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Surgery is very prevalent in the USA. More than 42 million surgical procedures are done annually, including 1 million of those are orthopedic.

As surgical procedures become less invasive and more refined, patients are expecting quicker , less painful, and complete recovery times. But there still remains a lot of variability in post-surgical outcomes.

It’s difficult to determine why some patients recover well and some have poorer outcomes. The paper I’m referencing is taking a look at psychosocial factors and how it influences a patient’s recovery outcomes.

Psycho = cognitive, emotional, rational you

Social = cultural and social influences such as family, occupation, age, gender that shape your identity


It turns out attitude and mood were the strongest predictors between a favorable and poor outcome.

So who are bad candidates?

1) people who are worried and anxious about their illness/injury leading up to surgery, actual surgical procedures, and anticipated difficulty of recovery;

2) depressed patients.

How about the criteria for good candidates?

People who have/show:

1) belief in doing the necessary things to recover has a positive impact.

2) confidence in managing pain or discomfort well

3) being an active participant in the recovery process.

Plus, there are surgeons out there who will cancel elective surgeries if the patient feels anxious, depressed, and fears death before the surgery. It is common practice now to discuss these fears with the patient.

Some patients have premonitions of their death and go on to predict their death! What is the mind-body connection up to here? Regardless, surgeons take pre-surgery jitters and cold feet seriously.

Here’s an article expressing the variance in surgeons’ views on these premonitions – Physicians Are Talking About: A Death Foretold

Overall, it’s promising and reassuring to read surgeons take their patients’ fears/worries/anxieties to heart and leverage their expertise to assuage them.


1)Rosenberger, P.,  Jokl, P., Ickovics, J., (2006). Psychosocial Factors and Surgical Outcomes: An Evidence-Based Literature Review. J Am Acad Orthop Surg 2006;14:397-405

2) Physicians Are Talking About: A Death Foretold

3) Photo credit – foter.com

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