Ears/Nose/Throat, or ENT) Surgeons (ear, nose, throat, head, and neck)
  • Pediatric and Neonatal Surgeons (infants, children, adolescents, and young adults)
  • Plastic and Reconstructive Surgeons (cosmetic surgeries and reconstruction for trauma or illness like cancer)
  • Transplant Surgeons (organs that can be transplanted, such as lungs, heart, kidneys, and liver)
  • Urologic Surgeons (urinary tract and male and female reproductive organs)
  • Weight Loss Surgeons (digestive system)
  • Vascular Surgeons (arteries, veins, and lymphatic system) 

What Credentials Should I Look For?

All doctors undergo additional training after medical school in order to practice medicine. Surgeons train longer than most specialists, and many elect to continue their training in more specific areas. Knowing more about that extra training can help you better understand a surgeon's skill and experience level. Many surgeons, medical centers, and hospitals make this information easy to find as part of a doctor's profile.

Residency

This is a graduate training program that follows medical school. Surgical residencies last between 5-7 years. Surgical residents train under the close supervision of an attending surgeon and rotate through different specialties to establish a broad understanding of their field. Many surgeons complete a General Surgery residency before moving on to a specialized fellowship. Some surgical specialties, like ENT surgery or Urologic surgery, have their own residency programs.

Fellowship

A surgical fellowship is a postgraduate training program for surgeons who want to focus on a specific area of surgery after completing their residency. Like a residency, fellows train under more experienced surgeons but in a narrow area of expertise. Some fellowships are accredited by the Accreditation Council for Graduate Medical Education (ACGME), while some niche fellowships may not be recognized because they are highly specialized.

Board Certification

This voluntary process demonstrates that a surgeon has met rigorous standards set by their peers through a governing organization, or board. Major boards are recognized by the American Board of Medical Specialties and the American Medical Association.

There are different boards for different specialties; for example, the American Board of Surgery (ABS) has two primary and four specialty certifications:

Other surgical specialty boards include the American Board of Colon and Rectal Surgery, the American Board of Neurological Surgery, and the American Board of Thoracic Surgery.

Board-Certified vs Board-Eligible

To become board certified, surgeons must complete all parts of their specialty's board certification, including passing a qualifying written exam. Board-eligible means that a surgeon has completed their surgical residency but has not taken the exam yet.

Surgeons must become recertified within a certain period of time and take continuing education courses to stay current on the latest advances in their field to maintain their board-certified status.

Not all surgeons are board-certified, and not all subspecialties have a board certification. However, board certification is a helpful way to know that a surgeon has received the highest level of training and is up-to-date on the latest advances.

Professional Societies and Organizations

These groups establish and promote new guidelines for care and help educate members about the latest developments in the field. Membership in these societies can indicate that a surgeon is active in their specialty’s clinical and research communities.

These organizations can also be a great resource for your search. For example, the American College of Surgeons (ACS) offers a helpful Find a Surgeon tool that lets you search by speciality, subspecialty, or location. The ACS is the world's largest organization of surgeons, and their comprehensive member database of board-certified surgeons is a great place to start looking.


So, I Found Some Surgeons I Feel Comfortable With. Now What?

It's time to start making appointments. Reach out to your top choices for what's called a surgical consultation, or consult. Skilled surgeons are in high demand, so keep in mind that sometimes it can take some time to get scheduled. When making the appointment, their care team will ask about what you're looking for so that urgent health issues can be prioritized.

Do They Take My Insurance?

Money might not seem important when your health is at stake, but surgery can be very expensive. Avoiding another stressful element can help you focus on your health. So verify that they accept your insurance, even if their website states they do. Nothing is more frustrating than finding a surgeon who's a great fit, only to learn that your insurance won't cover the procedure. Some insurance plans also require a referral, so talk to your primary doctor about what you'll need.

During My Consultation, What Should I Ask?

