Navigating the Health Care System

Advice Columns from Dr. Carolyn Clancy

Former AHRQ Director Carolyn Clancy, M.D., prepared brief, easy-to-understand advice columns for consumers to help navigate the health care system. They address important issues such as how to recognize high-quality health care, how to be an informed health care consumer, and how to choose a hospital, doctor, and health plan.

If you need surgery, there's a better-than-average chance that you'll have it and go home the same day. That's good news for several reasons, but same-day surgery does require some planning on your part.

Thanks to advances in technology and anesthesia, nearly 6 of every 10 surgeries performed at hospitals are done as "outpatient" procedures, which means you go home the same day you have your surgery. Nearly 35 million such surgeries are performed each year in the U.S.

For example, most eye and ear surgeries are performed as same-day surgeries, and so are some skin procedures. In some cases, you can have your gallbladder removed at 7 a.m. and be home by noon. Some of these surgeries are done at surgery centers or in doctors' offices.

This shift to same-day surgery can result in lower costs. For some patients, same-day surgery is more convenient and safer than staying in the hospital. But no surgery is risk-free. Same-day surgery means that you, or the people who help take care of you, may have to change your bandages or manage your pain medicines.

There are several steps you can take to increase your chances for a successful surgery. My agency, the Agency for Healthcare Research and Quality (AHRQ), offers the free guide Having Surgery? What You Need to Know. It provides advice and resources to help you prepare for surgery.

Some surgeries must be done right away. But many are not urgent, which means you have time to talk with your doctor and decide what course is best for you. Before your surgery, you should:

  • Ask questions. Do I need this surgery? Is there some other way to treat my condition? What are the benefits if I have this surgery? What are the risks or side effects? What will happen if I don't have the surgery? My Agency has an online tool to help you create a list of questions.
  • Learn about the surgery and its possible benefits and risks. The first step in learning about your surgery is asking questions. The next step is finding trusted sources of medical information at your library or on the Internet, including Healthfinder. You may also benefit from a growing area of research—much of it done by my Agency—that compares different treatments for your condition. This is called comparative effectiveness research, and it is designed to help patients make good decisions. For example, it can help you learn about the pros and cons of certain types of surgery.
  • Check the qualifications of any facility you're considering. Call your health plan or visit the facility to find out:
    • If your health plan will cover your care there.
    • If it is licensed. Also check to see if the facility is accredited by either The Joint Commission  or the Accreditation Association for Ambulatory Health Care. The accreditation certificate should be posted in the facility.
    • How well trained and experienced the facility's health care professionals are.
    • If the facility is affiliated with a hospital. If it is not, find out how the facility will handle an emergency that might happen during your visit.

If you decide surgery is right for you, take the following steps to improve your chances of a successful surgery and full recovery:

  • Make sure your surgeon, all other doctors and nurses know about the medicines, supplements, and over-the-counter medicines you take and any allergies you have. Bring a list of your medicines with you to your visits before the operation and on the day of your surgery. Once you're home, make sure you understand what medicines you are—or aren't—supposed to take and for how long. Do not assume that if you have already answered the questions once that the information has been shared with all members of your health care team.
  • Ask about potential complications with your surgery. It's important to know what to look for and who to call if problems arise. In addition, ask if you should schedule follow-up appointments (e.g., physical therapy) before surgery.

Research shows that patients who ask questions and are informed about their surgeries typically work better with their doctors in making the best decisions about their care. Being prepared before having surgery will help ensure that you have a smooth recovery.

I'm Dr. Carolyn Clancy, and that's my advice on how to navigate the health care system.

More Information

AHRQ Podcast
Care Transitions—What You Need to Know  (Transcript)

Agency for Healthcare Research and Quality
Having Surgery? What You Need to Know

Questions Are the Answers: Planning for Surgery

Effective Health Care Program

Department of Health and Human Services
Healthfinder

The Joint Commission
 

Current as of April 2010
Internet Citation: Same-Day Surgery: What You Should Know. April 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/columns/navigating-the-health-care-system/040610.html