Fear has a role in elective surgery decision making. I’m not convinced that many doctors understand this.

Throughout the last six months, we tracked a large number of second opinions.  Many of you wanted to know if meniscus surgery or rotator cuff surgery was necessary and was adequately indicated.  My intuition over the last decade has been that many of you choose to proceed with surgery due to fear of what might happen if you didn’t have surgery. In our office, we find that patients will often put off surgery if the risk of doing so was low and if their quality of life is not sufficiently affected.  So we started to track this.  I wanted to know in more detail what was driving your decision to proceed with surgery.

Questions you may be afraid to ask your surgeon

  • Can my meniscus tear become worse without surgery?
  • Will my rotator cuff tear without surgery?
  • Can I wait for my knee replacement?
  • Can I continue to walk, bike, run or swim despite my arthritis?
  • Do I have to have surgery now?

When we dove deeper into the decision making variables that most of you found to be important, there were a few surprises.  Above were some of the most common questions I received. Fear appeared to be a tremendous motivator.  And for some reason, many of you were afraid to ask your surgeon or didn’t think to question your surgeon.

You should not be afraid to ask any questions.

I do not pretend to know what happened during the interaction with their first doctor.  I do not know if that doctor asked what was driving the decision to opt for surgery. But I was concerned that so many of the people I spoke to are willing to avoid surgery if they understand that the risk of not having surgery was relatively low.

Surgery does not always achieve the desired result. Surgery is not without risks. The only surgery without risk is surgery on someone else. A lot of the issues that you are considering surgery for have often been proven not to require surgery.

For most elective Orthopedic Surgery the primary driver should be the effect the diagnosis has on your quality of life. If non-surgical treatment has failed, you’re miserable, and the chance of operative success is good, then surgery might be the right choice for you. The main takeaway is… you do have a choice, and you should not be afraid to ask questions.

Disclaimer:  this information is for your education and should not be considered medical advice regarding diagnosis or treatment recommendations. Some links on this page may be affiliate links. Read the full disclaimer.

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About the author:

Howard J. Luks, MD

Howard J. Luks, MD

A Board Certified Orthopedic Surgeon in Hawthorne, NY. Dr. Howard Luks specializes in the treatment of the shoulder, knee, elbow, and ankle. He has a very "social" patient centric approach and believes that the more you understand about your issue, the more informed your decisions will be. Ultimately your treatments and his recommendations will be based on proper communications, proper understanding, and shared decision-making principles – all geared to improve your quality of life.

2 comments on “Fear and Surgical Decision Making

  • How often to Rotator cuff tears go undetected ? I live in bad pain where I cant even sleep at night, This has been going on for quite awhile, I originally had surgery to repear a Slap Tear,,labral tear, I went through physical therapy but I never got better, My surgeon dismissed me and sent me to another surgeon, He did not recommend surgery, My surgeon had sent me there to break up adhesions but the surgeon did not want to do it,, I went to another surgeon and he said I had a torn rotator cuff and if I didn’t have surgery it would end up getting worse< the other doctor whom my surgeon sent me to, talked me out of it I am sorry I didn't have it done because I suffer in really bad pain. I don't understand how one doctor is adamant about me getting rotator cuff surgery and another doctor is not, Something has to be wrong because the pain limits me and I cant live like this. Also, what is the best test to determine any abnormalities in the shoulder? I have talked to quite a few people who said that nothing showed up on their MRI but when the doctor went in, they had torn rotator cuffs,how often does this happen, Also, what do frayed rotator cuffs indicate, are they normal findings in the elderly? I am now 60, I also have pain in my upper arm which seems to be getting worse, Any advice you could give me would be greatly appreciated. Thank Youn

    • HI JoAnn… Some rotator cuff tears may go unrecognized, but it is rare. We do not need to have a tear to have pain. I always worry about surgeons who rush people into surgery. Very, very rarely are rotator cuff issues that urgent.

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