Why having a stressed surgeon could mean a more successful surgery

Surgery patients have fewer complications if their doctor is stressed in the operating room, a new study has found.

How well patients fare after surgery depends on a handful of factors, including their age, health status, and the severity of their condition – but their doctor’s stress levels may also be important, according to the study, which was published in the journal JAMA Surgery.

The analysis included 793 surgeries performed by 38 doctors at four hospitals in Lyon, France.

Researchers used chest monitors to track changes in the doctors’ heart rates – a proxy for stress – in the first five minutes of surgery and then tracked the patients’ outcomes one month later.

They found that a higher stress level was associated with fewer major complications from surgery, but not with a shorter stay in the intensive care unit (ICU) or a lower risk of death.

“Surgeon physiology matters to patients,” Dr Jake Awtry, the study’s lead author and a surgery resident at Brigham and Women’s Hospital in the US, told Euronews Health.

He added that ICU stays and deaths were rare in the study and that those results might be different if more patients were included.

Types of stress

The findings appear to contradict previous research that suggests surgeon stress could be dangerous for patients.

In a 2003 study, for example, surgeons made more mistakes when operating in stress-inducing conditions like having loud background noise, while a 2018 paper found that a surgeon performed worse when under “acute mental stress”.

One potential explanation for the counterintuitive new results is that moderate stress levels could help doctors get into a “flow state” of deep concentration, while “excessive” stress could result in more mistakes, the researchers said.

Physician experience level and the type of operation could also play a role. In the study, most of the surgeries were elective procedures, while the surgeons were all attending physicians with more responsibilities.

That could make them better equipped to handle stress without getting overwhelmed, the study said.

The measure for physician stress is “a little non-specific, that we can’t point to one thing that led to that state,” Awtry said.

“But we’re saying that people here are at an optimal level to perform, and that plays out in their patient outcomes”.

Going forward, Awtry said that knowing a surgeon’s stress levels could be used to improve healthcare outcomes. For example, a physician’s stress level could be displayed on the wall during an operation, signalling in real time whether it’s safe for someone to interrupt the surgeon with a question.

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He added that the world’s top athletes track their physiological markers to “guide their training, their recovery, and how they expect to perform on a given day”.

“If we could have a similar perspective for surgeons, it would be really valuable”.