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Medicine in small doses

The consequences of surgeons behaving badly are explored in a book edited by Flin and Mitchell, Safer Surgery. Analyzing behaviour in the operating theatre, Ashgate 2009. Similarly, Woods explores disruptive and intimidating behaviour amongst health-care workers, and proposes the importance of a commitment to civility in his Joint Commission Resource (JCR: http://www.jcrinc.com) publication ‘Civil Leadership: The final step to achieving safety, quality, innovation and profitability in health care’ JCR, 2010. Arguments, rudeness and aggressive behaviour by surgeons and other members of the operating theatre team can have significant effects on their victims’ cognitive skills, particularly their ability to concentrate and even those of innocent bystanders. Psychological studies have shown that those watching these interactions perform significantly worse in memory and creatively tasks than a group that have not observed the interaction (Flin, BMJ 2010; 340: c2480) This lack of civility amongst health-care professionals poses a serious threat to patient safety and the quality of health care.