When Is Surgery Unnecessary: Question and Answers

Author: Rosemary Gibson, M.Sc.
June 2010
 
Q. What is an unnecessary surgery?
A. A surgery is unnecessary if it does not have a clear advantage over a less risky alternative. It occurs when an operation does not represent a greater benefit to the patient and he or she will not be better off.
 
Q. Are there certain surgeries that are overused and performed too often when they are not medically necessary?
A. Yes. A consensus has emerged in recent years among physician leaders about selected surgeries that are performed when they are not always medically appropriate. This consensus is based on research published in peer-reviewed journals such as the Journal of the American Medical Association. The most commonly overused operations are back surgery, heart by-pass, hysterectomy, and prostatectomy.
 
Q. What can palliative care do to help avoid unnecessary surgery?
A. High-quality palliative care can help patients understand their illness and make informed decisions about their care, together with their families.
 
Q. What questions should a patient ask to avoid unnecessary surgery?
A. Patients should ask their doctor or surgeon these questions:

• What are my treatment options? Are there alternatives to surgery that would be good for me?
• What are the risks of each option? How often do they occur?
• How does the evidence of “what works” apply to me and my situation?
• What will my quality of life be when I am at home?
• What will happen if I wait to have surgery, or decide not to have it?

Q. Does patient involvement in decisions about surgery make a difference?
A. Yes. Studies clearly show that when treatment choices are available, and patients are fully informed about the risks and benefits of each, they are more likely to choose less invasive options.