'Unprofessional' Surgeons Hurt Patient Outcomes: Study

Before having that operation, you might want to ask your surgeon's colleagues about his behavior.

A new study finds that patients whose surgeons have more complaints from coworkers about unprofessional conduct are at increased risk for complications during and after surgery.

Researchers examined data on more than 13,500 adult patients in the United States who were operated on by 202 surgeons between 2012 and 2016.

Patients whose surgeons were reported for unprofessional behavior in the 36 months before their operations were at increased risk for complications such as wound infections, pneumonia, blood clots, kidney failure, stroke and heart attack.

Unprofessional behavior included poor or unsafe practices in the operating room, disrespectful communication with coworkers, and failure to follow through on expected professional responsibilities, such as signing verbal orders.

"Surgical teams require every team member to perform at their highest level. We were interested in understanding whether surgeons' unprofessional behaviors might undermine culture, threaten teamwork, and potentially increase risk for adverse outcomes of care," said corresponding author Dr. William Cooper in a Vanderbilt University Medical Center news release. Cooper is vice president for patient and professional advocacy at the medical center.

Compared to patients whose surgeons had no reports of unprofessional behavior, those whose surgeons had one to three reports were 18% more likely to have complications, and those whose surgeons had four or more reports were nearly 32% more likely to have complications. The study only observed an association and did not prove cause and effect.

There was no difference between the two groups in rates of death, the need for a second operation, or readmission to the hospital within 30 days of their first operation, the researchers found.

In addition, female surgeons were less likely than male surgeons to get reported for unprofessional conduct, according to the study.

"Unprofessional behavior modeled by the team leads reduces the effectiveness of the team," noted study senior author Dr. Gerald Hickson, professor of medical education and administration at Vanderbilt, in Nashville, Tenn.

"It's really about common sense," he added. "If someone is disrespectful to you, how willing are you to share information or ask for advice or help from that individual?"

"Future work should assess whether improved interactions with patients, families and coworkers by surgeons who receive interventions for patterns of unprofessional behavior are also associated with improved surgical outcomes for their patients," the researchers concluded.

The study was published in the journal JAMA Surgery.

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