'Great Surgeons' Who Bully Med Students Put Us All At Risk

Nobody likes a mean doctor. A physician who spews jargony gibberish, the surgeon who snaps at a nurse, the gerontologist who doesn’t have a kind word for your mother — these are not the doctors we recommend glowingly to friends.

While we often excuse their bad “bedside manner” because they are “good doctors” or “gifted surgeons,” doing that is hurting everyone, a must-read story in Aeon suggests.

Doctors who are bullies are often dangerous doctors, as well, according to author and Harvard medical student Ilana Yurkiewicz.

She opens her Aeon story with a tale that should sound familiar to those who’ve watched Grey’s Anatomy or ER:

He comes to the operating room late, greets no one, and berates the nurse for not setting up the stepstools the way he likes. He tells the resident she doesn’t know the anatomy and sighs when she adjusts her grip on a surgical tool. He slaps the hand of the medical student when she reaches for the retractor to pull back skin for a clearer view.

The operating room is tense for hours.‘I need a different clamp,’ he says at one point, ‘this one is too dull.’ ‘I’m on it,’ says the scrub nurse. ‘You’re not,’ he retorts, ‘or else it would already be in my hand.’

All of us adorned in blue scrubs and surgical caps stand on edge, braced against the next wrathful outburst. ‘I want to see the tip of my blades,’ the resident explains, staring intently at the monitors where her laparoscopic instruments have not quite come into view. ‘Just cut,’ the lead surgeon barks at her.

By the end of the operation, the intern’s hand shakes as he sutures the wounds closed, to the beat of the running condescending commentary on his halting speed and less-than-perfect stitches.

She goes on to explain that while most people in health professions are generous team players, those who aren’t do more than rub people the wrong way: By making their underlings nervous, they close necessary channels of communication. The more hesitant a resident is to ask an attending a question, the more likely that she’ll just go full steam ahead, uncertainties be damned.

When medical teams don’t foster mutual respect and open communication, it’s not just interns and nurses who suffer — it’s patients.

Yurkiewicz explains:

Australian researchers reported a shocking find: the vast majority of medical errors, some 70‑80 per cent, are related to interactions within the health care team. In the early 2000s, a report by the Joint Commission that accredits health care organisations in the US studied adverse events over a 10‑year period and discovered that communication failure was the number-one cause for medication errors, delays in treatment, and surgeries at the wrong site. It was also the second leading cause of operative mishaps, postoperative events, and fatal falls.

Still, bullying is a huge part of medical culture. Much like in a fraternity, yesterday’s downtrodden, snapped-at junior doctors become tomorrow’s insult-slinging attendings.

But it doesn’t have to be that way.

The solution, Yurkiewicz suggests, is to attack the problem from all sides. Mistreatment needs to be reported and sanctioned. Medical professionals need to make sure patient care — not egos, and not saving face — is at the forefront of every decision. And the system needs to treat doctors more humanely, so they’re not underslept, underfed, and predisposed to general grumpiness.

Doctors would surely be thankful, but the real winners here will be their patients.

Read the whole article at Aeon >>

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