Surgeons and surgery: what surgeons say, in their own words

Last updated September 20, 2026.

Read together, the 611 KevinMD posts on surgeons and surgery say one thing consistently: the operation is the easy part to see and the hardest part to judge. Surgeons on the site have argued for fifteen years about whether residents really do the cases they scrub on, whether a checklist prevents anything, whether the public should see a surgeon’s complication rate, whether the robot is worth $2,489 more than the laparoscope, and, since 2024, whether artificial intelligence will make surgery precise and less wise. Robot or robotic appears in 7 percent of posts in 2013 to 2016 and AI in 18 percent of posts since 2025. Where surgeons disagree, on checklists, on public reporting, on volume pledges, and on robots, both sides are on this page under their own names.

This page is a maintained record of what surgeons, surgical residents, anesthesiologists, and other physicians have written about surgery on KevinMD.com, a physician-authored publication founded in 2004 by Kevin Pho, MD, a board-certified internal medicine physician in Nashua, New Hampshire. It draws on 611 essays and podcast transcripts with surgeon, surgery, surgical, operating room, orthopedic, neurosurgery, transplant, robotic, laparoscopic, or anesthesia in the title, published between June 2005 and September 2026 by 325 named contributors, 414 of the posts bylined by physicians, 36 of them podcast episodes with transcripts, and 13 written anonymously. Of the 611, 145 were published from 2023 onward and 43 in 2026 alone, the most of any year. Every claim is attributed to a named author with the month it was published, quoted in the author’s own words, and linked to the original.

This record is about the craft and the culture of surgery. Surgical malpractice is on the Medical malpractice: what physicians say, in their own words record and posts about it were routed there; surgical residency hours are also on the Residency: what residents and physicians say, in their own words record; women surgeons are also on the Women in medicine: what women physicians say, in their own words record; surgical error disclosure on the Medical errors: what physicians say, in their own words record. The surgeon who writes as Skeptical Scalpel is the most frequent contributor and is cited under that byline. Each section opens with a direct answer, then what named authors have said, in the order they said it. Contributors who sell services into this subject are identified where they are cited. This is surgeon opinion and experience, not clinical guidance.

What do surgeons say about surgical training?

Surgeons on KevinMD have written about training as a fight over who holds the knife: a 2016 essay tells patients to want residents in their operation, the same year another asks whether residents really do the cases they scrub on, and a 2018 study found trainees learning the robot in the shadows. The first-night essays, from 2020 and 2023, describe a time before work-hour limits that the 2026 posts say now bottlenecks the surgical backlog. Resident or residency appears in 24 to 39 percent of posts in every period.

Eve Karkowsky, MD, an obstetrician-gynecologist, wrote in May 2014 that when she graduated “I wanted to write a book called How Not to Get Yelled At in the Operating Room,” in “Reducing the stress of teaching surgical residents.” James Wu, MD, a surgical resident, wrote in April 2016 that “Banning the resident only replaces them with a scrub nurse or technician,” in “You should want surgery residents for your operation. Here’s why.” Skeptical Scalpel, MD, a retired surgical chairman, wrote in December 2016 that for elective patients “the residents do not play significant roles in most components of perioperative management,” in “Are surgical residents really doing the cases they scrub on?” Skeptical Scalpel, MD, a retired surgical chairman, wrote in May 2017 of one hospital’s study, that “Between 2008 and 2012, residents were permitted to perform appendectomies without direct supervision by an attending surgeon,” in “Residents performing surgery: Why can’t we reach a middle ground?” Matt Beane, PhD, a researcher who observed hundreds of procedures, wrote in January 2018 that “Only a minority of residents found effective alternatives,” in “Young surgeons are learning robotic surgery in the shadows.” Arthur Williams, MD, a surgeon, wrote in July 2020 that “And there was no doubt that I was an intern,” in “The first night on call as a surgery intern.” Randall S. Fong, MD, a surgeon, wrote in September 2023 that “There were no limits on work hours, a time before the U.S,” rules changed, in “Inside the grueling life of a surgery intern.” Christen Russo, MD, an orthopedic surgeon, wrote in April 2026 that the pipeline is improving, with “women comprising approximately 20 to 22 percent of orthopaedic residents,” in “How one doctor navigated orthopedic residency while pregnant.” Danny Goel, MD, an orthopedic surgeon, wrote in August 2026 that “Every conversation about the surgical backlog focuses on the same fix: more OR time, more staff, more beds,” in “In 2026, the surgical backlog has a training bottleneck.”

What do surgeons say about the operating room, checklists, and culture?