In a word: everything. This is your chance to learn about the procedure, but it's also your opportunity to learn about the surgeon: what their approach is, their demeanor, their experience, and their understanding of your condition. No question is silly or useless if it helps you feel more confident about the procedure. Bring notes if you're concerned about remembering complex medical terms. Some helpful questions include:

Are there nonsurgical options? Surgeons should be aware of all of the treatment options for your condition. For some serious or chronic illnesses, surgery can be the only viable solution. If surgery is the only option, they should be able to explain why. Be mindful of any surgeon that pressures you to have surgery, or to have it soon.

Can my procedure be done using a minimally invasive approach? Many procedures can now be performed using minimally invasive techniques, so it's a good idea to ask about it. Minimally invasive procedures offer several benefits over open surgery, including benefit:

  • Smaller incisions
  • Faster healing
  • Reduced risk of complications 
  • Short or no hospital stays
  • Less pain
  • Minimal or no scarring

Not all surgeries can be performed this way, and it may not yield better results, so ask the surgeon to explain why they use the approach they do.

How many times have you performed this operation? Again, experience is an incredibly important factor in the success of most procedures; the more experienced, the better.

What will I need to do to prepare? Perioperative care refers to the entire process of having surgery, from when you decide to have the procedure to your recovery. Your procedure has three phases:

  • Preoperative: before the operation. This can include diet or managing medications that might impact the procedure, or what types of activities you should or should not do leading up to the surgery.
  • Operative: during the operation. This is the operation itself, including the type of anesthesia involved, how long it will last, and what the procedure will entail. It also includes where the surgery will be performed, such as in a hospital or outpatient surgical center.
  • Postoperative: after the operation. This phase is focused on recovery, including any physical rehabilitation, restrictions on activity, or how and when to return to work.

This is a good opportunity to find out about how the surgeon approaches their work. Attention to all of these phases is essential for the best outcomes, so knowing that they have a plan in place for everything you need and a team to support them—and you—is a great sign.

Are you part of a larger care team? It’s worth checking to see if a surgeon works with other experts, especially for complex conditions. This is common with academic medical centers, where different specialists coordinate care as a team.

What results can I expect? While we would all like to know that surgery will completely cure our condition, that's not always the case. Having realistic expectations about a procedure is important, and a surgeon should be able to talk honestly about risks and outcomes based on experience.

Remember, this is an interview. You're choosing the best surgeon for you and your needs, so make sure that you ask about whatever concerns you have.


Should I Get a Second Opinion?

Absolutely. Even if you think a surgeon is perfect for you, a second opinion can make you feel more confident about your decision. It can also help you become better educated about the procedure and your options. Second opinions can often be done with telehealth appointments, so they may not be as challenging to schedule.

Be wary of any surgeon that discourages you from getting a second opinion. An ethical surgeon will encourage you to get all the information you can and to consider every option.

Word of Mouth

Do you know anyone who has had the surgery performed by the surgeon you’re considering? It can be helpful to get feedback from someone who has been through the procedure and recovery process. Keep in mind that everyone’s health circumstances are unique, so their experience won’t be the same as yours. But speaking with others can help you feel better informed about the real-world results and can give you some insight into how the surgeon and their team treat their patients.

Word of mouth can also be a great way to find a surgeon that you might not have considered, especially if someone you know had a positive experience working with them. But make sure to then research the surgeon for yourself.

What Other Factors Should I Consider?

This is about you and your health, so you should consider what is important to you. If you've reduced your options to a few surgeons who have convinced you they will provide the best care possible, practical considerations may help you make the final decision. These include:

  • Do you want a doctor who can perform surgery at a hospital closer to home, or is it worth traveling for your procedure?
  • Do you want to work with a surgeon who has a relationship with your specialists to make coordinating your care easier? 
  • Is finding an in-network surgeon a priority because of your health insurance?
  • How urgent is your health issue? If you had to wait to schedule your surgery until there was an opening on a surgeon's calendar, would it be worth the wait?
  • Did you like a particular surgeon's demeanor? Did they have the qualities you are looking for?

Once you have settled on a surgeon who can perform the procedure you need, where you want it, and when you want it, it's time to focus on getting ready. Make sure you follow all instructions leading up to and following your procedure. You went out of your way to find the right fit, but all that research won't matter if you don't do your part.

Surgery can be a life-changing option for many conditions, and making the right choice can help you get back to living a happier, healthier life.

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