Doctor's orders good indication of recovery time after surgery

By REBECCA WALSH health reporter

A doctor's word is the best predictor of recovery time after an operation, a study has found.

Auckland researchers found that the advice given by a surgical registrar about when a person should return to work or "normal activities" after an appendix operation is more important than factors such as the type of surgery (laparoscopic or open) or whether complications were involved.

It is also more significant than the patient's age and occupation.

John Windsor, professor of surgery at Auckland City Hospital and one of the authors of the study, is surprised by the results.

"We weren't expecting medical prediction to be influential at all. We thought it might be a small part of it."

Traditionally, people whose surgery was performed laparoscopically and who were younger and fitter were expected to recover quicker, he said.

The study, published in the ANZ Journal of Surgery, involved 98 patients, aged 15 to 69, who had their appendix removed at North Shore Hospital.

The patients were interviewed before and after discharge from hospital.

The researchers found that after the doctor's advice, the other determinants of when a person returned to work were the physical activity involved in their job, the need for post-operative pain relief and the amount of sick leave they obtained.

Factors that could have influenced a person's return to normal activities, such as personality type, pain threshold and whether they had other sources of advice, were not measured.

Professor Windsor said doctors needed to take more note of the influence they could have on a patient's recovery time based on what they said.

He said the economic implications in terms of health expenditure and time off work were significant.

Dr Claire Cartwright, director of the psychology clinic at Auckland University, who was not involved in the study, says that if a patient has a successful operation, has trust in their surgeon and their surgeon is optimistic about their recovery, it can have a positive impact.

But she said it was likely that many people who took the suggested amount of time off needed it.