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Are Double-Booked Surgeries Putting Patients at Risk?

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.”