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Barbers of Civility: An Unkind Hospital Public Relations Problem That Affects Everything

By Stewart Gandolf, Chief Executive Officer

kind handsThis headline really grabbed us: Rude Surgeons Hurt Patients, Increase Costs.

It’s about a study with internal hospital and medical practice PR implications that can’t be good. (Let’s hope this doesn’t sound familiar to you. “Those [surgeons] who berate their staffs are practicing 'bad medicine,' experts say,” according to the item in this month’s issue of The Archives of Surgery. Titled Barbers of Civility, the theme and consequences presented in the article are far more serious than simply being polite around the office.

Study authors Andrew Klein, MD, MBA and Pier Forni, PhD point to consequences in patient outcomes, the number of medical errors, increased medical costs and reduced patient satisfaction. And we suspect that it would also have consequences in professional reputation and prospectively to referrals from medical colleagues.

"Often, surgeons get hired on the basis of their knowledge, training and technical accomplishments," Dr. Klein—a transplant surgeon himself—said in a news release. "But operating rooms are social environments where everyone must work together for the patient's benefit. When a surgeon, who is in the position of power, is rude and belittles the rest of the staff, it affects everything."

A news report observed, “One reason for the more favorable outcomes, the commentary pointed out, may be that 75 percent of hospital pharmacists and nurses say they try to avoid rude or difficult physicians even if they have questions about a patient's medication, according to recent research.”

We’re reminded of a well-known neurosurgeon who was highly regarded in professional circles for his training, experience and credentials. Clinically, he was outstanding. But patients, referring physicians, staff and coworkers rarely had a good word about his personality.

In the kindest of descriptions he was thought of as abrasive with everyone. Ultimately his reputation suffered and physicians were reluctant to direct referrals to his office. It’s the type of hospital or medical practice public relations problem that is difficult to resolve.

In fact, the solution is more than public relations alone. “To address the problem, polite or civil behavior must be nurtured during surgeons' training along with other essential qualities, such as ego strength, confidence, focus, work ethic and dedication,” observes NIH Medline Plus. “For example, if surgeons knew their co-workers better it would help establish a positive culture that would result in improved care, surgical outcomes and job satisfaction.”

The good news is that surgeons who are civil, the report claimed, can more effectively help their patients and reduce costs.

If you’re struggling with a tough problem and would like to discuss it in confidence, quietly let us know.

Andrew S. Klein, MD, MBA; Pier M. Forni, PhD. Arch Surg. 2011;146(7):774-777. doi:10.1001/archsurg.2011.150

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