Anesthesia Management: ASA lecture: Professionalism Ultimately Results in Better Patient Care

What is professional behavior for a physician? It depends on whom you ask, but the bottom line is that a lack of professionalism not only reflects on you personally, it can affect the care of patients. Those issues were discussed during “Tired Of Not Being Taken Seriously? Professionalism And How It Affects You.”

“Professionalism is in the eye of the beholder. There is no comprehensive definition,” said Saundra Curry, M.D., Professor of Anesthesia at Columbia University, New York. She also added that a study of surgical team behaviors and patient outcomes “found increased morbidity and mortality in patients with poor behavioral markers during surgery.”

The study indicated that poor behavior led to a stressful atmosphere resulting in:

– Adverse drug reactions/wrong drug administration

– Wrong patient/procedure/site/side/device

– Transfusion reaction

– Peripheral nerve damage

– ETT misplacement

– Regional complications

– Broken teeth

– Post-op respiratory failure/physio/metabolic/hemodynamic disorders.

A 2006 study found that surgeons caused the most disruption, followed by anesthesiology attendings and RNs and abusive language. That led to stress, frustration, loss of concentration, adverse incidents, errors and poor patient care.

Studies in 2011 and 2012 reported “incivility” in the O.R. that was bad for the health of the staff, as well as burnout, increased medical errors and malpractice claims, and job turnover.

“To counteract this, we need to build up our resistance,” Dr. Curry said. She offered tips for professional responsibility, including working collaboratively, being respectful of one another and participating in the process of self-regulation.

When working with surgeons, physician anesthesiologists should show respect, discuss issues ahead of time to avoid surprises, and speak to them when you perceive their lack of respect and make them own up to it. In the O.R., physician anesthesiologists should work positively with nurses and other staff members, and let them know you appreciate them.

With patients, anesthesiologists should offer comprehensive preoperative evaluation to help them understand your importance and participate in patient education sessions as available.

When facing system issues, physician anesthesiologists should participate in hospital committees to affect change and take part in political action – either personally or through contributions so that others can plead your cause.

“The goal of medicine is excellent patient care,” Dr. Curry said, and she quoted Dr. William Mayo, who said, “The best interest of the patient is the only interest to be considered.”