47 Secrets Surgeons Are Keeping Away From You

• HOW TO HANDLE STRESS

‘It’s this mechanism to maintain calm. When we become unglued, everyone becomes unfocused, and that’s when patients die. How you handle stress is absolutely critical.’ —Kathy Magliato, MD

• YOUR DOCTOR SHOULD NOT PUSH YOU TO MAKE A FAST DECISION ABOUT PROSTATE CANCER SURGERY

‘Most prostate cancers are extremely slow-growing, and there is so much misleading information out there, so you should take your time.’ —Bert Vorstman, MD

• READ THE OPERATIVE NOTE DICTATED BY THE SURGEON

‘If you have unanswered questions about your surgery, ask for the report.’ —Paul Ruggieri, MD

• IF YOU HAVE PAIN IN YOUR CALF AFTER SURGERY, OR IF IT SWELLS AND LOOKS RED, CALL YOUR DOCTOR RIGHT AWAY

‘Those are the main symptoms of a blood clot, which is a risk of just about every surgery.’ —James Rickert, MD

• WHAT REALLY KEEPS US UP AT NIGHT

‘It’s not making a mistake in the operating room; it’s the noncompliant patients. When patients don’t do what we tell them, bad things can happen.’ —Kurian Thott, MD, an ob-gyn in Stafford, Virginia

• OBESE PEOPLE ARE A CHALLENGE

‘Starting an IV is tough because chubby arms don’t have many visible veins. It’s difficult to place a central venous catheter. Post-op, they’re more likely to get infections. Just getting someone who weighs 300 pounds out of bed is hard.’ —General surgeon who blogs under the name Skeptical Scalpel

• DON’T ASK TOO MANY QUESTIONS

‘When one extremely hostile relative bombarded me every time I walked in, I developed a tendency not to go in the room. If you have three pages full of questions, show them to the nurse. Say ‘How many of these should I wait to ask the doctor about? How many can you help me with?’’ —General surgeon who blogs under the name Skeptical Scalpel

• ABOUT 25 PERCENT OF OPERATIONS ARE UNNECESSARY

‘This is not an insurance company putting pressure on doctors; this is not a government regulation. This is private hospitals pushing doctors to generate more money by doing more procedures. It goes on at America’s top hospitals. The Cleveland Clinic has said this system of paying doctors is so ethically immoral that it started paying its doctors a flat salary no matter how many operations they do.’ —Marty Makary, MD

• RULES THAT RESTRICT RESIDENTS’ HOURS MEAN DOCTORS COME OUT OF TRAINING WITH A LOT LESS EXPERIENCE

‘When I was training, I was almost always in the hospital. Now it’s more like shift work. ‘Hey, it’s 7 p.m. I’m out of here. He’s your problem now.’’ —Sid Schwab, MD

• SOME ORTHOPEDIC SURGEONS MAKE MILLIONS IN SOFT CONSULTING AGREEMENTS WITH DEVICE MANUFACTURERS

‘Sometimes the same doctors have performed a record number of implants for that company.’ —Marty Makary, MD

• IF YOU NEED A MEDICAL DEVICE, ASK IF YOUR DOCTOR HAS A FINANCIAL RELATIONSHIP WITH THE VENDOR

‘If so, chances are you’re going to get that type of joint or screw, even if it’s more expensive or not the most appropriate.’ —James Rickert, MD

• WHEN A PATIENT DIES

‘I operated on a man who had something very complex and died in the operating room. He had a wife and two children. When I came out to tell them, the children were screaming, ‘Mommy, Mommy, I want my daddy.’ That was very hard. Even though we present ourselves as very strong, we’re vulnerable to depression and other problems. We’re human.’ —A surgeon in Florida