Could patients who are under the care of surgeons with a history of communicating impolitely be at higher risk of medical complications? A new study says: Yes.
This month, Vanderbilt University Medical Center research found connections between rude or disrespectful behavior from surgeons and the quality of their performance in the operating theater.
The study analyzed unsolicited patient and family reports detailing bad experiences talking to surgeons, recorded by the National Surgical Quality Improvement Program (NSQIP). By studying data based on 32,125 patient reports, researchers aimed to delve deeper into reasons for medical malpractice claims.
“This study builds on more than 20 years of Vanderbilt research experience,” said lead author William Cooper, M.D., at the Vanderbilt Center for Patient and Professional Advocacy. Cooper continued:
“Dr. Hickson, one of the co-authors, conducted groundbreaking work that proved that physicians with more than their fair share of unsolicited patient complaints are at higher risk for medical malpractice claims. We recognize that making families unhappy increases the likelihood of families filing suit in the face of any adverse outcome.”
Indeed, this latest study showed another group of people affected negatively by disrespectful interactions with high-risk physicians: other surgical team members.
Sticks and Stones – and Words, Apparently – Can Hurt Patients, It Turns Out
According to findings, surgeons attracting the most complaints caused 14 percent more post-surgery complications than surgeons perceived as “respectful.” Examining the first 30 days following procedures, researchers found these patients experiencing everything from surgical site infections to stroke, pneumonia, and cardiovascular conditions.
This 14 percent difference could represent over 350,000 adverse outcomes – every last one of them preventable if surgical teams were able to do their jobs properly.
“We need to reflect on the impact patients and families experience from these avoidable outcomes,” said Gerald Hickson, M.D., senior vice president for Quality, Safety, and Risk Prevention at VUMC. “From conservative economic estimates, the cost of addressing the excess surgical complications could amount to more than $3 billion annually.”
Getting to the Root of the Problem
Although Vanderbilt University’s study points out that avoidable medical errors warrant careful consideration, these events are not new.
Last year, research found that preventable medical negligence has become so commonplace in America’s hospitals that they are the third leading cause of death. These errors not only end lives but cause serious injuries – even disabilities, such as the life-altering cerebral palsy. This condition, as well as others such as Erb’s palsy, result from medical errors made during pregnancy or birth. But the effects are lifelong.
This epidemic of error owes to the fact that unfavorable outcomes of care go unreported. Doctors and other medical professionals – whose top priority should be the safety of their patients – are unwilling to own up to their mistakes. Instead, they prioritize their careers and reputations. Many hospitals, too, make little-to-no effort to track harmful incidents for fear of closure.
It is ignorance toward this growing problem that has allowed it to continue. But, thankfully, studies such as this one help to get to bottom of the reasons behind life-altering medical mistakes and injuries.
Communication Is Key
The Vanderbilt team has developed a program called the Patient Advocacy Reporting System (PARS) to identify clinicians at high risk of medical malpractice claims. This system is used by more than 140 hospitals in the United States and has investigated 1,600 physicians since 2000. 80 percent of these changed their behaviors and received fewer complaints and claims.
But, authors suggest, more healthcare institutions need to make bigger strides to listen to and record patient stories to reduce future health risks. Meanwhile, patients and families are able to provide strong insight into the goings-on within hospitals and expose careless medical error.
And the most promising solution?
Surgical team members whose work is impacted by disrespectful behavior may be reluctant to share their concerns. Study authors, however, urge medical professionals who witness or receive disrespectful behavior to be bold enough to come forward.
“Physicians are lifelong learners,” said Cooper, “and respond if their medical colleagues have the courage to provide feedback in an organized, stepwise approach.” We can only hope this is true.