Why are surgeons such arrogant arseholes

[KirtonandKim]

*not all of them

Seasoned manager of over 25 years. Brought in to manage a team of surgeons who have ridiculous retention of staff (they can’t). Managers, operational, PAs and juniors - they cannot retain anyone.

2 months in and I can see why. They are without a doubt the most arrogant group of people I’ve ever had the misfortune of trying to manage. I’ve managed “bad” teams before - but nothing like this. And it’s just shrugged and accepted as “what surgeons are like”.

They know they are untouchable - they know they have us over a barrel and we can’t sack them. But the constant moaning and bitching and whining and utter lack of any insight into their own behaviour is fucking flabbergasting

God I can’t face work tomorrow

But actually although a lot of colleagues I've had over the years have been total pricks at work, at home they are some of the loveliest people. One of the kindest, loveliest men I know is a surgeon. I worked with him once and it was like some monster took over him as he entered the operating room. I think he was just stressing and thinking about the surgery but my god I was so embarrassed. ts really bizarre its like as some surgical monster takes over them as soon as they enter the hospital

@WhatisanODP during my training I did a eight week stint in theatres, there was one surgeon who treated everyone terribly, sitting in the break room one day with a couple of ODPs and anaesthetists and this surgeon marches in and starts screaming at one of the ODP's, one of the anaesthetists chucks a biscuit on the floor at his feet , surgeon looks down at the biscuit and back at the anaesthetist and the anaesthetist says ' I hear you went to X boarding school ? time for a little light relief ? ' Surgeon goes puce and storms off. I don't think anyone else breathed out for at least a minute. Turns out surgeon had been a little worse for wear at the last Christmas party and mentioned the rancid age old tradition of soggy biscuit , bleurgh !

[quote Rainbowsew]@HmmmmmmInteresting why wouldn't you want him to do the op?[/quote]
Mopping up? Sounds like he wants people to like him

There is empirical evidence to support that poor behaviour like this affects outcomes of teams, ie patients die as a result of this this type of behaviour. If a junior doesn't feel empowered to standup and question the behaviour of their seniors of any profession then mistakes are more likely to happen.

OP - check out #civilitysaveslives it is a campaign run by doctors (so the surgeons' peers) they may have helpful tips for you.

Also the video about Elaine Bromley, about team working in theatres.

The best way to solve this is prevention so medical students are learning about the effects of poor leadership and team working. Unfortunately your current surgeons will have learnt their current pattern of behaviour from their seniors but the cycle must be broken.

I don't believe in pandering to their toddler tantrums just because they're skilled at their job, they need to understand that their behaviour has an effect on how a team works. I don't envy you your job as I have some experience in dealing with surgeons although not as a manager.

Interesting thread.

On the whole I have found surgeons to be about 70% pleasant and helpful.
GPs about 40/50% helpful
Nurses about 20/30% helpful with midwives being the rudest and most unempathic individuals I have ever come across.

I'll also add that the chap who lives opposite is a consultant surgeon. He was at home a great deal last summer. His wife chatters - he nods at us.

My family had an awful experience with a neurosurgeon a few years ago. He told us that our family member was taking up a bed and if he was on call the night they came in, he never would have operated as they're too old (at 70). He also told us they were brain dead in the most callous way. I dread to think what he was like with his staff if that's how he treated patient's families. The Neuro registrar was so lovely and kind on the other hand

I was going to ask which specialty. The worst I've had is transplant. As one of my colleagues once said, 'goodness knows why they are so arrogant, they only deal with the plumbing, not like they're fixing anything!'

@NutterflyEffect to be fair the surgeon with the worst bedside manner on the ward I last worked on was also the surgeon I would want to perform my surgery if I needed it. He was fantastically skilled, he just lacked finesse with those who were conscious.

'... lacked finesse with those who are conscious'.

That's so funny.

Maybe surgeons don't need to be nice?

Isn't it a running joke in Scrubs?

They are a mixed bag - I'm responsible for about 30. Of these I would say 2 are arrogant dickheads. There are about 10 who are great and the rest are Ok but manageable. They all did virtual clinics throughout the pandemic, carried on with on call and operated on NHS patients in the private sector. There was no question of them not doing anything. When they couldn't operate they formed teams to prone patients on ITU.
We had zero tolerance especially as the anaesthetists and physicians were run ragged.
Of the nightmare 2 we are currently documenting everything - they will go, you just need to be constantly on it.

