Are all surgeons arrogant?
The recent publicity surrounding the prosecution and conviction of breast cancer surgeon Ian Paterson risks seriously undermining trust in surgery and in surgeons, especially in relation to his reported arrogance and supposed ‘God complex’ (see the BMJ 2017 for further details and discussion). Sadly, he is not the first surgeon to be accused of these unfortunate characteristics – nor will he be the last. Surgeons do require a high level of confidence in their own ability; however, they need to communicate that confidence with humility, rather than arrogance. Surgery is an innately risky business; surgeons need to be in charge, make the tough calls and know what to do if things do not go according to plan. Patients do not want a timid, under-confident, surgeon.
That being said, a proficient surgeon does not have to be arrogant. Effective surgeons not only welcome second opinions, they are open to new ideas and new techniques, analyse their results and learn from their mistakes, as well as those of others. It appears that Ian Paterson failed in this respect, and instead allowed himself to become overconfident and complacent.
It seems plausible that Ian Paterson permitted himself to believe that his wrongful behaviour and non-evidence-based operations were somehow justified. The fact that Paterson kept himself apart from colleagues, seldom if ever discussing his cases or attending conferences, is revealing. What is rather surprising is that it took so long for his colleagues and his employers to realise that something was amiss.
As has often been pointed out, surgery is not a solitary act. The individual surgeon is no longer the lone ‘captain of the ship’. The notion of the heroic leader is outdated and inappropriate in a modern health service. Safe, effective surgery should now be team-based, with accountability being distributed across the team, rather than invested in an individual leader.
What are your views?