The answer to the first question, quite simply, is yes, you do; and to the second one, no – not if you want me to be your plastic surgeon.
You are a human. And, as a doctor, it is preferable that I keep you alive, and, if possible, address your ailment without harming you. What you may consider as “small” and unimportant, is still medical – that is why you are coming to me, right?
The purpose of the consultation is not only to write down your name, establish your problem, and deciding to act. During a consultation, we also establish a relationship of trust, we determine whether you trust me to take care of you, and it also gives me the opportunity to determine whether I should treat you.
I like to get to know my patients better, so I ask many questions about your personal life – whether you are married, and have children; how old your children are and where they live; what you do for a living. I am treating a person, and the more I know and understand that person, the better I can treat that person. If you have no support from family and friends after a large surgery, I need to consider whether it is appropriate to perform that surgery.
If you have a demanding job, we need to make decisions based on that, to ensure that you can get back to work as soon as possible.
I also take a detailed medical history. This medical history includes your family’s medical history, because certain diseases occur in certain families. Your past medical history tells me a lot about you, how well you will cope with the proposed surgery or treatment, and which complications I could expect.
As part of your medical history, I need to know have any allergies – if we use medication you are allergic to, you could die, if you are allergic to certain plasters, your post-operative recovery could be extremely uncomfortable. And if I never asked the question, I would not know, would I?
Most importantly, I also need to know which medications you use – not only those prescribed by your general practitioner or other specialists you visit, but also those you buy over the counter, and very importantly which homeopathic supplements, vitamins and other supplements you use.
Certain medications and supplements need to be discontinued before surgery, such as those containing aspirin, Omega 3 and 6, Evening Primrose oil, Krill oil and cod liver oil, as these medications increase your risk of bleeding, with subsequent complications and bruising during and after surgery.
Patients coming for so-called “minimally invasive” treatments such as Botox and fillers, need to discontinue these as well, otherwise they run the risk of extensive bruising – a not so “minimally invasive” complication.
Homeopathic drugs, like Valerian and St John’s Wort impact on anaesthetic drugs, and if I am unaware of this, I cannot tell the anaesthetist, and you could suffer from adverse reactions.
There are many more questions I ask, but by now you should understand that I am very thorough during my first consultation, and will not consider treating you or performing surgery unless I have discussed this with you.
Now we still need to discuss the reason you came to see me. You need to know how the surgery is performed, or the treatment done, what you can expect immediately thereafter. You need to know what outcomes you may reasonably expect, which complications and risks there are. You need to know how soon after the proposed surgery or treatment you can attend work or major social events, what to do it there is a complication, how quickly you can expect to see results or to recover, when you can drive, when you can gym.
Once we have discussed all of this, you can make an informed decision to know whether you would like to proceed. And, so can I, because believe me, we cannot just proceed with surgery or treatments, if I am not comfortable with doing the procedure or treatment either.
So, in conclusion, NO – I will not do anything without consulting you first.