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Introduction

For this is the great error of our day in the treatment of the human body, that physicians separate the soul from the body.1

 —SOCRATES

 

Dr. Adrienne Boissy writes:

We knew early on that a communication skills program that was built and rolled out in a healthcare system that was largely run by surgeons needed not only surgeon input into content, but surgeon facilitators. People would make assumptions about "the type of person who teaches communication skills" and we wanted to highlight those assumptions and then squash them.

With some anxiety, we approached surgeons one by one and invited them to join our work. This was couched as, "We need your help. Surgeons are a huge part of the organization. You are well respected in the field, and we don't want a program to move forward without making sure we capture your voice." The overwhelming response to this approach was "OK." We wondered what we had been so afraid of.

Benzel was one of the first surgeons that we thought of and one of the first to come onboard.

Hog-tied. That's how I (Edward Benzel) initially felt about my involvement in facilitation training. I used that phrase liberally. Dr. Boissy had approached me about becoming a facilitator while I was the chairman of Neurosurgery. I responded that I thought there was a young female neurosurgeon who had just joined the clinic who might be ideal. Boissy and my institute chair pushed back, saying that having the younger, less experienced female surgeon sent a message. Perhaps a message we don't usually talk about: that communication skills training is a gentle, feminine matter. Ultimately, I dove in.

I often hear that there is trepidation about approaching surgeons to participate in communication skills training. Surgeons have long been represented as aloof, highly intelligent, disconnected people. Look no further than the movies or TV. This was encapsulated by William Hurt in the film The Doctor: "I'd rather you cut straighter and cared less." There is no question about the importance of surgeons' technical skills. Who wants to suffer or die from unnecessary surgical complications? However, the dichotomy that implies that we must choose surgeons who are either technically skilled or empathic is a false one. Do you want an airplane pilot who knows how to take off or one who knows how to land? Is it too much to ask for both? Why can't we expect surgeons to be able to operate and to communicate? Strong communication skills are critical to a surgeon's work. They help in obtaining an accurate and complete history, educating the patient about treatment options, obtaining informed consent, helping the patient to understand the care plan, reducing patient complaints, and lowering the risk of malpractice suits. Medical and surgical colleagues face similar challenges, but some communication challenges have a unique flavor in the surgical setting—error disclosures, discussions ...

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