Surgeons emotionally affected by surgical complications

Many surgeons are seriously affected on an emotional level when complications occur in the operating theatre, according to a new study.

Researchers at Imperial College London interviewed 27 surgeons about the personal and professional impact of surgical complications. Many reported that they receive inadequate support from their institutions for dealing with such incidents.

The findings, published in the British Journal of Surgery, provide insights into the factors that affect surgeons’ reactions to surgical complications and how surgeons could be better supported in their aftermath.

The operating room is one of the highest risk areas for serious complications, with potentially profound consequences for patients and healthcare professionals. But there has been little research into how surgeons respond to serious complications or how best to support staff following such events.

Recent findings indicate that surgeons who reported a surgical error in recent months are more likely to have a lower quality of life and symptoms of burnout and depression. Such effects are important for surgeons and their families as well as for their patients, as high levels of stress may affect a surgeon’s clinical performance and compromise patient safety.

To explore the impact of complications on surgeons, Dr Anna Pinto and colleagues at Imperial examined how surgeons are affected by such incidents on a personal and professional level, which factors affect their reactions, how they cope with their consequences, and how they perceive support at their institutions.

The researchers conducted individual interviews with 27 general and vascular surgeons from two large NHS trusts in London. The interviews revealed that surgeons are seriously affected by major surgical complications, particularly those for which they feel responsible.

All participants referred to at least one case in their practice where a complication affected them significantly on a personal and professional level. How preventable the complications were, the surgeon’s personality and experience, patients’ outcomes and reactions, colleagues’ reactions, and the institution’s culture all played a part in determining the surgeons’ reactions.

Surgeons generally described institutional support as inadequate. They suggested several approaches to better support surgeons in managing the impact of complications, including better mentoring, teamwork approaches in surgical practice, blame-free forums for the discussion of complications, and supports aimed at the human aspects of complications.

“This study contributes to an understanding of the wider impact of surgical complications on surgeons’ personal and professional wellbeing,” said Dr Pinto. “Given the potential impact on patients as well as on surgeons, additional support and mentoring should be seriously considered by the surgical community and by those involved in the management of surgical services. Further research is needed on how to implement support structures that meet the needs of the small number of surgeons who are affected to the point that personal life and clinical practice deteriorate.”

The study was supported by funding from the Health Foundation. The Imperial Centre for Patient Safety and Service Quality, where the work took place, is funded by the National Institute for Health Research.