研究表明，手術(shù)后病人的表現(xiàn)可能取決于醫(yī)生的行為

研究表明，手術(shù)后病人的表現(xiàn)可能取決于醫(yī)生的行為

Whether patients have problems after surgery could depend on their surgeons' behavior, a new study suggests.

一項(xiàng)新的研究表明，病人手術(shù)后是否有問(wèn)題可能取決于他們的外科醫(yī)生的行為。

The study, published Wednesday in the journal JAMA Surgery, found that patients were at higher risk of complications if their surgeons were more often reported by colleagues for "unprofessional behavior" in the three years leading up to the surgery.

這項(xiàng)周三發(fā)表在《美國(guó)醫(yī)學(xué)會(huì)外科雜志》上的研究發(fā)現(xiàn)，如果外科醫(yī)生在手術(shù)前的三年里經(jīng)常被同事舉報(bào)有“不專(zhuān)業(yè)的行為”，那么患者發(fā)生并發(fā)癥的風(fēng)險(xiǎn)就更高。

"Having critical things happen at the exact right time is an essential function for those teams," said study author Dr. William O. Cooper, director of the Center for Patient and Professional Advocacy at Vanderbilt University Medical Center. "And to do that, people have to be able to talk with each other, show mutual respect and constantly be aware of what's going on around them."

“讓關(guān)鍵的事情在正確的時(shí)間發(fā)生是這些團(tuán)隊(duì)的一個(gè)重要功能，”研究作者威廉·O·庫(kù)珀博士說(shuō)，他是范德比爾特大學(xué)醫(yī)學(xué)中心患者和專(zhuān)業(yè)倡導(dǎo)中心的主任。“要做到這一點(diǎn)，人們必須能夠相互交談，表現(xiàn)出相互尊重，并經(jīng)常了解周?chē)l(fā)生的事情。”

In the study, 14.1% of patients whose surgeons had been reported by co-workers at least four times experienced medical or surgical complications, including subsequent infections, lung and kidney problems.

在這項(xiàng)研究中，有14.1%的患者的外科醫(yī)生至少被同事舉報(bào)過(guò)四次，他們經(jīng)歷了醫(yī)療或手術(shù)并發(fā)癥，包括之后的感染、肺部和腎臟問(wèn)題。

The numbers -- which come from more than 13,600 patients and roughly 200 surgeons at two academic medical centers -- may seem like a small increase, Cooper said. But if they are representative of the country at large, "that could mean more than half a million additional complications every year, just teasing out the effects of these unprofessional behaviors ... which also results in costs."

庫(kù)珀說(shuō)，這些數(shù)據(jù)來(lái)自于兩個(gè)學(xué)術(shù)醫(yī)療中心的13600多名患者和大約200名外科醫(yī)生，看起來(lái)可能只是略有增長(zhǎng)。但如果他們是整個(gè)國(guó)家的代表，“這可能意味著每年有超過(guò)50萬(wàn)的額外并發(fā)癥，只是梳理一下這些非職業(yè)行為的影響……這也會(huì)帶來(lái)成本。”

Surgeons might be reported for a range of unprofessional conduct -- like yelling at co-workers or disregarding hospital policies -- that need not include examples of direct harm or neglect to patients. Rather, the data suggests that bad behavior could more broadly create an environment in which people don't communicate effectively or are afraid to speak up or ask for help, Cooper said.

外科醫(yī)生可能會(huì)因?yàn)橐幌盗羞`反職業(yè)道德的行為而被舉報(bào)，比如對(duì)同事大喊大叫或無(wú)視醫(yī)院政策，但這些行為不需要包括對(duì)病人造成直接傷害或忽視的例子。相反，數(shù)據(jù)表明，不良行為可能會(huì)在更大范圍內(nèi)造成一種環(huán)境，在這種環(huán)境中，人們不能有效地溝通，或者害怕發(fā)言或?qū)で髱椭瑤?kù)珀說(shuō)。

Although the study can't show direct cause and effect, previous research has also linked negative behavior among surgeons to poorer performance and malpractice claims, according to another recent study whose author said these findings are hardly surprising.

盡管這項(xiàng)研究不能顯示出直接的因果關(guān)系，但根據(jù)最近的另一項(xiàng)研究，先前的研究也將外科醫(yī)生的不良行為與較差的工作表現(xiàn)和醫(yī)療事故索賠聯(lián)系在一起。該研究的作者表示，這些發(fā)現(xiàn)并不令人驚訝。

"It's not just how well you cut, sew and tie," said surgical oncologist Dr. Alex Haynes, who was not involved in the study. "It's how well you communicate, lead and explain that matters to how your patients do."

“重要的不僅僅是你切、縫、扎的有多好，”外科腫瘤學(xué)家亞歷克斯·海恩斯博士說(shuō)，他沒(méi)有參與這項(xiàng)研究。“你的溝通、引導(dǎo)和解釋的能力對(duì)你的病人的表現(xiàn)至關(guān)重要。”

CNN spoke to several surgeons and trainees across various fields. But it can be hard to tell just by looking at colleagues, with some complaints seeming minor or arbitrary. And many unprofessional behaviors go completely unreported.

CNN采訪了來(lái)自不同領(lǐng)域的幾位外科醫(yī)生和實(shí)習(xí)生。但僅憑同事的意見(jiàn)很難判斷，有些抱怨似乎微不足道或武斷。許多不專(zhuān)業(yè)的行為完全沒(méi)有被報(bào)道。

Still, doctors say the field is changing for the better. The stereotype of the brusque surgeon, Haynes said, "is probably more historic than current. When we look at who are becoming surgeons now, in the 21st century, it's very different than it was decades ago."

盡管如此，醫(yī)生們說(shuō)這個(gè)領(lǐng)域正在向好的方向發(fā)展。海恩斯說(shuō)，對(duì)暴躁的外科醫(yī)生的刻板印象“可能是歷史上的，而不是現(xiàn)在的。在21世紀(jì)，我們看看誰(shuí)正在成為外科醫(yī)生，這和幾十年前有很大的不同。”