The operating room posts on KevinMD are about who may speak: an anesthesiologist brought the cockpit’s two-challenge rule to the OR in 2013, a retired chairman spent three years asking whether checklists actually reduce complications, two anonymous surgeons described locker room talk and bullying in 2017, and the 2024 and 2026 posts say the checklist was never about memory but about silence. Checklist appears in 4 percent of posts in 2013 to 2016 and 11 percent since 2025.

Marjorie Stiegler, MD, an anesthesiologist, wrote in July 2013 that “Critical language is not unique to operating room teams, however,” in “Cockpit culture and using the two challenge rule in the OR.” Skeptical Scalpel, MD, a retired surgical chairman, wrote in January 2014 that a hospital investigation found “the level of situational awareness of the operating room staff was inadequate, and teamwork and communication were poor,” in “A patient falls off the OR table: Who’s to blame?” Skeptical Scalpel, MD, a retired surgical chairman, wrote in July 2014 that he is not against checklists: “When I was a surgical chairman, I implemented and used one in both the operating room and the ICU,” in “Do surgical checklists work? A closer look at the data.” Skeptical Scalpel, MD, a retired surgical chairman, wrote in January 2017 that a University of Vermont study found “a 24-item operating room checklist did not significantly reduce the incidence of any of nine postoperative adverse outcomes,” in “Do surgery checklists really work?” An anonymous physician, a surgeon writing anonymously, wrote in May 2017 that “I cannot remember ever feeling so degraded by a male attending,” in “There’s no place for locker room talk in the OR.” Brooke Buckley, MD, MBA, a surgeon, wrote in February 2026 that “The surgical safety checklist was never about memory,” in “The surgical safety checklist: Why silence is the real enemy.” Colin G. Knight, MD, a surgeon and former flight surgeon, wrote in May 2026 that “the safety culture I learned on the flight line still shapes how I run an operating room,” in “What aviation safety can teach surgery about culture.”

Should patients see a surgeon’s outcomes? What surgeons say about volume and public reporting.

Surgeons on KevinMD agree that volume predicts outcomes and disagree about what to do with that fact: a patient-safety researcher wanted hospitals to pledge minimum volumes and publish them, a resident answered that the ambulance goes to the nearest hospital anyway, and the retired chairman argued that individual surgeon report cards do not have the numbers to be honest. By 2026 a surgeon writes that the data is no longer theirs alone. Volume appears in 7 percent of posts in 2013 to 2016 and 12 percent since 2025.

Peter Pronovost, MD, PhD, a patient safety researcher, wrote in June 2015 that for decades evidence has shown “mortality is lower, and outcomes are better, when you seek certain procedures from physicians and hospital teams with more practice,” in “Can hospitals restrain themselves from doing low-volume surgeries?” Peter Pronovost, MD, PhD, a patient safety researcher, wrote in December 2016 that “the accuracy of some patient safety ratings can be poor,” in “Surgery volumes should be made public. Here’s why.” Vamsi Aribindi, MD, a surgical resident, wrote in December 2016 that if a patient has surgery 50 miles away and a complication at home “guess which hospital the ambulance will take them to,” in “The case against a surgery volume pledge.” Skeptical Scalpel, MD, a retired surgical chairman, wrote in October 2017 that “For most operations, aggregating over 3 to 4 years would still not yield enough volume for proper analysis,” in “An argument against public reporting of individual surgeon outcomes.” Skeptical Scalpel, MD, a retired surgical chairman, wrote in June 2018 that “The most surprising finding of the study was although the surgeons’ complication rates were clearly stated above the figure,” few participants could read them off it, in “The risks of publically reported surgical outcomes.” Miles J. Varn, MD, a physician who runs a health advisory company, wrote in March 2021 that “physicians and hospitals that do not perform a procedure frequently have higher rates of complications and deaths,” in “Choosing an experienced surgeon and high-volume hospital can impact your outcome.” Tamir Wolf, MD, PhD, a surgeon who leads a surgical video company, wrote in March 2024 that “hospitals are data-rich and insight-poor, or DRIP,” in “If surgery is so precise, why are we leaving outcomes up to chance?” Marc Granson, MD, a surgeon, wrote in June 2026 that “I looked at internal scorecards and noticed which names appeared on the better side of the outcomes curve,” in “Surgeon outcomes data is no longer ours alone.”

On the decision to operate, surgeons on KevinMD describe consent as a conversation the form does not capture, a surgeon’s buy-in as a commitment the patient does not see, and judgment, the 2026 essays say, as the skill no one sees from the gallery. The pandemic added the question of what elective means, and one 2026 essay describes an insurer calling the operating room mid-operation.

