title: Neurosurgical patients' perceptions of the "surgeon+": a qualitative study.
abstract: OBJECTIVE
  Neurosurgical patients bear a varying degree of anxiety when confronted with having to undergo surgery or even visit with a neurosurgeon in consultation. Previous studies have suggested that patient perceptions can heavily influence the patient-physician encounter. Accordingly, a better understanding of these perceptions can marshal our knowledge regarding strategies for improving patient-physician interactions during such an apprehensive time. The aim of the present study was to qualitatively examine patient values and preferences for a neurosurgeon who participates in extraclinical activities (i.e., a "neurosurgeon+") and understand the factors that influence these perceptions.
  
  
  METHODS
  Semistructured face-to-face interviews with 47 neurosurgical patients were conducted. Patients were recruited from the Toronto Western Hospital neurosurgery clinics for cranial and spinal conditions. Descriptive summary statistics were used to characterize the study participants. Family members were encouraged to contribute to the interviews. Interviews were audio-recorded, transcribed, and subjected to thematic analysis by using open and axial coding.
  
  
  RESULTS
  Patients generally indicated that they want to feel confident in their neurosurgeon. A number of factors contribute to this confidence, including a strong positive referral from another physician. Patients are inclined to search for information pertaining to the qualifications of neurosurgeons online, and a perception of the neurosurgeon's adeptness given his or her qualifications is important for patients. Although there were some differences in patient values between those in the cranial and spinal groups, overall, neurosurgical patients tend to positively view their neurosurgeon's involvement in extraclinical duties.
  
  
  CONCLUSIONS
  This study details the first comprehensive clinical qualitative study of patient perceptions of neurosurgeons and provides a descriptive framework for understanding patient values in this clinical domain.
authors.affiliation: Faculty of Medicine and.
authors.forename: Nardin
authors.initials: N
authors.lastname: Samuel
authors.affiliation: Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Toronto; and.|Division of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
authors.forename: Mohammed F
authors.initials: MF
authors.lastname: Shamji
authors.affiliation: Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Toronto; and.|Division of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Bernstein
mesh_terms: D000328:Adult; D000368:Aged; D002983:Clinical Competence; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009493:Neurosurgery; D010358:Patient Participation; D057240:Patient Preference; D010817:Physician-Patient Relations; D011446:Prospective Studies; D036301:Qualitative Research; D012017:Referral and Consultation
keywords: neurosurgeon+; patient perceptions; patient values