Getting an extra consultation before surgery might not give you a better outcome: Canadian study

A new study that looked at more than 300,000 patients found that a medical consultation prior to a routine surgery wasn’t connected to a better surgical outcome, suggesting these consultations might not be necessary.

A new study that looked at more than 300,000 patients is suggesting that when it comes to medical outcomes, it might not be necessary to have an appointment with a specialist prior to a surgery that is considered routine.

The study, published Monday in the peer-reviewed journal JAMA Internal Medicine, found that having a preoperative consultation wasn’t associated with a better outcome after surgery.

The idea behind a preoperative consultation with a medical specialist — such as a cardiologist, endocrinologist, or nephrologist, among others — is to go over health issues that could lead to complications during surgery. Surgeons in Canada refer more than 40,000 patients a year for these consultations to prepare for a surgery, but debate has been stirring over whether they are fully necessary or not.

“As a specialist who sees patients for preoperative medical consultations, I’m not convinced these visits are always helpful,” Dr. Weiwei Beckerleg, a general internist at the Ottawa Hospital and assistant professor at the University of Ottawa, as well as lead author of the research, said in a press release. “Most patients I see have already covered the same ground with their anesthesiologist. I’ve had patients ask me ‘Why am I here?’”

In this new study, researchers looked at patient data from 2005 to 2018 in Ontario, focusing on their surgical outcomes and whether they had a preoperative medical consultation.

If these consultations led to an improvement in surgical outcomes, it would be an argument for their benefit. But researchers actually found that in general, outcomes were slightly worse.

Data from around 359,000 patients in the study showed that while 0.7 per cent patients who had no consultation died within 30 days of their surgery, 0.9 per cent of those who had a preoperative medical consultation died within the month after surgery.