The Surgical Never Errors Post number 2

The prima donna in the room

prima donna……a very temperamental person with an inflated view of their own talent or importance.

I am certain that all of the blog readers would be quick to assign the label of prima donna to you know who, me and my brethren surgeons. We prefer to think of ourselves as team leaders with great concern for orchestration of the activities that take place during the operation, more analogous to the conductor of an orchestra. To further refine this analogy, let’s say that the conductor of the orchestra plays concert piano during the performance and acts as the guest conductor. Why guest? because as guest conductor he or she does not choose the players in the instrument sections but has to play along side them. This analogy continues to work because serious professional surgeons rehearse operations, especially complex operations in their heads multiple times before the operation starts.

Most of us would prefer to not have a prima donna surgeon as our surgical team leader. The last thing we need is a hard to get along with narcissist leading a team that doubtless does not respect the surgeon and may even dislike the person.

When you are anesthetized or sedated, you will not be able to observe your surgeon’s personality traits, however when you are fully conscious, awake, and alert in the surgeon’s office pay attention to your surgeon’s interaction with others. Surgeons of either sex may act out in the office. For the purposes of this discussion I will assume that the patient is not a narcissistic prima donna but we all know too well that some patients may possess this unflattering trait as well. BTW we do our best to prune patients of this type out of our practice. We can tell much about patients by the way they treat office staff. I usually tell a patient who treats my staff with no respect that we and the patient are not a good mix….no chemistry.

Do not be fooled by a pompous surgeon. Pomposity does not imply exceptional surgical skill. Observe how the surgeon interacts with staff. As HCPs we are professionals who should empower and respect staff, not denigrate, abuse, or embarrass the staff. Such bad boy or bad girl behavior should be obvious to patients and warn that the surgeon may be prima donna. Surgeons who have the opinion they they are better than every one with whom they work set up a power dimension index prone to error occurrence especially if they believe that they are too good to be the cause of an error. The staff feels inhibited to say something to this type of surgeon for fear of retribution, being called on the carpet, and perhaps belittled. The staff member observes this kind of surgeon possibly making a serious error will remain silent and permit the error to occur even if that means the patient will be injured. Believe me, you do not need this type of surgeon to operate on you.

What about cultural differences between team members and how that also may have an effect on power dimension index? We will go into this politically incorrect area next time.

Have a great day and thanks for reading my patient safety blog!