Do patients have a choice in anaesthesia and surgery?

Abstract

Patient choice is a long-held aspiration for many NHS stakeholders. From its inception, the role of the general practitioner (GP) has been central to patient choice, as a disseminator of information and in terms of choosing treatments and physicians. This article explores the current state of patient choice in relation to surgery and anaesthesia, drawing on the most contemporary research and current professional guidelines. It confirms that, despite the desire of those involved, patient choice in surgery is still confined to ‘where and when’ rather than ‘who and what’, and even this limited choice is not open to all. It also suggests that patient choice of anaesthetic is, in practice, similarly limited. It concludes that although the GP is still central to the choice process, there is a worrying level of preference misdiagnosis on the part of clinicians. Finally, it asks the question, ‘Do patients really want choice?’ or, with locality and convenience repeatedly cited as top priorities, do they just want their local hospital to be competent?