Exploring shared surgical decision‐making from the patient's perspective: is the personality of the surgeon important?

Abstract

Aim The aim was to determine the importance of a colorectal surgeon's personality to patients and its influence on their decision-making. Methods We present a two-part mixed methods study using the Guidance for Reporting Involvement of Patients and the Public (GRIPP-2) long form. Part 1 was an online survey (25 questions) and Part 2 a faceto-face patient and public involvement exercise. Part 1 included patient demographics, details of surgery, overall patient satisfaction (net promoter score) and patient views on surgeon personality (Gosling 10 Item Personality Index). The thematic analysis of free-text responses generated four themes that were taken forward to Part 2. These themes were used to structure focus group discussions on surgeon-patient interactions. Results Part 1 yielded 296 responses: 72% women, 75.3% UK-based and 55.1% aged 40-59 years. Inflammatory bowel disease (45.3%) and cancer (40.2%) were the main indications. 84.1% of respondents reported satisfaction with their surgical experience (net promoter score). Four key themes were generated from Part 1 and validated in Part 2: (i) surgeon personality stereotypes (media differed from patients' perspective); (ii) favourable and unfavourable surgical personality traits (openness, conscientiousness, emotional stability preferred over risk-taking and narcissism); (iii) patient-surgeon interaction (mutual respect and rapport valued); (iv) impact of surgeon personality on decision-making (majority unaware of second opinion option; management of postoperative complications). Conclusion Patients believe surgeon personality influences shared decision-making. Low levels of emotional stability and conscientiousness are perceived by patients to increase the likelihood of postoperative adverse events. Further work is required to explore the potential influence of surgeon personality on shared decisionmaking and postoperative outcomes. Keywords surgeon, personality, patient and public involvement, PPI What does this paper add to the literature? This is the first study to explore patient perceptions of the influence of the surgeon's personality on shared decision-making. Patients believe high levels of openness, conscientiousness and emotional stability are positive personality traits in surgeons and believe that, if lacking, the management of postoperative outcomes can be negatively influenced.

A Systematic Review of the Abdominal Surgeon’s Personality: Exploring Common Traits in Western Populations

“…The common surgical traits described in this review may be considered advantageous in establishing rapport with patients and, perhaps, contradicts the 'surgeon stereotype' of rudeness, aggression and being difficult to work with [39]. Patients have previously indicated that they believe that surgeon personality influences surgical decision-making (including informed consent and communication of treatment options) as well as the surgeon's response to post-operative complications [40]. Whilst we do not advocate personality testing as a recruitment strategy for trainee selection, the authors hypothesise that periodic personality testing of surgeons throughout their career (given that personality changes with age and experience) may facilitate continuing professional development via multiple methods, for example, targeted non-technical skills training for surgeons, and also aid identification of surgeons at risk of work-related stress or burnout with timely occupational health interventions [41].…”

Exploring shared surgical decision‐making from the patient’s perspective: is the personality of the surgeon important?, Bisset et al

“…It is with great interest that I read the article by Bisset et al in this month's issue of Colorectal Disease [1]. This study builds on previous work by Moug et al, which showed that colorectal surgeons are more likely to demonstrate high levels of emotional stability and conscientiousness in comparison with a non-clinical population [2].…”

The relationship between perceptions of shared decision‐making and patient‐reported outcomes in a cross‐sectional cohort of haemorrhoidectomy patients

“…Interestingly, this finding persists despite controlling for surgeon effect between different providers. Bisset et al [25] describe how surgeon personality and communication style directly influence the SDM process. Thus, the effect of social deprivation on the patient–physician relationship is one that warrants further exploration.…”