When patients undergo surgery, they expect to have their doctors’
undivided attention. However, given the rise in “double-booked”
surgeries, that may not always be the case.
Late last year, theBoston Globe reported that overlapping or double-booked elective surgeries were frequently
performed at Massachusetts General Hospital (MGH) in Boston, accounting
for 15 percent of all procedures. Equally concerning, patients were not
informed that their surgeon would be performing concurrent procedures,
which raises informed consent issues.
As we have previously discussed on this San Diego Injury Blog, physicians
are generally required to inform a patient about the benefits, risks,
and available alternatives before initiating treatment. In some situations,
failure to obtain informed consent
can constitute medical malpractice.
The practice of double booking surgeries also increases the risk of a medical
error. According to the
Boston Globe, surgical residents performed entire procedures while the attending surgeon
was performing a surgery in another hospital. In other cases, attending
surgeons were unavailable to render assistance to less-experienced residents
because they were delayed with another operation. Also concerning, some
patients were under anesthesia for long periods of time while the surgery
team waited for a double-booked surgeon to arrive.
While MGH defends the practice, other doctors have acknowledged that double-booking
can put patients at risk. “Two cases at the same time with one surgeon
— you’re talking about a formula for disaster,” said
Dr. L.D. Britt, chairman of the department of surgery at Eastern Virginia
Medical School and a past president of the American College of Surgeons.
“Two patients with one surgeon trying to go from room to room with
complex cases — that’s unacceptable. It should be abolished.”
In the wake of the investigation, the American College of Surgeons announced
that it is considering new guidelines for the practice of concurrent surgeries.
Topics that the ACS committee will address include whether its guidance
on concurrent surgeries needs to be more precise and the issue of informed consent.
“We are going to move as quickly as we can on this,” ACS Executive
Director David Hoyt said. “This is a priority.”