Perhaps I can discuss a little bit how this actually happens. So a person would come to me, sometimes they will already come with the tests that are done, sometimes we have to make the diagnosis, but once the diagnosis is confirmed, I do like to meet with the family of our now patient and the patient themselves to try to come up with a plan. Because nothing that we do is written in stone, right? My responsibility as a surgeon, as a doctor, is to provide my patients with the best advice that I can. But the patient is the one who’s going to drive that agenda, right? I can come up with a hundred reasons why a gallbladder should be removed.
But if the person says, “Listen, doctor, I’m not ready for it. I’m going on vacation. I don’t want to do it. I’m afraid.” What I will do is I will tell them, “You know what, that’s fine. As long as we keep in touch. As long as you know what to look for, you need to look for A, B, C. If that happens, please let me know right away.” We are fortunate that many a time, we are not faced with a life and death situation. That happens as well, many times. But most of the time, that is not the case. And so when the patient comes to us, there’s always different ways to begin our journey together as a patient, as a doctor. And this is part of the rapport that’s going to be established. My responsibility is to let the patients know what is the best course of action from the medical perspective. Fully understanding that the patients will have the autonomy. They will have an ability to independently decide. And another thing that is extremely important is for a surgeon specifically to ask the patients and their family to get a second opinion.
I’m delighted when the patients go and seek advice from another provider, because if anything, it will, it should validate what I already had told them, but sometimes it’s not. But that’s the importance of having choices. The patient is the one in the driver’s seat. And so they need to have that ability to get the advice that they need coming up with whatever decision is going to be best for them and their families. It is never something that must be done in an elective situation. And elective meaning that we have time to think about it. There is emergency, there is elective cases, and there is a kind of emergency cases. In emergency, I have to say to the patient, “You know what, to save your life, you must have that.” That happens. That happens a lot. However, most of the time we have time to think. I have time to think as a surgeon and the patients and their families should take the time, and very frequently a second opinion, to decide if that’s what they want to do.