Top Docs 2008 Part III: Why to Speak Up


Meet the Surgeon (Really, They’re Not That Scary)

Tufts’s chief of surgery Bill Mackey opens up.

You’re a vascular surgeon. Does the whole you’ve-got-their-life-in-your-hands thing intimidate patients? Sometimes they’ll say to me, “Just do whatever you think is right,” which puts me in an awkward position. The surgeon wants trust from the patient, but not blind trust: I want to know your goals, your expectations, and your anxieties.

What should smart patients ask their surgeons? Ask them if they’re board certified in that particular specialty. Then ask when they recertified. Ask how often they do this procedure. You generally want the doctor to say, “I did 112 of these last year,” or “I do this on a weekly basis.” Less satisfying? “You know, I saw one of these performed once, and it looked like fun!”

What’s the oddest patient concern you’ve heard? Occasionally you get people who worry that we’re going to steal a kidney or something, for transplants. More common is the misconception that I’ll be performing “ghost surgery”— assistants will do the work and I won’t actually be there.

Is there such a thing as a bad time to schedule surgery? There’s a lot of urban lore about this—for instance, I’ve heard you don’t want to have surgery at a teaching hospital in July, because that’s when the new interns arrive. But you do want to be part of a surgeon’s normal workflow with his usual team. If a doctor typically operates during the daytime on Mondays, Tuesdays, and Thursdays, you probably don’t want to force him to work at 9 on a Wednesday night.

How do you get patients acclimated to the OR? Do you give tours beforehand? It’s not really practical to do that, as there are sterility issues. And besides, they’re mostly in use. But more and more, patients are shown videos that take them through every step of the surgery. We also do webcasts from the OR for them to watch, too.

Do surgeons ever let patients keep anything that’s been removed?
Most hospitals have rules that everything has to go to pathology. You have a right to ask, though. I know patients who have their gallbladder removed and want to keep the gallstones.