What's the worst day of the week to have surgery?

September 21, 2025 •

4 min read

According to a study of nearly 430,000 patients, those who underwent surgery immediately before the weekend experienced a significantly increased risk of adverse outcomes compared to those treated after the weekend. This raises a critical question for many patients: What's the worst day of the week to have surgery? The answer points toward Fridays and the weekends.

Quick Summary

Studies show that Fridays and weekends are associated with slightly higher risks of complications and mortality for surgical patients, a phenomenon known as the 'weekend effect.' This is likely due to reduced hospital staffing and fewer senior physicians available on weekends, rather than any change in surgical care during the procedure itself. Elective surgery patients may benefit from scheduling earlier in the week.

Key Points

Fridays and weekends have higher risks: Studies show a phenomenon known as the 'weekend effect,' where surgeries performed late in the week are associated with a slightly higher risk of adverse outcomes like complications, readmissions, and mortality.
Staffing levels are a key factor: Reduced staffing, including fewer senior surgeons and specialists, on weekends is a primary reason for the observed increased risk.
Elective surgeries are most affected: The weekend effect is more significant for elective procedures where recovery occurs over the weekend, while emergency surgeries proceed regardless of timing.
The absolute risk increase is often small: While statistically significant, the absolute increase in risk is typically very small, and patients should not panic or delay necessary care.
Informed decision-making is crucial: Patients should discuss hospital staffing and weekend protocols with their surgical team to make the most informed choice for their elective procedure, prioritizing the best surgical team.
Other factors matter more: For most procedures, the skill of the surgical team and the quality of the hospital are more critical determinants of a successful outcome than the day of the week.

The 'Weekend Effect' Explained

The notion that the day of the week can influence surgical outcomes might seem surprising, but it is a well-documented phenomenon in medical literature known as the 'weekend effect.' This term describes the observation that patients who receive certain types of medical care, including surgery, on weekends may have a higher risk of complications or mortality compared to those treated on weekdays. While the difference is often statistically significant, it's important to frame this within the overall context of surgical safety, which remains high.

The primary driver of the weekend effect is not a change in the surgical procedure itself, but rather a reflection of the hospital's operational differences. Staffing levels, access to senior specialists, and the availability of diagnostic services often change significantly on weekends. For patients undergoing surgery on a Friday, the critical initial 48 hours of postoperative recovery—when complications are most likely to arise—occur over the weekend when resources may be more stretched.

Staffing and Resource Availability

One of the most cited reasons for the weekend effect is the difference in staffing levels and experience. Hospitals typically operate with a leaner team of physicians, nurses, and ancillary staff over the weekend. This includes:

Fewer senior physicians: Weekend shifts may have fewer senior surgeons, specialists, and attending doctors on-site, with more junior staff handling patient care. This can mean less immediate access to a senior colleague for consultation if an issue arises.
Lower nursing staff: Nursing staff levels may also be reduced, leading to higher patient-to-nurse ratios. While weekend staff are dedicated professionals, the higher workload per person can impact the speed and frequency of observation and response to subtle changes in a patient's condition.
Reduced ancillary services: Specialized tests and scans, physical therapy, and other supportive services critical for postoperative care may have reduced availability on weekends. Delays in these services can affect recovery time and increase the risk of complications.

Implications for Elective vs. Emergency Surgery

The weekend effect's impact can differ between elective and emergency procedures. For urgent or emergent surgeries, the timing is a necessity, and patients receive care whenever it is needed. Delaying emergency surgery is not an option and would carry a far greater risk than any weekend effect. However, for elective procedures, patients have some control over their scheduling and can use this information to make more informed decisions.

Studies consistently show that the weekend effect is more pronounced in elective surgeries. This is because elective cases scheduled on a Friday will likely spend their entire immediate post-op period recovering over the weekend with potentially reduced staff. In contrast, patients who have elective surgery on a Monday or Tuesday will recover during the peak operational days of the hospital when a full roster of staff and services is available.

