Surgery is almost always performed by a team, but in many cases it's a team in name only. So says a new study of more than 2,100 surgeons, anesthesiologists, and nurses. Researchers asked the respondents to "describe the quality of communication and collaboration you have experienced" with other members of the surgical unit. Perhaps not surprisingly, surgeons were given the lowest ratings for teamwork and nurses the highest. "The study is somewhat humbling to me," said Martin Makary, the lead author on the study and a surgeon at Johns Hopkins. "There's a lot of pride in the surgical community. We need to balance out the captain-of-the-ship doctrine." The researchers attribute many operating room errors, such as sponges left in patients and operations performed on the wrong part of the body, to poor teamwork. But improving the system is easier said than done. One recent study in Pennsylvania found that, over an 18-month period, there were 174 cases of surgeons operating on the wrong limb or body part. Johns Hopkins is modeling surgical team training after airline crew training. "Teamwork is an important component of patient safety," says Makary. Tell that to a patient at a hospital. A few years ago, at a hospital in Hyderabad, a surgery left a man paralyzed; in Chennai, a woman who had gone in for tubectomy lost her bladder; at a premier hospital in Delhi, a patient who received a blood transfusion meant for another patient suffered severe reactions; and the Delhi High Court brought to book a private hospital for the death of a boy due to "accidental" laser sparks from a machine. These cases are hardly unusual. One study of British surgical teams revealed errors in 40 percent of cases. "Most of these happen because doctors don't listen," says Dr. Prashant P. Joshi, cardiologist with Indira Gandhi Medical College in Nagpur. He says that a study shows that 90 percent of doctors interrupt patients in the first 20 seconds of their conversation. In 2009, a surgical team at Atlanta's At Atlanta Medical Center, a surgical team mistakenly drilled into the wrong side of a patient's head.

1) Assuming you aren't headed for a career as a surgical team member, what can this research tell you about your individual ethical responsibilities as a team member?

2) Recognize that the pressure to be a good team player and the diffusion of responsibility often lead us to question too little and assume someone else will catch any error. If you question, you run the risk of being labeled as "not a team player," but if you accept errors or marginal performance, the outcomes may reflect negatively on your career. Which approach you should choose?

3) Realize all members of teams are not created equal. A surgeon in the operating room and a pilot in the cockpit tend to dominate teams. That makes it all the more important that you question their decision making.

4) If you have a say in the composition of the team, which kind of team members you will choose who are less prone to groupthink?