Why Are Surgeons More Aggressive And Short Tempered Than Doctors Of Other Streams?

This question was originally posted on Quora.com and was answered by Beth Tango, former Emergency Physician at Large Regional Hospital (1998-2015)



Why are surgeons more aggressive and short tempered than doctors of other streams?

Disclosure: I don’t particularly like surgeons in general, so what I write is in no way meant to be excuses for them. However…

1. Surgeons’ lifestyles are incredibly demanding. They tend to wake up very early to see their post-operative patients in the hospital before they start the surgeries for the day. Some of their patients are in the ICU and are very ill; they need a lot of thought and care. They also have to fit in clinic days where they evaluate patients to see if they are good surgical candidates, and to follow-up with patients after they get discharged from the hospital. In addition, they are on call fairly frequently. Most practice in small groups, which means that one out of every 3–7 nights, their sleep is getting interrupted when a patient, family member, or another medical professional has a concern. I can hear you thinking to yourself, “They knew what they were signing up for.” You’re absolutely right. This does not negate the fact that their work burden is very high. If I were chronically short on sleep, I’d tend to be short-tempered.
   
   
2. Surgeons make money by performing surgery: they will be biased (however subtly) toward being aggressive in wanting surgery for a patient. Especially since surgeons also tend to actually enjoy doing a surgery. They also sometimes lack training in non-surgical methods of managing disease, and also assume that if a patient made their way to their office that means non-surgical means had been exhausted. So, sometimes surgeons think that the only way to proceed is to do surgery.
   
   
3. By nature, surgery requires decisiveness and confidence in one’s skills. Anesthesia these days is one of the largest factors in how well a patient does in surgery. So a surgeon needs to be able to make accurate, quick decisions, and work quickly. When one is operating, and especially in emergency situations, sometimes “politeness” and “civility” can fall by the wayside unless it’s a deeply ingrained character trait of the surgeon. Frankly, I wouldn’t want the surgeon to be hesitating about how to politely word an order to an assistant in an emergency surgery on me. I’d rather his/her brain activity was completely centered on how to fix me. That can be interpreted to be aggressive behavior. And that kind of stress (chronically) can certainly make one short-tempered.
   
   
4. If you are referring to what we, in the medical field, are euphemistically calling “disruptive behavior”, i.e. being abusive such as yelling at staff or patients, throwing things, demeaning people, etc., the culture of surgery historically has allowed for these kinds of behaviors and for surgeons to be somewhat “coddled”. It is being recognized more and more, however, that this sort of behavior greatly affects the workplace, and in turn, patient safety. And there is a physician-community-wide acknowledgement that we need to help these disruptive physicians become more adaptive in the work environment.

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and most of the times surgeons are right