Surgeons who are unprofessional towards their colleagues have patients who experience more complications post-surgery.

What pops into your mind when you think of a surgeon? One would hope it’s someone professional, accomplished, empathetic and assured – ready to provide top-quality care to you as a patient. But an unfortunate stereotype of surgeons, at least from years past, is the overworked, supercilious and cold wielder of the scalpel. Rude to patients and coworkers, they’re probably the last person you want to have conducting some delicate operation on you. It’s been known for many years now that surgeons behaving badly can have an impact on other health professionals, including issues of burnout and depression. But how does a surgeon’s bad behaviour influence your safety as a patient?

In this US research, they collected two key sets of information about more than 200 surgeons. The first was the reports that their colleagues had made of their unprofessional behaviour, through hospital reporting systems, over a three-year period. ‘Unprofessional behaviour’ didn’t just mean swearing or throwing instruments around the room.

It encompassed a range of behaviours, including passive-aggression, not answering questions when they were asked and sarcasm or belittling communication. Then, they looked at how the patients of those same surgeons did over the years;  if they’d had a good outcome or if they’d had complications after surgery. Then they married the two sets of data – sorting the surgeons into groups based on the number of complaints from colleagues they’d received and the associated surgical outcomes data of each surgeon.

What they found was that the unprofessional behaviour of a surgeon was significantly linked to the safety outcomes of their patients. Compared with surgeons who had no complaints against them, surgeons who had four or more complaints were about 30 per cent more likely to have a patient with a surgical complication. That could include things like infection, a need to assist with the patient’s breathing, or that the patient had to return to the emergency room after surgery.

Implications

The authors believe that when a surgeon behaves poorly, it interrupts the normal flow of critical information in an operating theatre. For example – the nurse may be afraid to speak up when they see something go bad and that in turn leads to poorer outcomes for the patient.

They argue that systemic change is needed to help alter our perception of what makes a good surgeon. Ability and skill are important, but empathy is, too.

Last Reviewed: 17/04/2020

© Norman Swan Medical Communications.



References

For reference: Cooper, et al (2019). Association of Coworker Reports About Unprofessional Behavior by Surgeons With Surgical Complications in Their Patients. JAMA Surgery doi: 10.1001/jamasurg.2019.1738.

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