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

Jeffrey B Cooper; Robert E Berry Jr; Sylvia Bereknyei Merrell; Judith A Clair; Fred G Davis; Sara Goldhaber-Feibert; Haytham Kaafarani; Hamza Khan; Rebecca D Minehart; Helen S Wei; Fei Wu; David Benavides Zora; May Cm Pian-Smith

doi:10.1097/XCS.0000000000001941

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

J Am Coll Surg. 2026 Mar 25. doi: 10.1097/XCS.0000000000001941. Online ahead of print.

Authors

Affiliations

¹ Department of Anesthesiology, Massachusetts General Hospital, Mass General Brigham, and Harvard Medical School, Boston, MA.
² Department of Obstetrics & Gynecology, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA.
³ Office of Child Health Equity, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA.
⁴ Carroll School of Management, Department of Management and Organization, Boston College, Chestnut Hill, MA.
⁵ Tufts University School of Medicine and Lahey Clinic, Boston, MA.
⁶ Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA.
⁷ Division of Trauma, Department of Surgery, Massachusetts General Hospital, Mass General Brigham, Boston, MA.
⁸ College of Business, Department of Managerial Studies, University of Illinois Chicago, Chicago, IL.
⁹ Alpert School of Medicine at Brown University, Providence, RI.
¹⁰ Division of Acute Care Surgery, Trauma and Surgical Critical Care, Department of Surgery, University of Kentucky, Lexington, KY.
¹¹ Critical Care Medicine, Piedmont Columbus Regional, Columbus, GA.
¹² Division of Cardiac Anesthesia, Department of Anesthesiology, Westchester Medical Center, New York Medical College, New York.

PMID: 41879637
DOI: 10.1097/XCS.0000000000001941

Abstract

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 females) and 20 anesthesiologists (13 females), ages 31-81, representing 24 U.S. states. Interviews were audio-recorded, transcribed, and coded using Dedoose v9.2.22. After stabilization of a codebook, working in teams, investigators applied consensus coding with 100% inter-rater 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 attributes. 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.

Keywords: Perioperative relationships; expectations; patient safety; perceptions; qualitative research; teamwork.