How To Pick A Good Surgeon

A new study published in the journal Annals of Surgery indicates that for three complicated surgical procedures - heart bypass, removal of the pancreas, and unblocking carotid arteries - older surgeons have higher rates of patient death within 30 days of surgery than younger surgeons.

Specific findings of this study are as follows:

• Compared with surgeons aged 41-50, surgeons older than 60 years of age had higher rates of mortality among their patients for the following procedures: pancreatectomy, coronary artery bypass grafting, and carotid endarterectomy
• Of the 461,000 surgical cases analyzed, the following procedures did not vary in mortality rate based on surgeon age:
  • Esophagectomy
  • Cystectomy
  • Lung resection
  • Aortic valve replacement
  • Aortic aneurysm repair
• Surgeons 40 years of age or younger who were presumed to have less experience than older surgeons had similar rates of mortality for all surgical procedures analyzed as surgeons aged 41-50

The authors of this study emphasize that although there is a statistically significant increase in patient mortality for the three complicated types of surgeries cited above when performed by surgeons 60 years or older, just as important a factor is each surgeon's caseload.

"Practice keeps skills high, so an all-or-nothing approach to surgery in the pre-retirement years may be better than gradually fading away."
- Study co-author Dr. John Birkmeyer of the University of Michigan

Here are some key recommendations that I share with people who ask for advice on how to pick a good surgeon:

1. Pick a surgeon who does little but the procedure that you need to have done. If you must have a lump removed from your breast, pick a surgeon who does this procedure a hundred or more times per year.
2. Pick a surgeon who will respect the choices that you will make regarding diet, lifestyle, and follow-up care after your surgery. Share your post-surgical recovery plan with your surgeon prior to agreeing to have him or her do surgery on you.
3. Your mind-set and emotional status going into surgery are critical factors that will determine how well your surgery will go. A good surgeon should make you feel comfortable and cared for at all times.

Although some health challenges, particularly acute medical emergencies, require surgery as soon as possible, the vast majority of health conditions are best addressed initially with health-promoting food and lifestyle choices.