John Schumann, MD, an internist, wrote in March 2013 that as a patient’s son declined surgery for his dying mother “the orthopedic nurse practitioner walked into the room, carrying a consent form,” in “Let no broken hip go unfixed: When a surgeon fails to communicate.” Skeptical Scalpel, MD, a retired surgical chairman, wrote in June 2014 citing a medico-legal encyclopedia that “the disclosure of risk depends on two general elements,” in “Must a surgeon mention death as a complication?” An anonymous physician, a surgeon writing anonymously, wrote in August 2019 that “Surgery is not risk-free, and sometimes minimally invasive techniques cannot safely be used to perform an operation,” in “The decision to undergo robotic surgery is a more than just about the length of the scar.” Stephen Cohn, MD, a trauma surgeon, wrote in October 2023 that unlike elective surgeons “we are thrust on families without their consent,” in “Navigating complex ICU conversations: a trauma surgeon’s perspective.” Anastasios Papadonikolakis, MD, PhD, an orthopedic surgeon, wrote in April 2026 that “As medicine becomes increasingly precise, it risks becoming less wise,” in “Artificial intelligence in surgery: Balancing precision with clinical wisdom.” Steven E. Warren, MD, DPA, a physician, wrote in May 2026 that an insurance representative who had never met the patient “called the operating room while the surgery was in progress,” in “Prior authorization during surgery is not oversight.” Mustafa Kemal Çalık, MD, a cardiovascular surgeon, wrote in September 2026 that “In an emergency, someone must decide what happens next, and sometimes that decision must be made in seconds,” in “Surgical judgment: the skill no one sees from the gallery.”

What do surgeons say about burnout, suicide, and the surgeon’s life?

The surgeon’s-life posts on KevinMD begin with a 2011 survey in which one in sixteen surgeons had contemplated suicide and continue through an anonymous surgeon who slept in her car during a leave of absence, an eye surgeon asking after 12,000 operations when to stop, and a physician who has run a suicide helpline since 2012. Burnout appears in 1 percent of posts before 2013 and 8 percent since 2025.

Kevin Pho, MD, wrote in January 2011 citing the Archives of General Surgery that “In a national survey, one in 16 surgeons reported contemplating suicide,” in “Your surgeon may be contemplating suicide.” An anonymous physician, a surgeon writing anonymously, wrote in January 2016 that “I spent the first month of my leave of absence sleeping in my car,” in “This surgeon loves her job. But it’s killing her.” John C. Hagan III, MD, an ophthalmologist, wrote in September 2017 asking after 12,000 eye surgeries and 30 years “Do I need to stop doing surgery,” in “Putting down the scalpel: The aging surgeon.” Pamela Wible, MD, a family physician who runs a physician suicide helpline, wrote in January 2018 that “In 2012, I became alarmed by how many doctors were dying by suicide,” in “Surgeon suicide-homicide: What happened to Dr. Chris Dawson?” Julie Wei, MD, a pediatric otolaryngologist, wrote in March 2024 that, worse “physicians continue to commit suicide at the highest rate in America over other professions,” in “Physician burnout: a surgeon’s story of exhaustion, recovery, and systemic change.”

What do women surgeons say?

Women surgeons on KevinMD write about a specialty that admits them and does not adjust for them: sexism heard on the medical student’s rotation, the question of what a husband thinks, being told estrogen impedes surgical performance, announcing a pregnancy to a program with fear, and orthopedics, where women are 7 to 8 percent of practicing surgeons. Women or female surgeons appears in 3 percent of posts in 2013 to 2016 and 0 percent since 2025.

An anonymous physician, a medical student writing anonymously, wrote in January 2015 that “I cannot believe sexism is still experienced in what I thought was a gender neutral, progressive profession such as medicine,” in “Sexism in the OR: What’s a medical student to do?” Dr. Nikki Stamp, a cardiothoracic surgeon, wrote in April 2015 that “there is a stereotype that women surgeons need to be more masculine than the blokes,” in “So you want to be a female surgeon. Here are 10 tips to make it.” Sarah Shubeck, MD and Arielle Kanters, MD, surgical residents, wrote in April 2018 that “We’ve been told that our ‘estrogen’ is an impediment to our surgical performance,” in “Women in surgery: a tweet to action.” Lauren A. Umstattd, MD, a surgeon, wrote in October 2019 that “I wish I had been proud to announce my pregnancy, rather than scared,” in “Advice to a pregnant surgical resident.” Christen Russo, MD, an orthopedic surgeon, wrote in April 2026 of women, that “they represent only about seven to eight percent of practicing orthopaedic surgeons,” in “How one doctor navigated orthopedic residency while pregnant.”

