Surgical procedures require coordinating the schedules of patients, surgeons, nursing and support staff, as well as the availability of the hospital operating room where the surgery will take place. The complexity of managing all these schedules means that some facilities schedule “concurrent surgery” to make the best use of everyone’s time. Also known as overlapping surgery or simultaneous surgeries, concurrent surgery is a method of managing surgeries where two operations, whose critical parts occur at the same time, are managed by the same surgeon. [1] At times there may be only a minimal overlap, where the beginning of one surgery overlaps with the close of a second surgery. In other instances, there may be a more significant overlap that requires the surgeon to go back and forth between the two patients. Hospitals that conduct concurrent surgery cite scheduling constraints and surgeon education as the reasons for the practice. [2] However, critics of concurrent surgery argue that it is a safety concern for patients. [3]
The risks of concurrent surgery
Many people consider that simultaneous surgeries present dangerous risks to the patient, or are unethical. First, it may be difficult for surgeons to effectively divide their attention between two patients. [4] Presumably, a surgeon should focus on any patient undergoing surgery, without distractions. Adding a second surgical patient raises the risk of distraction and diminished focus on each patient. Second, an ethical dilemma may arise if the surgeon performs simultaneous surgeries without their patients’ knowledge and approval. [5] Likely, most patients would prefer to know if their surgeon planned to be absent during parts of their surgery.
Why hospitals perform overlapping surgeries
Massachusetts General Hospital’s (Mass General) policy permitting concurrent surgeries has come under scrutiny and criticism. Noting that simultaneous surgeries are often performed out of necessity, [6] Mass General spokesmen state that emergency situations sometimes require surgical specialists who may already be performing other surgery. [7] Other reasons cited for the practice include increased patient access to lengthy procedures, as well as improved time management of the surgical team and the surgeries performed. [8] Additionally, the hospital says that concurrent surgery is an educational tool, allowing fellows and residents to perform more procedures and gain experience and independence.
Guidelines for concurrent/overlapping surgeries
Rules and guidelines regarding concurrent surgeries are in place to inform and protect patients. However, critics argue that they are not stringent enough and are not consistently enforced. [9] For example, surgeons at teaching hospitals are barred from billing Medicare for procedures if the critical parts of the surgeries overlap. [10] But some have claimed that these billing rules are rarely enforced. [11] Other guidelines require that patients be informed when their surgeons plain to perform concurrent surgeries, [2] but those guidelines are voluntary, and are not typically followed. [12] As a result of such criticism, a U.S. Senate committee is studying whether to working to ban concurrent surgeries. [13]
Get informed about concurrent surgeries
Whether or not concurrent surgeries are banned, patients should be aware of the issue prior to giving informed consent. Patients should ask their surgeons if they will be performing simultaneous procedures in addition to their own. Ask what the repercussions may be, and consider whether to reschedule the procedure, or whether other changes may improve your confidence in the surgeon and the outcome
If you or a loved one has been injured through concurrent or overlapping surgery, contact The Allen Law Firm at 866-388-1307 for a free consultation.
[1] See https://www.bostonglobe.com/metro/2016/12/05/senate-committee-calls-for-ban-surgeons-doing-simultaneous-operations/EYjO9jiAfLYJsliIrdY4LO/story.html; www.massgeneral.org/overlapping-surgery/about.aspx.
[2] www.massgeneral.org/overlapping-surgery/about.aspx.
[3] https://www.bostonglobe.com/metro/2016/12/05/senate-committee-calls-for-ban-surgeons-doing-simultaneous-operations/EYjO9jiAfLYJsliIrdY4LO/story.html.
[6] See www.massgeneral.org/overlapping-surgery/about.aspx.
[9] https://www.bostonglobe.com/metro/2016/12/05/senate-committee-calls-for-ban-surgeons-doing-simultaneous-operations/EYjO9jiAfLYJsliIrdY4LO/story.html.
