Patients seeing surgeons who elicit the greatest number of patient complaints are 14 percent more likely to experience complications within 30 days of a procedure than patients who see surgeons widely perceived as respectful, according to new research from Vanderbilt University Medical Center in Nashville, Tenn.
Here are five things to know from the study, which is published in JAMA Surgery.
1. The study examined de-identified data from the National Surgical Quality Improvement Program for 32,125 patients treated at one of seven health systems. Eleven percent of patients experienced a complication, including surgical site infections, pneumonia, renal conditions, stroke, cardiovascular conditions, thromboembolic conditions, sepsis and urinary tract infections.
2. Researchers correlated that complication rate with patient and family reports of disrespectful and rude surgeon behavior. These accounts were documented by the hospitals' patient relations offices for two years before the patient underwent a surgical procedure.
3. Some patient complaints described behaviors that could intimidate or deter patient-physician communication. Other complaints detailed observations of a physician's disrespectful or rude interaction with other healthcare team members that might distract focus.
4. "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," said Gerald Hickson, MD, senior vice president for quality, safety and risk prevention at VUMC.
5. This study builds on a body of research out of Vanderbilt examining the link between patient satisfaction and the likelihood of malpractice litigation. It also suggests physician incivility can impair the healthcare team's response to patient complications.
"Patients and their families are uniquely positioned to observe physician behavior and performance," said lead author William Cooper, MD, a professor of pediatrics at Vanderbilt University and director of the Vanderbilt Center for Patient and Professional Advocacy. "And analysis of their stories provides insight into how physicians who interact with patients with disrespect and rudeness might also interact with other medical professionals and how those interactions could impact patient care. Team members who experience disrespect may be less likely to speak up, ask for help or see changes in patients' conditions."