Rude, Disrespectful Surgeons May Also Be More Error-Prone: Study

Patients who complained about their doctor had more post-surgical complications, researchers say

By Robert Preidt

Wednesday, February 15, 2017

WEDNESDAY, Feb. 15, 2017 (HealthDay News) -- Surgeons with a history of patient complaints regarding their personalities or attitude are also more likely to make mistakes in the operating room, a new study finds.

Researchers compared surgical outcomes with patient reports of unprofessional behavior by their doctors at several health systems in the United States.

The investigators found that people treated by surgeons who had the most complaints had nearly 14 percent more complications in the month after surgery than patients treated by surgeons viewed as more respectful.

Complications included surgical-site infections, pneumonia, kidney conditions, stroke, heart problems, blood clots, sepsis and urinary tract infections, according to the study led by Vanderbilt University Medical Center (VUMC) researchers.

Lead author Dr. William Cooper said surgeons who are rude and disrespectful to patients might also treat other medical professionals poorly, which could affect the quality of care. Cooper is a professor of pediatrics and director of the Vanderbilt Center for Patient and Professional Advocacy.

"For example, if a surgeon speaks disrespectfully to an anesthesiologist during a procedure, the anesthesiologist may become reluctant to speak up the next time the surgeon and the anesthesiologist work together," he said in a Vanderbilt news release.

"Similarly, if a nurse's reminder to perform a safety procedure such as a surgical time-out is repeatedly ignored, the nurse may be less likely to continue to share his or her concerns with the surgeon," Cooper noted.

Study co-author Dr. Gerald Hickson is senior vice president for quality, safety and risk prevention at VUMC. He said that "we need to reflect on the impact patients and families experience from these avoidable outcomes. From conservative economic estimates, the cost of addressing the excess surgical complications could amount to more than $3 billion annually."

The findings also suggest that analyzing patient and family reports about unprofessional behavior could help spot surgeons with higher complication rates.

Hospitals could then take steps to improve the doctors' behavior and, possibly, also patient care, the researchers said.

Hickson called the numbers significant.

"Even though there was only a 14 percent difference in adverse outcomes between patients cared for by the most respectful and least respectful surgeons, if you take those numbers and distribute them across the United States where 27 million surgical procedures are performed each year, that could represent more than 350,000 surgical-site infections, urinary tract infections, sepsis -- all kinds of things that we know can be avoided when surgical teams work well together," Hickson said in the news release.

And Cooper thinks professionals could benefit from an opportunity to see themselves the way other team members see them.

"Most develop insight and self-regulate," he said. "Physicians are lifelong learners and respond if their medical colleagues have the courage to provide feedback in an organized, stepwise approach."

The study was published online Feb. 15 in the journal JAMA Surgery.

SOURCE: Vanderbilt University Medical Center, news release, Feb. 15, 2017

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