Assessment of Factors Influencing the Abbreviated Surgical Health Care Experience

OBJECTIVES: Clear benefits of minimally invasive surgery to patients are shorter hospitalization, less preoperative evaluation and diagnostic studies, less intense postoperative care, earlier return to family, strenuous activities and work, and less interaction with the physician, surgeon, nurse, and other healthcare team personnel. These positive effects of modern surgical health-care are countered by an associated decrease in physician-patient contact, decrease in development of trusting relationships with the surgical healthcare team, markedly increased anxiety on the part of the patients, fragmented relationships with the healthcare team, misunderstanding of medical recommendations, treatment options, and associated expectations. This shallow and disruptive relationship results in mistrust, less than optimum outcomes, and potentially litigious circumstances. METHODS AND RESULTS: We have delineated each of these factors and have modified our local environment to address each of these issues and to reverse the adverse effects on patients. The model we have used emphasizes the collaborative benefits of the hospital, the operating room nurse team, the surgeon's office, and the surgeon. CONCLUSIONS: The negative effects of the abbreviated surgical experience will only be reversed by conscious effort on the part of surgeons, operating team personnel, and hospital management to reintroduce the patient as the center of attention. Managed care influences will not support improved communication and trust between patients and surgeons.