Game Theory in the Practice of Surgery and the Operating Room Environment
https://www.sciencedirect.com/science/article/pii/S0039606012003121?via%3Dihub
Game theory can also be referred to as the “theory of social situations”. It is often involved in explaining a lot of social behaviors, but the theory itself including its applications are not studied as much in medical literatures. The article in the link above presents a comprehensive review on the game theory and its abound dilemmas in the practice of surgery and the operating room environment.
The article presented this following situation. A new orthopedic surgeon walks into the operating room declaring that his add-on knee arthroscopy case needs to go immediately. The surgeon was unavailable when he was asked to perform the surgery at an earlier time that day. Right now, all the rooms, anesthesiologists, including the nurses are occupied, and his case is the third in the queue.
This situation is pretty similar to the Prisoner’s Dilemma that the professor introduced in class, and we can apply the game theory to the surgeon’s case, if he chooses to not act cooperatively by increasing the priority of his add-on case and insisting to perform the surgery at a time that is the most convenient for him. Then, he will be the only person benefiting from that strategy, while everyone else in the operating room will be losing. In this example, the surgeon should communicate with the other 2 surgeons ahead of him in the queue to come to a mutual agreement which might help him resolve the prisoner’s dilemma.
In order to minimize the irrational nature of operating room management, Dexter et al demonstrated that daily operation decisions should follow 5 rationally order priorities: maintain patient safety, open access to the OR, maximize OR efficiency, reduce patient waiting times, and personal satisfaction.
In conclusion, clear and consistent communication are the basis for a well-run operating room. Surgeons who understand the basic game theory principles are better prepared for navigating the complex OR system and optimizing the cooperative behaviors for all stakeholders’ benefits.