How would you feel if you were in surgery, and your surgeon kept running in and out of the room to work on someone else?
While this may seem like a far-fetched idea, it isn’t. Simultaneous operations – when the surgeon oversees 2 operations occurring at the same time – is par for the course at many hospitals around the U.S. This means that a surgery patient is often left in the hands of surgical trainees while the senior doctor leaves the room for an unspecified amount of time. If any complications arise while the doctor is away, the trainees will have to improvise without more experienced guidance.
What’s worse, double-booked surgery patients are often unaware they’ll be sharing a surgeon with someone else. In fact, more often than not they never even find out.
Fortunately, all of this may soon be coming to an end. An influential Senate committee has released a report detailing the findings of an investigation into “concurrent surgeries.” The report’s conclusion is that simultaneous operations pose a threat to patient safety and should be discontinued.
The Finance Committee’s report is only the most recent event in an ongoing debate. In recent years, the question of simultaneous operations has divided doctors and the medical community across the country. While the Senate will urge all hospitals to ban the practice, it remains to be seen if their advice will be taken into consideration.
Tragedy at Mass General
Controversy surrounding concurrent surgeries reached the national stage in 2015 after a Boston Globe Spotlight series tore into the issue. Spotlight’s article told the story of Tony Meng, a 44-year-old father of 2 who became paralyzed while undergoing a double-booked surgery at Massachusetts General Hospital.
Meng decided to undergo spinal surgery so that he could become more active and play sports with his children. When he asked his surgeon, Dr. Kirkham Wood, if he would be performing the entire procedure, Wood replied “Yes.” Meng was unaware that Wood would be performing another spinal surgery at the same time.
As Meng’s surgery slipped into crisis, Dr. Wood kept leaving the room to work on his other patient, delegating the work of saving Meng’s nervous system to a rookie surgical resident. When Meng woke, he couldn’t move his arms or legs. When, months later, he learned that Dr. Wood had been conducting a simultaneous operation, Meng said “If that’s the case, I feel deceived.”
A Divisive Issue
There was little research into the dangers of simultaneous operations before the Senate Finance Committee began its report. One unpublished study from the University of Toronto found that postoperative complications increased for hip-replacement patients who underwent concurrent surgery. However, another study by the Mayo Clinic found no differences between the outcomes of overlapping and non-overlapping procedures.
Though some doctors argue concurrent operations allow hospitals to employ a team-based approach, increasing efficiency, many critics wonder if doctors aren’t just double-booking procedures for the double payout.
Numerous doctors have spoken out against the practice. Dr. Dennis Burke was fired from his position at Massachusetts General Hospital after he stepped forward with a group of anesthesiologists to condemn simultaneous operations. Dr. Burke shared hospital records with the Boston Globe in which patient privacy had been protected.
Another critical voice in the debate is Dr. Michael Mulholland, the chairman of surgery at the University of Michigan. At a panel discussion at Mass. General last summer, Dr. Mulholland voiced the common sense concerns most people would have about sharing a surgeon:
“How would a reasonable patient react to a surgeon saying, ‘I plan to be in an adjacent operating room operating on a different patient during your proposed procedure – is that acceptable to you?’ There are no data to answer that question, but I think that common sense says that virtually no patient would find this acceptable.’’
Dr. Mulholland is right. In a country with great resources, and many talented surgeons and doctors, such a trend is nothing if not unacceptable.