Regardless of how long you've been practicing, you have undoubtedly come across a patient that has unrealistic expectations for surgery. This typically manifests in an unhappy post-operative patient. The patient may complain that their scar is too big, their recovery is taking too long, they are not able to return to work when they want, they cannot return to sports activities as quickly as they would like, they can’t wear stilettos, and the list goes on. And as we all know, an unhappy patient is more likely to file a lawsuit than a happy patient.

How Do You Develop Realistic Patient Expectations Prior to Surgery?

Prior to surgery, it is important to determine and document the patient’s current physical and social situation. What are the patient’s current physical limitations? What type of work does the patient do? Does the patient currently participate in sports? Is the patient responsible for caring for small children, elderly parents, livestock, etc.? Does the patient have to climb stairs to reach the bedroom/bathroom? Does the patient have a support person at home? Is the patient able to comprehend instructions? Does the patient have transportation? Can the patient afford to be off work for an extended period?
The answers to these questions, and others, taken into consideration with the patient’s medical history and physical examination, can help you to determine, along with the patient, the best surgical options for that patient.

What Does the Patient Expect from Surgery?

Are the patient’s expectations realistic? It is important to have open and honest communication with your patient regarding what to expect from surgery. Does the patient understand the planned procedure and what will be required of him/her to obtain the optimal outcome from surgery? Does the patient understand that there is a possibility of complications arising from surgery? Can the patient realistically comply with post-operative instructions? This communication is part of the informed consent process whereby you discuss with the patient, and document, the surgery that is planned, the reason(s) for surgery, the potential benefits and outcomes of surgery, the potential risks and complications of surgery, and other options to surgery, including the risks and benefits of other options.

What are Other Ways to Mitigate Unreasonable Expectations?

Encourage your patient and family or support person to ask questions and become involved in their care and treatment. Instruct the patient to inform you if they are concerned about any aspect of their care and take the time to answer their questions or concerns. The time you invest with your patient pre-operatively will likely result in fewer post-operative calls, better patient outcomes, and happier patients.

Having contemporaneous documentation of the patient’s physical limitations prior to surgery, conducting conversations with the patient, providing pre- and post-operative education and instructions, discussing informed consent, and being upfront about your rationale for treatment decisions, can all show you are a caring and concerned physician. This will go a long way in your defense should a patient decide to file a lawsuit.

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The information contained on the PICA Blog does not establish a standard of care, nor does it constitute legal advice. The information is for general informational purposes only. We encourage all blog visitors to consult with their personal attorneys for legal advice, as specific legal requirements may vary from state to state. Links or references to organizations, websites, or other information is for reference use only and do not constitute the rendering of legal, financial, or other professional advice or recommendations. All information contained on the blog is subject to change.