研究表明，手术后病人的表现可能取决于医生的行为

研究表明，手术后病人的表现可能取决于医生的行为

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

一项新的研究表明，病人手术后是否有问题可能取决于他们的外科医生的行为。

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.

这项周三发表在《美国医学会外科杂志》上的研究发现，如果外科医生在手术前的三年里经常被同事举报有“不专业的行为”，那么患者发生并发症的风险就更高。

"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."

“让关键的事情在正确的时间发生是这些团队的一个重要功能，”研究作者威廉·O·库珀博士说，他是范德比尔特大学医学中心患者和专业倡导中心的主任。“要做到这一点，人们必须能够相互交谈，表现出相互尊重，并经常了解周围发生的事情。”

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.

在这项研究中，有14.1%的患者的外科医生至少被同事举报过四次，他们经历了医疗或手术并发症，包括之后的感染、肺部和肾脏问题。

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."

库珀说，这些数据来自于两个学术医疗中心的13600多名患者和大约200名外科医生，看起来可能只是略有增长。但如果他们是整个国家的代表，“这可能意味着每年有超过50万的额外并发症，只是梳理一下这些非职业行为的影响……这也会带来成本。”

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.

外科医生可能会因为一系列违反职业道德的行为而被举报，比如对同事大喊大叫或无视医院政策，但这些行为不需要包括对病人造成直接伤害或忽视的例子。相反，数据表明，不良行为可能会在更大范围内造成一种环境，在这种环境中，人们不能有效地沟通，或者害怕发言或寻求帮助，库珀说。

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.

尽管这项研究不能显示出直接的因果关系，但根据最近的另一项研究，先前的研究也将外科医生的不良行为与较差的工作表现和医疗事故索赔联系在一起。该研究的作者表示，这些发现并不令人惊讶。

"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."

“重要的不仅仅是你切、缝、扎的有多好，”外科肿瘤学家亚历克斯·海恩斯博士说，他没有参与这项研究。“你的沟通、引导和解释的能力对你的病人的表现至关重要。”

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采访了来自不同领域的几位外科医生和实习生。但仅凭同事的意见很难判断，有些抱怨似乎微不足道或武断。许多不专业的行为完全没有被报道。

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."

尽管如此，医生们说这个领域正在向好的方向发展。海恩斯说，对暴躁的外科医生的刻板印象“可能是历史上的，而不是现在的。在21世纪，我们看看谁正在成为外科医生，这和几十年前有很大的不同。”