Does surgeon = jerk?

For those of you who follow me on Twitter, you’ve seen my feed the last few days filled with thoughts and comments from the AAMC Mid-Career Women’s Professional Development Course (#MidWIMS- storify from the meeting coming next week!).  The opening talk on Saturday was given by Julie Lien Wei, Professor of Otolaryngology and Division Chief at UCF.  One of her statements during her discussion of her career trajectory resonated deeply with me.

“I thought that becoming a surgeon was synonymous with being a (((jerk))).  One woman surgeon changed that.”

I’ll confess that I entered medical school with the image of surgeons as being less kind, less humanistic, and definitely less well-rounded than other physicians.  I was also very determined when I started medical school that I wouldn’t be a surgeon when I finished.  Fortunately during my 3rd year I came under the influence of a pediatric surgeon who epitomized a happy, enthusiastic, kind surgeon.  As a result of his influence and that of a couple others here I am, almost 20 years to the day from my acceptance letter to Texas A&M College of Medicine, happily ensconced in my career as a surgeon.  More importantly, I want to believe that I didn’t sell my soul to get here, and that I am every bit as kind, humanistic, and perhaps more well-rounded than my colleagues in other fields.

Even with the 20 years that have elapsed since my own decision-making, as surgeons we still have an image problem.  When I tweeted Dr. Wei’s statement, I had a student respond, “They are jerks.  The woman was an exception.” Ouch.

So this is all the further we’ve come?  As recently as 2010, one study showed that medical students enter with a negative perception of surgeons (good to know I wasn’t alone in that!). The perception that physician/ patient relationships are lower quality is a negative influence on selection of a career in surgery.  And we know that personality fit plays a role in specialty selection, meaning that if students consistently see behaviors that they perceive as incongruent with their values, they’ll vote with their feet.  However, the surgical clerkship appears to offer an opportunity for mitigation of these negative impressions.  Nevertheless, the perceptions appear to return to baseline within a year of the clerkship.

Clearly we aren’t yet where we should be.  We’re definitely not where I want us to be, and I’m basing that on information I see from my own students about how some of my colleagues and our residents behave at times.  Caveat:  I’m not saying I’m perfect every day because I’m not…but I try hard to be a good example, and if I sense I’m not being one I’ll own it.  I’m also generous with apologies if I’ve dropped the behavior ball.

Here’s my request for you, fair reader.

-If you are a medical student, what is your perception of surgeons?  How can we improve it?

-If you are not a surgeon but work with us, what do you see that we could change?

-If you are a surgeon, what do you see behaviorally in our specialty?  I know that bad behavior is significantly influenced by environmental tolerance (blog post for another day), but what else do you observe?

The bottom line, what I really want to resolve, is how do we fix our image so we’re not scaring off folks who would be incredibly talented?



5 thoughts on “Does surgeon = jerk?

  1. I somehow entered a group of 11 Orthopaedic surgeons who are the kindest, must humane, caring people I know. Initially I kept looking for the bad apple, the flaws, but in over two years see nothing but support, teaching, and teamwork. They consistently demonstrate good behavior and accept and expect the same of each other. I am a kinder, more patient focused, patient surgeon because of their influence and the amazing work environment I have found it creates…

  2. I have very limited exposure to the surgical/medical population, but I just wanted to share with you my most recent experience. My fiancé was badly in need of spinal surgery, so my boss (being the fixer she is) searched the inter webs to land on a local orthopedic surgeon she had read about before, Dr. Steven Cyr of the Ortho and Spine clinic of San Antonio. We got an appointment with one of his nurse practitioners, having no idea what to expect. We’d started hearing about how talented of a surgeon he was, and we’d started to believe it because it took us months to finally get a consultation with the man himself. When we finally got him alone to go over the procedure and what to expect, he gave us as much time as we needed to ask him any silly question we could think of. He described his method and why he uses it, showed us the materials he uses and explained why, compared it to other surgeons methods, made sure to explain things in terms we could understand, and then he turned to my fiancé and said, “we will treat you as if you were our own brother.” He displayed more honesty and caring than I had ever felt from a doctor. He gave us about an hour and a half of his time that day, and met with us on the day of his first surgery with the family to review the procedure and answer any questions they had. He’s always quick with the hugs, and tried to make sure that his patients and families feel special. He’s dropped in several times since just checking on TJ to make sure he’s doing okay and staying on track.

  3. I’ve been practicing medicine for 12 years and my experience tells me that certain personality types do gravitate towards surgery. Pediatric surgeons are the nicest, with orthopedics in second place. I don’t think you can change perceptions without changing reality… and so surgeons will mostly be thought of (correctly) as jerks for the foreseeable future. If it’s any consolation, many other doctors are jerks too. Here’s why: Each nice doctor has to work hard to dissuade new patients that we are not jerks. We have to earn their trust, because they often come in with very little (due to previous experiences). It’s kind of sad. Keep trying! You are appreciated by those you touch. “Uncaring hands are worth avoiding.”

  4. As a third year medical student, I rotated on our general surgery service with a close friend. I found the residents and attendings on our team to be incredibly nice and friendly, while my friend felt that they were a bunch of “jerks”. There was no inconsistency in the way we were treated or the types of behavior that we were exposed to. The difference, I believe, was the fact that I was headed into surgery and he was not. I related to the personality types of the surgeons and felt that I inherently understood their attitudes. In my mind, being brief, to the point and no-nonsense was effective, efficient and helped get the job done. In the mind of my friend, however, the same traits were perceived as impatience, rudeness and lack of empathy. Ultimately, I concluded, it takes a surgeon to know a surgeon, and it may very well be that non-surgical types will forever perceive surgical colleagues as “jerks” simply for a lack of ability to relate.

    1. Lauren, I also can’t help but wonder to what degree we’re fighting against image bias- even those of us who I know are “nice” surgeons sometimes get accused of being not-nice; people look for those things that confirm their biases, even if those behaviors are rare or significantly modulated.
      (Thanks to Sam Finlayson for his thoughts on this today.)