What do surgeons say about robots and artificial intelligence?

The robot arrived on KevinMD in 2012 and was on trial by 2013: a gynecologist asked insurers to stop paying $2,489 extra for a robotic hysterectomy, a surgeon asked whether the robot would go the way of the laparoscope, and a 2017 essay noted that costlier and slower had never stopped a sale. The AI posts since 2024 make the same argument at a higher level of abstraction, and one 2026 surgeon imagines an artificial general intelligence that is its own ICU. AI appears in 4 percent of posts in 2020 to 2022 and 18 percent since 2025.

Richard Patterson, MD, a surgeon, wrote in May 2013 that “Laparoscopy revolutionized abdominal surgery on a scale commensurate with that of general anesthesia,” in “Will the da Vinci robot go the way of laparoscopic surgery?” Jennifer Gunter, MD, a gynecologist, wrote in October 2013 citing a study that “a robotic hysterectomy was $2,489 more expensive than a laparoscopic hysterectomy,” in “Insurers should stop paying for robotic hysterectomies.” Peter F. Nichol, MD, PhD, a pediatric surgeon, wrote in December 2017 that two JAMA studies showed “robotic-assisted surgery cost more and took longer without achieving superior results to laparoscopic surgery on average,” in “Is there a future for robot-assisted surgery?” Barry Greene, MD, a surgeon, wrote in August 2021 that robotics may be part of the solution for “upskilling the tens of thousands of experienced and talented surgeons that will be needed in the coming decades,” in “Robotic surgery’s impact on training the next generation of surgeons.” Anastasios Papadonikolakis, MD, PhD, an orthopedic surgeon, wrote in April 2026 that “Today, decision-making is gradually migrating away from physicians toward systems designed to standardize care,” in “Artificial intelligence in surgery: Balancing precision with clinical wisdom.” David Stonko, MD, a surgeon, wrote in April 2026 that “An AGI-enabled robotic surgeon would not be limited by the quality of the ICU,” in “Artificial general intelligence and the future of surgery.”

What do surgeons disagree about?

On checklists, Atul Gawande, quoted by Skeptical Scalpel, MD,, said a randomized trial cut complications 42 percent, and the same author answered that most of the complications studied could not have been prevented by a checklist. On public reporting, Skeptical Scalpel, MD, answered Ashish Jha’s JAMA proposal with the arithmetic of small numbers. On volume, Peter Pronovost, MD, PhD, proposed a pledge and Vamsi Aribindi, MD, answered with the ambulance. On robots, Jennifer Gunter, MD, would stop paying and Barry Greene, MD, sees the future of training. On residents, James Wu, MD, tells patients to want them and Skeptical Scalpel, MD, asks whether they operate at all. The record does not resolve these; it dates them.

What would fix it? What physicians propose.

Asked what would fix surgery, surgeons on KevinMD propose adverse events reported to someone, volume thresholds voted on by the hospital’s own physicians, skills inventoried from the first day of residency, a vascular workforce so zip code does not decide amputation, and training capacity treated as part of the backlog.

Peter Pronovost, MD, PhD, a patient safety researcher, wrote in June 2015 that there is a hitch: “We need the vote of our hospital’s physicians,” in “Can hospitals restrain themselves from doing low-volume surgeries?” John C. Hagan III, MD, an ophthalmologist, wrote in September 2017 that “Every surgeon should inventory and evaluate their surgical skills from the first day of their residency,” in “Putting down the scalpel: The aging surgeon.” Daniel Torrent, MD, a vascular surgeon, wrote in February 2026 that “A patient’s zip code should not determine the quality of care they receive,” in “The vascular surgeon shortage: Why amputations are rising.” Danny Goel, MD, an orthopedic surgeon, wrote in August 2026 that “The surgical backlog will get real attention this year, and it should,” in “In 2026, the surgical backlog has a training bottleneck.”

How has the surgery conversation changed since 2005?

The record starts with Kevin Pho’s short commentaries from 2006 to 2011, 66 of them, counted here but not cited, and with the surgeon-bloggers of 2009 to 2015: Sid Schwab, Jeffrey Parks, and Skeptical Scalpel, whose 38 posts on checklists, residents, and report cards are the spine of the middle years. The 2016 to 2019 posts add women surgeons, the robot’s trial, and surgeon suicide. The pandemic years are about elective surgery that was not optional. Since 2023 the record is intern diaries, outcomes data, surgery centers, the training bottleneck, and AI, which is mentioned in 18 percent of the 2025 and 2026 posts.

