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• W2912551885 abstract "To the Editor: That anyone decides to entrust their life to an unknown physician in the span of a 20-minute office visit or 5-minute emergency department consultation is incredible. The awesome responsibility to honor that trust motivates surgeons to train as long, and work as hard, as we do. These high stakes may also make some of us irritable and dismissive towards anything deemed a distraction. As a result, patient communication and education can suffer. However, paternalistic medicine is no longer appropriate for the current Information Age. We are eroding the trust in the surgeon–patient relationship.1 Below are a number of ways we can do better. Patients deserve to know more about their surgeon. Patient outcomes are tied to operative volume.2 Our patients deserve to know how many of a particular operation we perform per year. We have all witnessed surgeon colleagues having biased discussions regarding open versus laparoscopic versus robotic techniques without disclosing their own familiarity (or lack thereof) with each approach. Surgical volumes should be made accessible to patients. Patients deserve complete information about their surgery. A prime example is the discussion regarding robotic assistance for minor surgeries, such as cholecystectomy. We surgeons play on patients’ beliefs that technological advancement equals better outcomes. We tell patients the incisions for robotic techniques will be small, but we omit the fact that laparoscopic incisions are smaller still. We omit the fact that the operation will likely take longer than a laparoscopic approach except in experienced hands (a reality that, again, emphasizes the need to be up-front about volume). We need standardized, written patient education materials. If we benefit more than the patient, the patient deserves to know. Patients deserve to know more about their treatment options, including our individual biases. More than ever, a number of treatment options exist for surgical conditions—all with very different risks and benefits.3 Examples include antibiotics alone versus appendectomy for uncomplicated appendicitis, laparoscopic irrigation versus colectomy for severe diverticulitis, and active surveillance versus thyroidectomy for small thyroid cancers. With no clear right answer, patients need our help to choose treatment that aligns with their values and goals. Patients look to us for guidance, but are unaware that each of our estimations of the risks and benefits can vary tremendously.4 Therefore, when counseling patients, we should strive to place our opinions in the context of existing, objective data and risk calculators. We must be introspective and open with our patients about our decision making. James X. Wu, MDClinical fellow, Head and Neck Surgery, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY; [email protected]; Twitter: @Back2TheSuture; ORCID: https://orcid.org/0000-0001-5090-7573. First published online February 5, 2019" @default.
• W2912551885 created "2019-02-21" @default.
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• W2912551885 date "2019-05-01" @default.
• W2912551885 modified "2023-09-23" @default.
• W2912551885 title "Rebuilding Trust in the Surgeon–Patient Relationship: Need for Transparency" @default.
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• W2912551885 doi "https://doi.org/10.1097/acm.0000000000002632" @default.
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