Surgeon and Anesthesiologist Perceptions and Expectations of Each Other: Implications for Improving Collaboration

BACKGROUND: Relationships within the surgeon-anesthesiologist dyad may influence perioperative teamwork, safety, and efficiency, yet little is known about the perceptions and expectations these physicians hold of one another. STUDY DESIGN: We conducted a qualitative, phenomenological study using semi-structured, one-on-one virtual interviews with 20 surgeons (7 women) and 20 anesthesiologists (13 women), ages 31 to 81 years, representing 24 US states. Interviews were audio-recorded, transcribed, and coded using Dedoose version 9.2.22. After stabilization of a codebook, working in teams, investigators applied consensus coding with 100% interrater agreement and performed thematic analysis focused on perceptions and expectations. RESULTS: Surgeons frequently described anesthesiologists with whom they had difficulty as lacking dedication, continuity of care, and equal ownership of patients. Anesthesiologists frequently described surgeons with whom they had difficulty as not recognizing anesthesiologist expertise, not demonstrating expected professional respect, prioritizing operative goals over patient physiology, and exhibiting problematic personality traits. Despite these negative generalizations, both groups articulated some positive perceptions of their colleagues and shared expectations of what can be characterized as operating room professionalism, including engagement, respect, effective communication, competence, flexibility, efficiency, and prioritization of patient care. Differences emerged in emphasis: surgeons highlighted conscientiousness and engagement, whereas anesthesiologists emphasized respect for their professional expertise. CONCLUSIONS: Surgeons and anesthesiologists hold unexpressed negative perceptions and unmet expectations of one another that may influence collaboration and perioperative care delivery. Increasing awareness of these attitudes may represent a first step toward improving relational coordination, teamwork, and patient safety.