@Soundoftheunderground

Oh and the breast surgeons at my hospital are genuinely the nicest bunch of people I’ve ever met.

Do you mean plastic surgeons? . As if so, dealing with one was plenty enough. I had a stand up fight with one in the middle of a pediatric ward at 12am as he refused to operate on my 7 year old dd who had just had a dog bite to the face. And why,... because he wanted me to pay cash up front before he would do the surgery! This was 12am on a Sunday morning.

He claimed he mostly worked for private and only ever took payment prior to service. The nurses had to peel me away whilst I was reminding him that he was the Dr on call at a trauma 1 emergency hospital and not there for a fucking elective boob job. God I still seeth about him years later.

I will never forget the he has clearly been drinking coffee prior to that as he had a coffee stain mustache around his, seeing that just gave me rage even more. I would have had a silent giggle about it usually, but this horrid man and his bean to cup coffee just nearly tipped me over the edge.

I said I would be reporting him as money is more important to him that patients. His reply was, do you think I'm here just for fun.

Arrgghhhh

Had a lot of dealings with cardio and neurologists and I found them very very bearable. The ent was the nicest of them all.

But a plastic surgeon..... 😡

Also some who have very poor bedside manner are great technically. I just used to warn my patients to ignore their manner as they would get the best outcome.

They used to come back to me and 'he wasn't so bad' Forewarned is forearmed and all that

@NutterflyEffect has it in a nutshell the cycle needs to be broken

DD had a gynae consultant whom we were seeing privately. Made apt at 5.30 (you know because I work) and received a call back to say that if she had empty slots before 5.30pm our appointment would be moved to an earlier slot but we'd have 24 hours' notice.

I called her secretary to say that my time was no less important than hers and to cancel the appointment because I would not be paying the bill of someone who had no mutual respect for her patients. The no on the BUPA website was wrong and her NHS secretary's, who shouted at me for daring to phone her and waste her time!

Such charm. Such nice manners. I wrote to her in the end to note my disappointment and got a very apologetic reply. She is on the board of my local Hospital Trust. Things will never change whilst people like that are in charge.

I've worked with surgeons for 20 plus years - their behaviour now is far better than it was 20 years ago - they are now pussy cats pretending to be tigers - 20 years ago, they were defintely tigers.

My worst example was a surgeon shouting at a patient in a critical care bed "I am your God. You would be dead but for me"

Another punched an anaesthetist in theatre and refused to engage in any disciplinary proceedings.

Name changed for this. Worked in theatres for years, and then in another role very closely with a broad ranges of consultants.

My time in theatres was a long time ago, so I really hope things have changed. Back then there were a few really pleasant surgeons (generally bowel and breast surgeons), but I have to say they were in the minority. We had one Max Fax surgeon who was an absolute pig. He shouted, called the female staff names - including 'dumb wench', told a mixed race member of staff to 'go back to the jungle where you belong', threw an instrument at me whilst I was standing minding my own business in theatre, and one day stood in the corridor in a theatre top that was too small (he was very overweight) ripped it all the way down the front and said 'get me a fucking shirt that fits'. Hopefully no-one of that would be allowed these days. Cardio thoracic and T and O surgeons were up there amongst the worst. One orthopod didn't want to get his socks bloody so insisted that staff used tubigrip/tubigauze to sew him a fresh pair of socks for each list.

I'm surprised at the Orthopaedic reg complaining up thread. When I scrubbed (NHS), we were taught to anticipate every instrument, suture etc and I'd always aim to get through each operation without the surgeon asking for a single instrument. Maybe there's a big turnover of staff in orthopaedic theatres?

In other specialties, anaesthetists were just the loveliest bunch (hence choosing to work in anaesthetics rather than scrubbing) paediatricians usually nice, paediatric oncologists great, DME easy to work with, neurosurgeons a complex bunch to deal with, plastic surgeons very fussy and particular. NutterflyEffect makes very salient points about the cause of some of the behaviour, and why it continues.

[quote frumpety]@WhatisanODP during my training I did a eight week stint in theatres, there was one surgeon who treated everyone terribly, sitting in the break room one day with a couple of ODPs and anaesthetists and this surgeon marches in and starts screaming at one of the ODP's, one of the anaesthetists chucks a biscuit on the floor at his feet , surgeon looks down at the biscuit and back at the anaesthetist and the anaesthetist says ' I hear you went to X boarding school ? time for a little light relief ? ' Surgeon goes puce and storms off. I don't think anyone else breathed out for at least a minute. Turns out surgeon had been a little worse for wear at the last Christmas party and mentioned the rancid age old tradition of soggy biscuit , bleurgh ![/quote]
😆

And this is why I love the anaesthetists.

