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New Study Links Unprofessional Behavior to Adverse Patient Outcomes


A new study published in JAMA Surgery suggests that patients tend to suffer when surgeons exhibit unprofessional behavior towards their colleagues, including nurses, physicians, and other care providers.

As a nurse, you may have been on the receiving end of a surgeon’s unprofessional behavior, but the study shows these kinds of incidents aren’t just rude or inconsiderate, they’re actually dangerous to patients. When surgeons exhibit this kind of behavior, such as yelling at their co-workers or showing a lack of integrity, nurses and other care providers may be less likely to speak up in the future.

Learn more about this new study and what it tells us about professional demeanor in the workplace.

How Inappropriate Behavior Affects Patient Outcomes

The study analyzed interactions between surgeons and their colleagues and whether these exchanges lead to adverse patient outcomes using post-operation reports. Researchers gathered data from the National Surgical Quality Improvement Program, a nationally validated, risk-adjusted, outcomes-based program to measure and improve the quality of surgical care.

For the study, researchers collected data on:

1. 13,700 patients
2. 202 surgeons
3. And 70% of these surgeons were male

The study defines “unprofessional behavior” across four areas of concern, including:

1. Unclear or disrespectful communication
2. Poor or unsafe care
3. Lack of integrity
4. Failure to follow through on professional responsibilities

The results of the study show that if surgeons were involved in one or more incidents of unprofessional behavior over a 36-month period, their patients were 12% to 14% more likely to experience post-surgery complications such as infections, pneumonia, stroke, and kidney failure.

Unprofessional behavior in the workplace can have a lasting effect on patient outcomes. If a surgeon yells at a nurse or another colleague, they will be less likely to offer suggestions in the future, even if the surgeon is showing a disregard for patient safety.

The study mentions an incident in which a nurse asked a surgeon for a safety-related break, but the surgeon responded by saying, “Get going without all this time-out nonsense.” Forcing nurses to work without breaks puts patients at risk.

Combating the “Brilliant Surgeon” Myth in Healthcare

Thanks to TV shows and movies like House, Grey’s Anatomy, and other medical dramas, the idea of the difficult but brilliant surgeon has been a mainstay in popular culture. Surgeons are highly skilled professionals that often work under pressure where the slightest error could result in the death of a patient. Some surgeons may abuse their role and mistreat others while performing surgery or discussing medical treatment.

A 2018 article in the AMA Journal of Ethics titled “The Evolving Surgeon Image” talks about the stereotype of the abrasive, disrespectful surgeon. The article links this kind of unprofessional behavior to the masculine archetype, stating, “As a male-dominated profession, it is not surprising that many of the extreme behaviors associated with surgeons reflect rigid definitions of masculinity. Traditional masculinity is associated with being powerful, strong, and in control; self-sufficiency, sexual prowess, and monetary success are lauded, and demonstration of weakness or vulnerability is frowned upon.”

The article mentions that roughly 81% of practicing general surgeons were male as of 2015. In orthopedic surgery, 95% of surgeons were male. But these statistics and theories are not meant to excuse this kind of behavior. The article goes on to suggest that having a more diverse surgical workforce, including more women and surgeons of color, may alter these stereotypes.

How to Combat Inappropriate Behavior Among Care Providers

Thanks to the study published in JAMA Surgeon, the healthcare community may start to reconsider these stereotypes. Unprofessional behavior can harm patients and lead to adverse outcomes, proving there’s no place for this kind of behavior in the workplace. Some surgeons have even suggested that being rude or insensitive can actually help them focus during stressful procedures, but this can be misleading, considering the results of the study.

Researching these trends can help healthcare providers think differently about themselves and their colleagues’ behavior in the workplace. Several top medical schools have also started offering courses on kindness and empathy, grading students in part by using personality assessments.

Studies also show giving surgeons more feedback in terms of their behavior in the workplace can also combat inappropriate behavior. However, it’s important to remember that the study previously mentioned found that just a small percentage of surgeons exhibited this kind of behavior. For the most part, the surgeons analyzed in the study were not disrespectful to their colleagues.

Everyone should be held accountable for how they treat their colleagues, regardless of their training, pay grades, or medical expertise. Hopefully more surgeons will resist the urge to be disrespectful to their colleagues, even when working under pressure.






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