Wednesday, April 20, 2011

Surgeon performance degraded by drinking to excess the night before. What excuses do reporters have?

A big media splash accompanied the publication of a paper in the April 2011 issue of the Archives of Surgery about surgeon performance on a simulator after a night of alcohol ingestion. Briefly, the paper showed that drinking to excess can negatively affect performance of tasks involving simulated laparoscopic cholecystectomy the next day even if alcohol levels are zero. What is not clear is whether making small errors on a simulator means that patients would be a) similarly vulnerable in a real operation and b) harmed by these errors. There is a big difference between playing with a simulator in a laboratory and operating on a living, breathing patient.

What is clear is that the reporting of this story leaves a lot to be desired. I looked at a number of articles and found numerous mistakes leading me to wonder if alcohol consumption affects reporters negatively too.

“Hung-over surgeons more error-prone” was how Reuters chose to headline the story. As the authors of the paper point out “There is no consensus definition of hangover and most studies identify various constellations of symptoms, including headache, diarrhea, anorexia, fatigue, and nausea.” There was no mention in the paper that subjects of the research had any of these symptoms.

“Time to give surgeons breathalizers [sic]?” was the headline on CNET News. The only problem is that the study was about the effects of alcohol on performance the day after drinking. Only one subject even had a detectable level of alcohol on a breath test the next day. And “breathalyzers” is misspelled. This story did point out the error in the Reuters headline regarding the absence of true hangovers. wrote “A second dinner-and-drinks experiment -- this one involving a group of surgery trainees and a control group that did not drink…” A similar error was made by which said, “In a two-part study involving 16 medical students and eight experienced surgeons…” The subjects in this group were students at Queens University, Belfast, not surgery trainees or medical students.
A website called AccessRx wrote “A recent study has shown that surgeons are more likely to make mistakes during a surgery if they are hung-over, even if there is no detectable alcohol in their system.” And they also say that the non-surgeon subjects were medical students. Many articles on this subject feature dramatic photos of seemingly distressed doctors in surgical garb. The one at AccessRx was at least amusing [below].

[He forgot his mask. Is that glass sterile?]

This is my favorite. From [printed in its entirety]:

“(FOX 25 / - This might not come as a surprise, but a new study says that surgeons who drink a lot the night before surgery are more likely to make mistakes the next day. Irish researchers set up two simulated surgeries. In the first, 16 college students were told to either drink or not drink the evening before. In the second, eight experts drank all they wanted. The study showed that there were more errors among the drinkers.”

The folks at AccessRx called for action stating emphatically, “Should some sort of regulation be put in place to restrict surgeons from drinking the night before a surgery?” 

Similarly, I call for alcohol testing of reporters before they file their stories.


Anonymous said...

I really enjoy your comments and opinions on various health care issues. I recently ran across this article on I was wondering what are your thoughts as an attending surgeon. Thanks.

Skeptical Scalpel said...

Thanks for the comment. I read the link. The story was way too long. As you might expect, I think it's a bad idea to have a "Doctor of Nursing Practice" degree. If they want to be doctors who take care of patients, they can go to medical school like the rest of us did. I blogged about "doctor-wannabee" nurse a while back. I haven't changed my mind.

You can read that blog here:

Michael Kirsch, M.D. said...

Get over it. We're deep in the era of headlines and sound bytes. Substance and fairness not necessary.

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