Should a patient avoid a surgeon on the surgeons’ birthday?

If you are going to have an emergency surgery, it may be worthwhile asking your surgeon whether it is their birthday on that day.

If you accept the findings of a recent study at face value, one should weigh up the pros and cons of seeking a different surgeon if one is available or request your surgeon to be extra careful.

An intriguing paper published in BMJ recently suggests so. The study looked at the outcome of Medicare patients who underwent emergency surgery in USA. It is a very large study in which 980876 procedures performed by 47489 surgeons were analyzed. Hence the study findings do need to be taken very seriously.

The study found that patients operated by surgeons on the surgeons’ birthday had a higher risk of death.

The study provocatively suggests, without any direct proof, that surgeons were possibly distracted on their birthdays and in their rush to go to their birthday celebration, they might have done “botched emergency surgeries” by not concentrating properly during surgery and by not providing good post-operative care.

The findings are entirely plausible from behavioural psychology point of view and the study authors seem to have done a thorough statistical analysis of various factors that could have spuriously affected the death rates.

Nevertheless, there remains a distinct possibility that the study findings are spurious. For instance, the scientific community is aware of the fact that if “any data is tortured enough”, the dataset will cough up spurious and unexpected results.

Apart from data dredging , one has to take findings from observational studies with a “pinch of salt”. That’s why we often see conflicting results about Nutrition published in Newspapers all the time.

Genuine Surgical errors can sometimes lead to death but much more commonly surgical errors can often lead to increase in rate of surgical complications. It is a bit of stretch for the study to suggest that surgeons all over the country are doing “ technically poor surgeries” everyday if that day happens to be their birthday and they are doing it in such a way to cause deaths without causing any surgical complications.

We don’t know whether the study inadvertently looked at male surgeons working on weekends at rural non-teaching hospitals as these factors could have a bearing on death rates.

Sad life events can adversely affect the work performance of any human being. But happy people are more productive at work. So the conclusion by the study that a happy event, such as a birthday, can adversely affect a surgeon’s performance deserves more scrutiny in a well designed study.

Read the full paper at BMJ website and share your views at the BMJ rapid response section.

References.(1). BMJ. Patient mortality after surgery on the surgeon’s birthday: observational study. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4381 (Published 10 December 2020)
Cite this as: BMJ 2020;371:m4381

(2) Conflicting healthy eating advice leaving public ‘clueless’, poll suggests. Rob Knight
Tuesday 16 July 2019 14:56

(3). Does Employee Happiness have an Impact on Productivity?. Saïd Business School WP 2019-13

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

What’s in a name?

awareness cancer design pink Photo by Miguel on Pexels.com

The word cancer is a dreaded one. Not without a good reason. Cancer is the number one killer. Even when someone has a good outcome, the cancer journey is torture. Emotional turmoil is immeasurably horrendous.

But many people would be surprised to hear that there exists a category of low risk cancers. “Low-risk Cancers are cancers which usually don’t kill; These Cancers are found either incidentally on scans performed for some other reasons or found as part of routine cancer screening.”

Because they are not deadly, Should the patients diagnosed with low-risk cancers be spared the dreaded label of cancer?

Should low-risk cancers be labelled something else and the word cancer used only for the “serious” high-risk cancers ?

Personally, I do not agree with renaming of the low risk cancers..Others disagree

Joint the debate at the BMJ.

Submit your views through rapid response

Reference: 
Should we rename low risk cancers? BMJ

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How to communicate that the disease is mild even though symptoms are disabling?

women s white long sleeved top

Beth McHugh makes a strong argument for doctors “not to explicitly discuss disease severity scale”.

But

(1) A valid informed consent would then become difficult

(2) Not discussing severity, is not a practical option for patients with certain illness.

My BMJ eLetter on this topic…

Risk categorisation will continue to be the norm in future as genomic data leads to personalised medicine.

England’s 100 000 Genomes Project