National Clinician Scholars Program at the Institute for Healthcare Policy & Innovation, University of Michigan, NCRC Building 14, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA.
Department of Surgery, University of Michigan, Ann Arbor, MI, USA.
Surg Endosc. 2019 Feb;33(2):471-474. doi: 10.1007/s00464-018-6320-z. Epub 2018 Jul 9.
There are many reasons to believe that surgeon personality traits and related leadership behaviors influence patient outcomes. For example, participation in continuing education, effective self-reflection, and openness to feedback are associated with certain personalities and may also lead to improvement in outcomes. In this context, we sought to determine if an individual surgeon's thinking and behavior traits correlate with patient level outcomes after bariatric surgery.
Practicing surgeons from the Michigan Bariatric Surgery Collaborative (MBSC) were administered the Life Styles Inventory (LSI) assessment. The results of this assessment were then collapsed into three major styles that corresponded with particular patterns of an individual's thinking and behavior: constructive (achievement, self-actualizing, humanistic-encouraging, affiliative), passive/defensive (approval, conventional, dependent, avoidance), and aggressive/defensive (perfectionistic, competitive, power, oppositional). We compared patients level outcomes for surgeons in the lowest, middle, and highest quintiles for each style. We then used patient level risk-adjusted rates of complications after bariatric surgery to quantify the impact surgeon style on post-operative outcomes.
We found that patients undergoing bariatric surgery performed by surgeons with high levels of constructive (achievement, self-actualizing, humanistic-encouraging, affiliative) and passive/defensive (approval, conventional, dependent, avoidance) styles had lower rates of adverse events compared with surgeons with low levels of the respective styles [High constructive: 14.7% (13.8-15.6%), low constructive: 17.7% (16.8-18.6%); high passive: 14.8% (13.4-16.1%), low passive: 18.7% (17.3-19.9%)]. Conversely, surgeons identified with high aggressive styles (perfectionistic, competitive, power, oppositional) had similar rates of post-operative adverse events compared with surgeons with low levels [high aggressive: 15.2% (14.3-16.1%), low aggressive: 14.9% (14.2-15.6%)].
Our analysis demonstrates that surgeons' leadership styles are correlated with surgical outcomes for individual patients. This finding underscores the need for professional development for surgeons to cultivate strengths in the constructive domains including intentional self-improvement, development of interpersonal skills, and the receptiveness to feedback.
有许多理由相信外科医生的个性特征和相关领导行为会影响患者的预后。例如，参与继续教育、有效的自我反思和对反馈的开放态度与某些个性特征有关，也可能导致预后的改善。在这种情况下，我们试图确定个体外科医生的思维和行为特征是否与减重手术后的患者水平结局相关。
密歇根州减重外科学术合作组织（MBSC）的执业外科医生接受了生活方式评估（LSI）。然后，将该评估的结果汇总为与个体思维和行为模式相对应的三个主要风格：建设性（成就、自我实现、人文鼓励、亲和）、消极/防御性（认可、传统、依赖、回避）和攻击性/防御性（完美主义、竞争、权力、对立）。我们比较了每个风格的最低、中、高三分位外科医生的患者水平结局。然后，我们使用减重手术后患者水平风险调整并发症发生率来量化外科医生风格对术后结局的影响。
我们发现，接受具有高水平建设性（成就、自我实现、人文鼓励、亲和）和消极/防御性（认可、传统、依赖、回避）风格的外科医生进行减重手术的患者，其不良事件发生率低于具有低水平相应风格的外科医生[高建设性：14.7%（13.8-15.6%），低建设性：17.7%（16.8-18.6%）；高消极：14.8%（13.4-16.1%），低消极：18.7%（17.3-19.9%）]。相反，具有高水平攻击性风格（完美主义、竞争、权力、对立）的外科医生与具有低水平攻击性风格的外科医生相比，术后不良事件发生率相似[高攻击性：15.2%（14.3-16.1%），低攻击性：14.9%（14.2-15.6%）]。
我们的分析表明，外科医生的领导风格与个别患者的手术结局相关。这一发现强调了外科医生需要进行专业发展，以培养建设性领域的优势，包括有目的的自我提升、发展人际交往能力和对反馈的接受能力。
