Why Surgical Skill Should Matter to Hospitals, Surgeons, and Patients

By: Christopher Simmonds

compressed nurseOne of the questions I have often pondered is why do patients choose certain procedures and certain surgeons. So I conducted some research which showed that there were three clear factors that influenced patient choice.

The first was the surgeon they were initially referred to. In the majority of cases, patients will do what their surgeons tells them is the best treatment modality for them. The second most important was family and friends. As soon as you have a diagnosis that will involve a surgical intervention people will talk to their extended network and listen to feedback on similar procedures or interventions.  In today’s connected world it is very easy to connect with a friend of a friend who has faced the same medical challenge.  The last major factor was the internet. While the majority of people will go on the web to browse health care information and to help reinforce decisions made with their healthcare providers, only a small percentage, around 10%, will change their physician and treatment choice based on the internet alone.

This is completely logical as any surgical intervention is really about trust that the surgeon and institution will carry out the procedure and that you will come out the other side as planned. Most people will choose to trust someone once they have met them or rely on the advice of family and friends and are less likely to trust what they have read on the web.

A few years ago I was able to publish a paper that looked at the aspect of patient satisfaction on patients’ willingness to recommend their treatment modality to others.

Hystersisters.com is an online community that was created in 1998 to act as a support group for women to women, dedicated to medical and emotional issues surrounding the hysterectomy experience and gynecologic-related conditions and illnesses, supporting women from diagnosis, to treatment, to recovery.

The research group sent out a questionnaire to the 300,000 members and received over 10,000 responses (however, only 6,263 met the inclusion criteria). We essentially were asking about their perception of their surgical experience and if they would recommend the procedure to someone else in the same position as themselves and, if faced with the same situation would go through the same procedure again.

The table below shows the answers across a variety of modalities and the % who would definitely recommend or choose the same procedure again.

hyster study table

As you can see, there was a significant difference between the types of surgical treatment offered and the willingness to recommend or have the surgery again.

What does this have to with Surgeon skill? I would hope this is obvious. Surgeons who have higher skills and have higher volumes will tend to have better outcomes. We have discussed this fact in earlier blogs.

Better outcomes lead to more satisfied patients who are more likely to recommend the surgeon and institution to family and friends. This will lead to more referrals which will continue as a virtuous circle. The reverse is also true when outcomes are not so positive they can have a negative impact on referrals.

At Mimic, we have always believed that helping surgeons master their tools through simulation is ultimately about helping patients have a better surgical experience and allowing them to get on with their lives as quickly as possible.


“The Impact of Different Surgical Modalities for Hysterectomy on Satisfaction and Patient Reported Outcomes”  Published on 17/17/04 in Interactive Journal of Medical Research
Michael C Pitter1*, MDChristopher Simmonds2*Usha Seshadri-Kreaden3*, MS Helen Hubert4*, MPH, PhD