Two things did not change. Resident or residency is named in 24 to 39 percent of posts in every period. And the sharpest posts are still written by surgeons about the day they were the intern.

Term 2005 to 2012 (136 posts) 2013 to 2016 (169 posts) 2017 to 2019 (79 posts) 2020 to 2022 (82 posts) 2023 to 2024 (72 posts) 2025 to 2026 (73 posts)
Resident or residency 24 percent 39 percent 37 percent 32 percent 38 percent 32 percent
Robot or robotic 7 percent 7 percent 10 percent 4 percent 6 percent 16 percent
Checklist 5 percent 4 percent 3 percent 0 percent 3 percent 11 percent
Complication 21 percent 29 percent 24 percent 15 percent 17 percent 22 percent
Burnout 1 percent 3 percent 3 percent 5 percent 18 percent 8 percent
Women or female surgeons 0 percent 3 percent 4 percent 0 percent 6 percent 0 percent
Duty hours or work hours 3 percent 3 percent 3 percent 0 percent 1 percent 0 percent
Malpractice or lawsuit 4 percent 6 percent 8 percent 2 percent 3 percent 7 percent
Volume 5 percent 7 percent 6 percent 11 percent 4 percent 12 percent
AI 0 percent 0 percent 3 percent 4 percent 24 percent 18 percent

Term frequencies are the share of posts in each period whose text contains the term at least once, computed on the September 20, 2026 corpus of 611 posts with one stored expression per term.

The KevinMD surgery corpus by the numbers

These figures describe the set of KevinMD posts this page draws on. They are counts of what KevinMD has published, not clinical data.

Measure Value
Posts in the corpus 611
Published 2023 or later 145
Published in 2026 (through September) 43
Named contributors 325
Posts bylined by physicians (MD or DO) 414
Podcast episodes with transcripts 36
Posts bylined by nurses 5
Written anonymously 13
Kevin Pho’s early commentaries, counted but not cited 66
Board-review case questions, counted but not cited 2
Posts not indexed, counted but not cited 67
Most frequent contributors Skeptical Scalpel, MD (38); Sid Schwab, MD (16); Bruce Campbell, MD (9); Jeffrey Parks, MD (9); Hope Amantine, MD (5)
Title matches routed or excluded 231: 6 malpractice posts to the medical malpractice record, 225 with the subject thin in the text

How this page was built and how it is updated

The corpus was assembled from title searches for surgeon, surgery, surgical, operating room, scalpel, orthopedic, neurosurgery, transplant, robotic, laparoscopic, bariatric surgery, and anesthesia. Malpractice posts were routed to the medical malpractice record, and posts whose text mentioned the subject fewer than five times were excluded. Term frequencies were computed against the full text of each post. Posts are counted whether or not they are indexed; citations on this page are limited to posts that are indexed and can be verified at the link. 67 posts in the corpus are not indexed, including Kevin Pho’s 2006 to 2011 commentaries and podcast episodes without transcripts; they are counted but not cited. Board-review case questions are counted but not cited. Quotations are taken verbatim from the original posts and were checked against the source text by script. Author credentials are as they appeared in the byline at publication; where the byline gave none, the credential is the one the post itself states. A journalist, a researcher, a spouse, a nurse, and a medical student are cited at the same weight as surgeons and identified as such. Contributors who sell services into this subject are identified where they are cited: Miles J. Varn, MD, runs a health advisory company; Tamir Wolf, MD, PhD, leads a surgical video company; Shakeel Ahmed, MD, owns surgery centers. Every source is linked in the sentence that cites it, and the full list appears at the end of the page. The closest archive is the Surgery tag. Related records: Residency: what residents and physicians say, in their own words, Medical malpractice: what physicians say, in their own words, Women in medicine: what women physicians say, in their own words, Medical errors: what physicians say, in their own words, and Artificial intelligence: what physicians say, in their own words.

This page is updated as new surgery essays are published on KevinMD. When it is updated, the date at the top changes, the counts in the tables are recomputed, and new named claims are added to the relevant section. Nothing is removed unless the original post is removed. An author who believes a quotation on this page misrepresents them can write to Kevin Pho and the page will be corrected.

To cite this page: Pho K. Surgeons and surgery: what surgeons say, in their own words. KevinMD.com. Updated September 20, 2026. https://kevinmd.com/surgery

The 46 KevinMD posts cited on this page, in order of publication