@HmmmmmmInteresting I typed a reply to you and seem to have lost it but I don't think it is a case of wanting to be liked but rather seeing the bigger picture.

Team work is a big thing in the theatre environment. Him mopping the floor could be the difference between getting another patient on the operating table that day rather than leaving them until tomorrow.

Involve HR
Involve GMC
Whistleblow
Involve medical director of hospital
Try dept training by MEDICAL defence union , done on zoom
Good luck

My consultant plastic surgeon is, quite possibly, the nicest man I have ever met. Incredibly polite and decent. All his nurses and his PA clearly adore him too. I don't think this is just because I'm a private patient either as he also does NHS work too.

But, yes, on the whole other surgeons are arrogant and self assured. But, then only a very few people can do what they can do.

[quote frumpety]@WhatisanODP during my training I did a eight week stint in theatres, there was one surgeon who treated everyone terribly, sitting in the break room one day with a couple of ODPs and anaesthetists and this surgeon marches in and starts screaming at one of the ODP's, one of the anaesthetists chucks a biscuit on the floor at his feet , surgeon looks down at the biscuit and back at the anaesthetist and the anaesthetist says ' I hear you went to X boarding school ? time for a little light relief ? ' Surgeon goes puce and storms off. I don't think anyone else breathed out for at least a minute. Turns out surgeon had been a little worse for wear at the last Christmas party and mentioned the rancid age old tradition of soggy biscuit , bleurgh ![/quote]
Please explain. No idea what this means

If your boss says I need you to do X during 9-12 and then a year later says actually due to service needs I need you to do y between 9 - 12 instead, do you go and argue the why should I case?

Depends. If my boss is a doctor then yes I will do it. If it is yet another manager in a long line of managers trying to tell me how they are going to “improve” things while fucking them up further then yes I am going to argue.
In medicine that usually means you lose the argument, have to do what you are told, it is all a mess and you are proved right and then yet another manager comes in to “fix” it. They are usually paid more than you and if they fuck up they are promoted

Yes some surgeons are dicks. Some are a product of their medical training. And some are just completely fed up of being told what to do by people who have zero clue and zero experience of their job. Tbf some of yours sound like dicks but I think without the context of some understanding of WHY they are like that you are going to struggle.
I remember when I worked for a surgeon and they were VERY pissed off about their secretaries going into a pool so their numbers were reduced. It seemed like they were throwing a tantrum. Is was actually because it made them really inefficient because their secretary knew how to book things to get shit done and and knew all their patients so knew what the priority was and could ask the surgeon when certain patients were involved if they knew they were specifically worried about them. It was not about laziness it was ALL about the patients

talking to a surgeon about communication is about as useful as asking a pastry chef to teach you to fly

[quote frumpety]@WhatisanODP during my training I did a eight week stint in theatres, there was one surgeon who treated everyone terribly, sitting in the break room one day with a couple of ODPs and anaesthetists and this surgeon marches in and starts screaming at one of the ODP's, one of the anaesthetists chucks a biscuit on the floor at his feet , surgeon looks down at the biscuit and back at the anaesthetist and the anaesthetist says ' I hear you went to X boarding school ? time for a little light relief ? ' Surgeon goes puce and storms off. I don't think anyone else breathed out for at least a minute. Turns out surgeon had been a little worse for wear at the last Christmas party and mentioned the rancid age old tradition of soggy biscuit , bleurgh ![/quote]
I am an anaesthetist and this would pretty much be the crowning glory moment of my career if I ever got the opportunity.

I've worked with a lot of surgeons over the years. The way they treat me has definitely improved as I've got more senior (I'm coming to the end of my training), and as we've got to know each other. There are definitely still arseholes and pure psychopaths, but there are also a lot of good guys and women out there. Some will be nice to patients but awful to nurses, others will be nightmare bosses to their juniors but sunshine itself to their theatre staff. Some are better at dealing with stressful situations than others.

Interestingly the most unpleasant encounter I ever had was with a breast surgeon back when I was a med student! The cardiac crew are the hardest for me, though that's at least partly because I'm pretty inexperienced in cardiac so a lot less confident than e.g. obstetrics or general surgery.