What kind of surgeon should you go to for another opinion?

As a matter of fact, what kind of surgeon, or other physician, should you go to for a first opinion?

The obvious answer is: a competent one. But how can you know?

Ideally, a competent surgeon should be both able and human. And also candid. Except in an emergency that allows not a moment's wait, you should ask questions about almost any proposed operation. Such as:

*What do you propose doing? Why?

*What should the outcome be? What are the chances of a successful outcome?

*Are there any possible ill effects or complications?

*What if I decide not to have the surgery? What are my alternatives?

A competent and caring surgeon will answer all these questions completely and willingly.

That's the ideal. In practice, many a top-rated surgeon is curt and cold. Yet sometimes that surgeon may be best for you. By and large, competence is more important than bedside manner, though coping with a Dr. Cold can be hell.

Is a proposed surgeon competent?

Ask your own doctor or any doctor or more than one doctor -- or nurse or other hospital or medical worker -- "Who's really good?" "Who has a top reputation?" "Who would you trust to operate on you or your wife?" "Have you ever had to use a surgeon yourself? Who was it?"

Ask about a surgeon's qualifications and credentials. Ask him or her. Or the surgeon's office staff, on the phone. Or the county or local or area medical society. Or the hospital whre the surgeon mainly operates. The administrator's or medical director's or department of surgery office should be able and willing to get you the answers to some questions.

Some possible questions:

*Does the surgeon regularly do this type of surgery? Did he or she do any last week? Last month? How many? With what result? The last may indeed be a touchy question. You probably won't get much of an answer in many cases, but any hesitancy -- rather than a simple statement like "He's one of our best surgeons" -- could make you want to inquire further.

Is the surgeon board-certified, that is, has he or she passed the rigorous combined written and oral examination given at the end of three or more years of specialty training by one of medicine's several specialty boards? Lacking other compelling information, your best bet is a board-certified surgeon.

What if the answer is: "The surgeon is board-qualified"? That means a physician has completed the training or residency period required before he or she can even take a specialty board examination. Many well-qualified, newly practicing surgeons are just waiting to take the exam.

Ask, "When did the surgeon complete residency training?" If it was a long while ago, he or she probably never took the exam or failed.

None of this means that all board-certified surgeons are paragons, or that there are not some non-certified, still excellent surgeons. But board certification at least says: this surgeon was once judged qualified by surgical peers.

Another question to ask: is the surgeon a fellow of the American College of Surgeons (and entitled to write F.A.C.S. after his or her name)? The college, the main surgeons' association in this country, says: "The letters F.A.C.S. are an indication . . . that the surgeon has passed a thorough evaluation of both professional competence and technical fitness. Fellows are board-certified surgeons or, in unusual circumstances, have met other standards comparable to board certification."

Is all this nit-picking?

Not according to the College of Surgeons. In a recent ad in Modern Maturity, organ of the American Association of Retired Persons, the college itself said:

"Ask questions. Be informed. Know your surgeon's qualifications. You'll feel a lot better about saying 'yes' to a recommended operation."

Or at times saying "no."