Where do we go from here? The personal impact of adverse events and complications in surgeons: Results from a cross-sectional study

Objective: Medical error is an inevitable part of modern healthcare, with a potential harmful impact for the patient and the surgeon. The phenomenon of negative personal responses for healthcare workers in the aftermath of adverse events is described as the "second casualty" and can involve significant physical and psychological distress. We present results from a cross-sectional survey of surgeons and their experience in the aftermath of adverse events or complications. Subjects and methods: Following ethical approval an anonymous online survey was distributed to all training and consultant surgeons in the Republic of Ireland. Data collected included basic demographics, personal response to an adverse event, coping strategies, contributing factors and perception of potential support structures. Results: A total of 110 responses were received representing surgeons with a broad range of experience and specialty. Eighty-nine percent (n = 98) of surgeons described negative psychological symptoms in the aftermath of adverse events. The predominant responses were anxiety, guilt and low mood. Sixty-seven percent (n = 74) reported that their training did not prepare them for the personal impact of events but found informal peer and family support to be beneficial and were open to the implementation of formal support structures. Conclusion: Surgeons suffer in the aftermath of negative outcomes and feel unprepared to manage the personal consequences. Institutions and representative bodies must step forward to change culture and develop supports for surgeons in the aftermath of adverse events and complications.