Disruptive docs make more mistakes in the operating room

New research finds that surgeons who are rude and disrespectful to patients are more likely to make mistakes in the operating room.

The study, published this week in JAMA Surgery and conducted by the Vanderbilt University Medical Center (VUMC) in collaboration with six other major academic health systems, found that hospital leaders may want to pay attention when they receive unsolicited complaints about physician behavior from patients and their families.

That’s because those patients treated by misbehaving doctors also had 14% more complications in the month after their surgeries than patients who were treated by surgeons with better bedside manners. Those complications included surgical site infections, pneumonia, renal conditions, stroke, sepsis and urinary tract infections.

Disruptive doctors also impact the work of members of the surgical team, the researchers found.

The study looked at 2011-2013 data from seven medical centers that participated in the National Surgical Quality Improvement Program. The data involved approximately 32,000 adult patients and 800 surgeons.

“Even though there was only a 14% 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," Gerald Hickson, M.D., senior vice president for Quality, Safety and Risk Prevention at VUMC, said in a study announcement. He estimated the cost of these excess surgical complications to be as much as $3 billion annually.

Researchers said the findings indicated the importance of healthcare leaders listening to and documenting patient stories in real time. Those who do can identify at-risk physicians and intervene to promote safety and reduce risk.

Eighty percent of the 1,600 physicians and surgeons who received interventions through VUMC’s Patient Advocacy Reporting System responded favorably, researchers said. As a result, they experienced fewer patient complaints about disrespectful behavior and fewer malpractice claims.

"Our findings reinforce the importance of giving professionals who are associated with a disproportionate share of patient complaints the opportunity to see themselves in the mirror, the way other team members see them," said William Cooper, M.D., Cornelius Vanderbilt Professor of Pediatrics and director of the Vanderbilt Center for Patient and Professional Advocacy, in the announcement. "Most develop insight and self-regulate. Physicians are lifelong learners and respond if their medical colleagues have the courage to provide feedback in an organized, stepwise approach."