A patient with poorly controlled type 2 diabetes is requesting elective hallux valgus surgery. The surgeon determines the patient is not a good surgical candidate at this time. How should this be communicated?
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A
Defer the conversation to the primary care physician who manages the diabetes
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B
Explain clearly that surgery is not advisable now, outline the specific metabolic targets needed, and describe a pathway to becoming a candidate
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C
Decline the surgery without providing a reason to avoid a difficult conversation
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D
Offer surgery with the caveat that the patient understands the elevated risk