Scientists Issue a Warning: Why Surgery May Be Worst on One Day of the Week

People care generally about the ability of the surgeon, the prestige of the hospital, and treatment after surgery in scheduling a procedure. However, scientists and physicians warn that how you plan a surgery -the day of the week you present for it-really can greatly affect your recoveries and survivability.

Recent studies show that patients who undergo surgery on a Friday or over the weekend are at an increased risk of complications, post-surgical infections, and even death. But why? Let’s look at the research, possible reasons, and what patients can do to protect themselves.

The ‘Friday Effect’: What Research Says
In a paper done at Imperial College London, they took observations of over 4 million NHS elective operations conducted between 2008 and 2011. Their findings suggested the following alarming trend:

Patients operated on a Monday had the lowest risk of dying after the operation.
The mortality risk rose stepwise over the week, peaking on Fridays.
Patients who underwent surgery on Friday were 44% more likely to die within 30 days than patients who had Monday surgery.
Weekend procedures carried an even higher risk of death (82%), even though fewer elective procedures are done on weekends.
These findings, in the British Medical Journal (BMJ), are similar to others conducted in other countries.

A 2017 University of Toronto study looked at more than 402,000 elective procedures and found that complications were more likely for Friday procedures compared with Monday through Thursday procedures. The difference was small but statistically significant, and it lends credence to the idea that surgery day impacts recovery outcomes.

Why Is Friday (and the Weekend) Riskier?
There are some theories regarding this effect, generally referred to as the ‘Weekend Effect.’ Specialists believe these reasons account for complications with late-week surgeries having a higher risk:

1. Lower Staff Levels on Weekends
Hospitals have skeleton staff over the weekends, meaning:

Fewer experienced doctors and specialists.
Support and nursing staff are normally at minimum levels.
Diagnostic tests, imaging, and specialist visits are not readily accessible.
If a patient experiences complications due to a Friday surgery, they will not receive timely treatment, with potential deterioration.

2. Post-Operative Delays
The most vulnerable period of recovery is the first 48 hours following surgery. If a patient has surgery on Friday, their vulnerable period of recovery extends into the weekend—when hospitals are short-staffed.

If there is any complication, there may be delays in the intervention.
Key postoperative tests can be postponed until Monday.
Less experienced doctors or house staff may be covering critical patients.
3. Surgeon and Staff Fatigue
By end of the week, surgeons, anesthesiologists, and hospital staff tend to be sleepier than on Monday or Tuesday. Studies have shown that:
Medical errors increase when healthcare providers are fatigued.
Cognitive functioning is impaired at the end of the week, and errors are likely longer procedures or small but critical.
4. Risks in Discharging Patients
Surgery patients can be discharged on Friday and leave over the weekend. Sadly:
Instructions for postoperative care will probably be rushed or incomplete.
Pharmacys and medical specialists will not be available .
Patients will probably wait until Monday to see a doctor in the event of home complications.
Are Mondays the Best Day for Surgery?
According to the studies, Monday is probably the best elective surgery day because:

Surgeons and hospital staff have restocked for the week.
The hospital is at full strength, so monitoring patients post-op would be more effective.
If complications arise, the specialties and resources are always on call for any day of the week.
Tuesdays and Wednesdays also have good outcomes, though not nearly as many staffing advantages as Mondays.

How Can Patients Lower Their Chances?
If you absolutely need to have elective surgery, do the following to facilitate easier recovery:

✔ Schedule your surgery early in the week (Monday or Tuesday).
✔ Find out about staffing during weekends in your hospital so that you can confirm post-operative care is offered.
✔ Plan home assistance—a family member or friend should be at hand if you are sent home on a Friday or a weekend.
✔ Carefully adhere to all post-op instructions, and in case of complications, report immediately to receive medical attention instead of waiting until Monday.

Does This Mean You Should Avoid Friday Surgeries?
Not necessarily. If your surgery is urgent or life-saving, the advantages outweigh the risks, no matter what day. Numerous successful surgeries take place on Fridays, and hospitals regularly strive to enhance patient care.

But if you have the option to schedule surgery and are flexible with scheduling, having Monday or Tuesday scheduled may offer the best hope for a complication-free recovery.

Final Thoughts
While it may seem counterintuitive, when you choose to have surgery can affect your recovery and likelihood of complications. The so-called ‘Weekend Effect’ highlights how staffing ratios, post-operative care, and availability of specialists all impact outcomes in patients.

By booking your surgery at the start of the week and keeping up to date with hospital procedures, you can take positive measures to have the safest experience.

Would you reschedule your surgery based on this research? Share your thoughts!