The Clinical Orthopaedics and Related Research journal recently published a study examining how surgeon attitudes influence reoperation and readmission rates.
The Federal Aviation Administration instructs new pilots about hazardous attitudes that are incompatible with safe flight, and the study examines how those attitudes might impact orthopedic surgery.
Those attitudes include:
• Macho
• Impulsive
• Worry
• Resignation
• Self-confidence
• Authority
The researchers used validated aviation psychology tools and converted the aviation scenarios to analogous situations for surgeons. There were 41 surgeons participating in the study with 37 completing the attitude prevalence protocol and 31 submitting complete reoperation and readmission data.
The researchers found:
1. There were nine surgeons — 24 percent — who reported levels of "macho thought" considered hazardous among pilots. There were elevated levels of self-confidence in three surgeons — 8 percent.
2. Only two surgeons reported impulsivity and one surgeon reported high levels of authority.
3. None of the surgeons reported hazardous levels of resignation and one reported elevated levels of worry.
4. Macho attitude levels predicted 19 percent of the variation in the surgeon's rate of readmission and reoperation.
5. Eleven surgeons — 30 percent — reported at least one elevated attitude level.
The researchers concluded, "High levels of hazardous attitudes may not be consistent with the routine delivery of safe surgical care in a teamwork setting where human factors and safe systems are the key to success."