Deciding on the Best Day for Your Surgery

For patients with flexibility, scheduling elective surgery earlier in the week is a common recommendation to minimize the potential weekend effect. Days like Tuesday or Wednesday are sometimes cited as ideal, as they typically feature high surgical volumes and experienced staff. However, it is crucial to remember that the absolute risk increase from the weekend effect is often small for many procedures, and hospitals are constantly working to standardize care. The most important factor remains the skill of your surgical team and the quality of the hospital, regardless of the day.

Taking proactive steps

Discuss scheduling with your surgeon: Talk to your surgeon about the hospital's weekend staffing policies. Ask about the availability of senior staff and any on-call procedures.
Plan for postoperative care: Ensure you understand the postoperative care plan, including how any potential complications will be managed over the weekend.
Be your own advocate: Pay attention to your recovery and don't hesitate to voice concerns to your nurses and doctors, especially if something doesn't feel right. Advocating for yourself and asking questions can make a significant difference.
Prioritize the surgical team: While timing is a consideration, prioritize having the best and most experienced surgical team for your specific procedure. This is the single most important factor for a successful outcome.

Weekday vs. Weekend Surgery Comparison


Feature	Weekday (Mon-Thurs)	Friday/Weekend (Fri-Sun)
Staffing Levels	Typically higher, with a full complement of surgeons, specialists, and nurses.	Generally reduced, relying more on on-call or junior staff.
Surgeon Experience	Studies suggest higher average surgeon experience levels on peak weekdays like Tuesday and Wednesday.	Some studies indicate slightly less experienced surgeons may be scheduled for Friday or weekend shifts.
Ancillary Services	Full availability of diagnostic labs, imaging, and physical therapy services.	Limited or reduced availability, potentially leading to delays in crucial tests.
Postoperative Monitoring	A greater number of staff and a lower patient-to-nurse ratio can allow for more frequent monitoring.	Higher patient-to-nurse ratios can potentially affect the timeliness of monitoring and response.
Outcome Risk	Associated with lower rates of complications and readmissions compared to later in the week.	Associated with a slightly higher risk of adverse outcomes, especially for elective surgeries.

Conclusion: Finding the Right Balance

While evidence points to a higher risk of adverse outcomes for surgeries performed late in the week or on weekends, this effect is small in absolute terms and does not apply equally to all procedures or hospitals. For many, delaying a necessary elective procedure to avoid a Friday is not worth the anxiety or wait. The key is to be an informed patient. Use this information to have a detailed conversation with your healthcare team about the hospital's specific protocols and staffing plans. By understanding the factors at play, you can make the best decision for your circumstances, prioritizing the skill of your surgical team above all else.

For more in-depth research on the subject, consider reviewing the articles published by medical journals like the JAMA Network Open.

Frequently Asked Questions

No. While studies show a slight increase in risk for surgeries performed on a Friday, the absolute risk remains very low, especially in high-quality hospitals. The evidence does not guarantee a negative outcome but suggests a statistically higher probability of complications.

The increased risk is primarily attributed to lower hospital staffing levels on weekends, including fewer senior doctors and specialists. If a complication arises after a Friday surgery, the patient's immediate postoperative care takes place when fewer staff are typically on-site.

For an elective procedure, you can discuss the research and your hospital's weekend staffing policies with your surgeon. If you feel more comfortable, you can ask about scheduling earlier in the week. However, for a necessary surgery, delaying it to avoid a Friday is generally not recommended.

The 'weekend effect' is a term used in medical literature to describe the observation that patients admitted to the hospital or having surgery over the weekend may experience a slightly higher rate of adverse events or mortality compared to those treated during the week.

The weekend effect has been observed across various surgical specialties and for both elective and emergency cases, though some studies suggest it is more pronounced for elective surgeries.

Hospital staffing and resource policies vary. Some hospitals may have implemented strategies to standardize weekend care, potentially mitigating the weekend effect. It is a system-level issue, and not necessarily an indictment of individual hospitals or surgical teams.

Your best course of action is to choose a highly experienced surgical team and a reputable hospital. Discuss all your concerns with your medical team, follow all pre-operative instructions diligently, and remain engaged with your care plan, especially during the postoperative period.