One of the biggest things we preach during the preoperative consultation stage is that patients need to have appropriate expectations for the upcoming procedure. We are very skilled at what we do and we’ll do everything in our power to help address your injuries, but know that we do not have a magic wand. Depending on your condition, there’s a chance that even if everything goes as planned during surgery, you’ll still have some lingering pain and discomfort after surgery.
A new study out of New York City found that mismatched expectations between patient and provider are not just an issue at our clinic. In fact, it happens in roughly 80 percent of cases. In today’s blog, we take a closer look at patient and provider presurgical expectations and explain how they can be better managed.
Presurgical Success Expectations
According to a study conducted by researchers at the Hospital for Special Surgery in New York City, patients tend to have higher expectations for their surgery than their physician. In fact, roughly two-thirds of patients undergoing a foot or ankle surgery had higher expectations for the operation than their surgeon. According to the data:
66.3% of patients had higher preoperative expectations than their surgeon.
21.3% of patients had expectations similar to those of their surgeon
12.4 of patients had lower expectations than their surgeon.
Another interesting finding during the study was that the majority of patients with lower presurgical functional scores also had higher postoperative expectations. The same correlation was found in patients with depression and anxiety, and in those with a high BMI. In other words, those with severe functional issues and those with physical or mental hurdles to recovery had higher expectations for their operation, whereas surgeons likely tempered expectations given the warning signs.
So why do patients often expect more from their foot surgery than what may be considered reasonable? Some believe that patients see surgery as a way to reverse physical damage, which isn’t always possible. Others believe the issue resides in the surgeon who fails to appropriately manage the expectations of their patient. That said, no provider wants to walk into a room and tell a patient that they may not be as healthy post-op as they had hoped.
“Although most surgeons do their best to engage in open conversations with their patients about what they can expect from surgery, many find it difficult to tell patients that they are not going be as good as new postoperatively,” said Scott Ellis, M.D., a foot and ankle orthopedic surgeon at HHS and author of the study. “It is challenging to get patients past the belief that surgeons have a magic wand.”
Dr. Ellis and his team believe the results of the study underscore the importance of an open and honest conversation about expectations prior to surgery, as well as the potential for preoperative education courses to ensure everyone is on the same page prior to surgery.