We are often required to put a huge amount of trust in surgeons, because they are responsible for performing procedures which may range from low to high risk.

But a new study warned that the professionalism of surgeons could determine how well a patient will recover after surgery.

The study published in JAMA Surgery, looked at interactions between surgeons and their co-workers and it was found that surgeons who behaved in an unprofessional manner towards their teams had more patient complications after surgery.

This is due to the fact that surgeons who behave this way compromise their team’s performance during surgery.

The study

Data was collected from 13 700 patients and 202 surgeons (70% were men), from the National Surgical Quality Improvement Program, which is a system used to track surgical care.

The post-operative reports were examined to see if the colleagues of surgeons reported any of the following four types of unprofessional behaviour:

• Unclear or disrespectful communication
• Poor or unsafe care
• Lack of integrity
• Failure to follow professional responsibilities

Unfortunately, these behaviours do have a big impact on a patient’s post-operative recovery.

The study included cases such as a surgeon shouting at a physician for five minutes after the physician administered medicine to a patient to raise their blood pressure, which in turn made the physician reluctant to raise concerns about the health of the patient in future.

In another instance, a nurse who required a safety-related break was told to “get going without all this time out nonsense” which showed a disregard for her safety.

Complications

The researchers found that surgeons who had one or more reports of unprofessional behaviour had patients who were 12–14% more likely to experience surgical complications 30 days after their surgery. Complications included kidney failure, stroke and pneumonia. It should be noted that the four behaviour subcategories with the highest likelihood for complications were not assessed.

What experts had to say

Jonah Stulberg, a general surgeon at Northwestern Medical Hospital told NPR that “nurses may be more likely to speak up about breaks in sterile technique if the physician is more receptive to them speaking up”. He added that if a surgeon spoke to them in an unprofessional manner or raised their voice, nurses might not say anything.

Dr. William Cooper who was a corresponding author on the study and is a professor of paediatrics and health policy at Vanderbilt University Medical Center said that it is important to note that the vast majority of surgeons are in fact respectful to their co-workers and “a very small proportion account for a disproportionate share of adverse outcomes”.

Cooper also said awareness of the issue could improve the general behaviour of surgeons. In fact, studies have shown that surgeons can improve their behaviour if they are given professional feedback. 

^{Image credit: iStock}

Deeanne Daniels