Updated 16 February 2017

Rude surgeons may make more errors during operations

Investigators found that people treated by surgeons regarded as 'disrespectful' experienced more complications during the month after their surgery.


"Why are specialists' receptionists so rude? One would think that since they represent the specialist they work for, that specialist's PA would be friendly and courteous," writes a frustrated Health24 reader to our CyberShrink.

However, it seems that the buck does not stop with the receptionist, and sometime doctors can also be . . . well just rude!

A history of complaints

A new study finds that surgeons with a history of patient complaints regarding their personalities or attitude are also more likely to make mistakes in the operating room.

Researchers compared surgical outcomes with patient reports of unprofessional behaviour 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 Centre (VUMC) researchers.

Surgical team morale matters

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 paediatrics and director of the Vanderbilt Centre for Patient and Professional Advocacy.

"For example, if a surgeon speaks disrespectfully to an anaesthesiologist during a procedure, the anaesthesiologist may become reluctant to speak up the next time the surgeon and the anaesthesiologist 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 their concerns with the surgeon," Cooper noted.

The high cost of a bad attitude

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 analysing patient and family reports about unprofessional behaviour could help spot surgeons with higher complication rates.

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

Hickson called the numbers significant.

Turn that frown upside down

"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 organised, stepwise approach."

The study was published online in the journal JAMA Surgery.

Advice from our Cybershrink

Health24's expert psychiatrist, Professor Simpson, says when service is bad, you should announce it loudly, and be specific in your criticism about exactly what was wrong and how it should be improved. Prof Simpson adds that where service has been particularly good, be just as clear about both thanking the person personally.

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