I am not a surgeon. But I know a lot of surgeons. And I work with a lot of surgeons. Most of them are really nice individuals. I would trust my life in their hands. I have also known some not so nice surgeons. Unfortunately, surgeons often have a stereotype of being egotistical, impatient, mean, arrogant, abrasive, and difficult (take a look at the article, "The evolving surgeon image"). I have heard stories of surgeons yelling at other physicians and nurses in the operating room. I have even heard stories of surgeons throwing instruments out of frustration. The British psychologist and author Kevin Dutton conducted an Internet survey of professions with the highest proportion of psychopaths - surgeons ranked in the top 5 of all professions (see his book, "The Wisdom of Psychopaths: What Saints, Spies, and Serial Killers Can Teach Us About Success"). Some authors have even suggested that it's beneficial for surgeons to act this way, claiming that we don't want our surgeons to be nice, we want them to be good ("Is the quest to build a kinder, gentler surgeon misguided?").
Hollywood has only perpetuated these stereotypes. For example, William Hurt starred as a surgeon in the 1991 movie, "The Doctor" who undergoes a radical, personal transformation in his attitude and approach to patients when he is diagnosed with cancer. Alec Baldwin played a cardiac surgeon in the 1993 film, Malice. At one point, his character denied having a "God complex" by saying, "I am God." There are a few Hollywood surgeons that have broken the mold (think of the Hawkeye and Pierce in the television series, M*A*S*H or the character played by Michael J. Fox in Doc Hollywood). Let me be clear though, you don't have to be a surgeon to be a jerk. I've also hear stories of physicians that aren't surgeons who have yelled and treated others in a disrespectful and unprofessional manner.
Here's my point though. Regardless of their specialty, all physicians (including surgeons) need to treat everyone with respect. Physicians can't do everything that is required to take care of the kinds of patients that are commonplace today - those with complex, really serious medical problems. It truly takes a team of professionals working together and collaboratively to provide safe, effective, high quality care. Gone are the days when the surgeon in the operating room was the "Captain of the Ship" with ultimate authority and responsibility for everything that happens during surgery (there was once a legal doctrine that held surgeons accountable for what everyone else in the operating room, including another physician, the anesthesiologist - thankfully, this doctrine has fallen out of favor). Similarly, most patients in the hospital today don't just have one attending physician - they have several physicians involved in their care. Medicine has become a team sport!
As it turns out, there is some pretty solid evidence to suggest that disruptive behavior (such as throwing instruments, yelling at others, or just plain old being mean) leads to worse care. A group of investigators recently published the findings from their study which looked at the number of post-operative complications (measured out to 30 days after surgery) in a cohort of more than 13,000 patients who were operating on by just over 200 surgeons. They also reviewed the number of reports of unprofessional behavior by each surgeon during the preceding 36 months before surgery. Here's what they found. Patients whose surgeons had a higher number of reports of unprofessional behavior (by their co-workers) had a much higher likelihood of suffering a complication within 30 days of their surgery. In fact, the complication rate was almost 15% higher for patients whose surgeon had at least 1 to 3 reports of unprofessional behavior in the preceding 36 months!
These findings are not new, and they are not unique to surgeons. Studies have consistently shown that disruptive physicians have higher complication rates and worse outcomes compared to their peers. Here's the bottom line. It pays to be respectful and collaborative. It pays to be inclusive. In my own experience and in my own research, we have found that physicians who ask others for their opinions and share a "mental model" of what they are thinking and considering are more likely to have better outcomes. In other words, it pays to be nice.
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