Dealing with Difficult Surgeons

It's one of the unpleasant truths about our profession: difficult surgeons. Are there any effective strategies for dealing with them? I'll share some tips that I've compiled from 19 years of experience at 4 different hospitals.

1. Keep the emotion out of it.

A difficult surgeon can trigger anger, resentment, or even apathy. But a strong foundation for dealing with conflict is being dispassionate. During my residency, I was doing a challenging thoracic epidural with my attending. After a while, the attending surgeon came into the OR and started making a loud fuss about "what was taking so long". My attending responded very matter-of-factly: "we're finding this epidural to be more challenging than usual, but I really feel that the patient would benefit from it...we're gonna try for another 10 minutes or so and then re-evaluate." I thought he handled that really well (he's now the Chair of the department). Take a moment to consider his statement: it was fact-based, calm/composed, and succinct; to top it off, it was patient-centered and presented a clear follow-up plan. Perfect. A different person might have responded defensively, with snark or blame-shifting, such as "well, some of your surgeries go on for hours" or "we got into the OR late because the pre-op nurses were slacking again". Stick with the facts and leave the drama to others. 

2. Stand your ground, but make sure you're on solid footing.

We all know that surgeons are cut from the same cloth: they think of themselves as decisive and certain. Therefore, they tend to respond best to people who appear decisive and certain. So how can you execute this? Here's a pro tip: take a moment to think about what you're going to say before you say it. You'd be amazed at how much your response can be improved by simply pausing for 2 or 3 seconds and allowing yourself to edit your response. Be firm and confident, but make sure you can back up what you're saying. If you're not sure about something, just say you're not sure, because bluffing is a sure way to lose credibility. 

3. Be the best physician you can possibly be. 

I know...you opened this post hoping to find a quick answer, but instead you're getting an exhortation to be a good physician. Hear me out. A surgeon may not like you for any number of reasons, and most of those reasons are probably irrational. Your focus needs to be on being the best physician in the OR. Know your medicine and know your patient--these are the qualities that earn real respect. Bring your A-game everyday by being a fully-prepared, outstanding clinician -- and no one in their right mind will criticize you. 

4. Be a consummate professional.

What does it mean to be a professional? It means showing up early, being prepared, treating everyone with respect, answering emails and texts, being meticulous in your work and mindful in your interactions. When you're a consummate professional, you'll earn the respect and admiration of everyone you work with. You know what kind of people criticize professionals? Amateurs.

5. Stick to patient care-- don't engage with them on extraneous issues.

Tempted to argue about politics with your surgeon? You're wasting your time. Stick with patient care issues. Engaging a surgeon in an argument about politics will only enrage you and distract you from your job. I assure you: nothing good will come out of it.

6. Remember, it's just a job. Don't let it eat you.

At the end of the day, everyone in the OR goes their separate ways. Leave work at work. That surgeon is nothing but an annoying co-worker...they don't live with you (your partner is a separate problem--I can't help you there!).