Rude doctors may endanger their patients, study suggests

When you’re choosing a doctor to perform your surgery, you certainly want to know their credentials – but it might be worthwhile to find out if they are generally a good person, too, a new study suggests. 

Some doctors argue that a degree of coldness helps them remain objective in emotionally charged situations.

But new research from Vanderbilt University suggests that some go too far and disrupt the sense of teamwork in their operating rooms.

The new study found that the patients whose surgeons were described as “unprofessional” by nurses and support staff were at 14 percent higher risks of complications.

As a surgeon cuts through layers of tissue and repairs organs or injuries, a patient’s life depends on the doctor’s head being clear and hands being steady.

But it also depends on the entire surgical team operating in sync.

A surgeon may get the glory – and about twice the money, compared to a nurse – but a successful operation is an all-hands-on-deck affair. 

Typically, surgery involves at least one doctor who is performing the operation, an anesthesiologist, at lease on nurse and one circulating tech, between two and four scrub techs and often even more medical and operating room (OR) personnel. 

As the leader, the surgeon’s attitude can deeply impact not only the mood but the outcomes in an OR. 

To test this theory, Vanderbilt scientists analyzed data and reports on surgeries performed on 13,653 patients in two hospitals in the US by 202 surgeons.  

They also looked at reports of misconduct made against those surgeons, and wondered if how doctors treat the staff around them might also be the canary in the coal mine for how concerned or flippant they are about patient safety. 

‘Nurses and other health care team members are well positioned to observe surgeons’ behaviors and can address unprofessional behavior directly or convey concerns through their institution’s electronic event-reporting system,’ the study authors write.

They cite, as an example, a nurse asking a doctor a question relevant to procedure and record-keeping and being brushed off by the surgeon.  

A nurse in that situation ‘might believe that Dr X is showing disrespect for and trivializing the system’s safety processes.’

The same can be true for other doctors involved in a operation, who find a surgeon difficult to work with. 

If another doctor acts quickly to rectify a problem during surgery and then gets punished by the surgeon, that could create other problems down the line. 

For instance: ‘A physician from another service who reports, “The patient was hypotensive and we started vasopressors. I told Dr Y (the surgeon) as soon as I started the infusion. Dr Y yelled at me for 5 minutes about not giving the necessary information,” might hesitate to speak up in future cases when a patient deteriorates,’ the report authors write.

The researchers found that patients operated on by surgeons with anywhere between one and three complaints filed against them were at a 14.3 percent greater risk of developing a complication. 

‘This study provides additional evidence of the important association between unprofessional behaviors and team performance by directly measuring patient outcomes,’ the study authors write. 

‘Although unprofessional behaviors by surgeons may occur in stressful environments with patients who have numerous comorbidities and critical illnesses, this study and [a previous one, taken together] suggest that these are the environments in which surgeons have opportunities to promote and support optimal team function.’

And that teamwork could be the difference between a smooth or long recovery or even life or death, for a patient.