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Double-booked surgeons raise questions about patient safety

When Californians need surgery, they assume that the doctor who has advised them about the necessity and risks of the contemplated procedure will be the surgeon performing the operation. Several recent studies have revealed that this assumption is not always correct. Many surgeons commonly perform surgery on two patients at the same time without informing the patient, and critics of the practice are questioning what this practice means for patient care.

This practice, known as "running two rooms," has been common in teaching hospitals for many decades. The primary surgeon supervises two teams of doctors and nurses who are attending to two different patients in two different operating rooms. The surgeon agrees to be present for the "critical portion" of each surgery, but defining the "critical portion" is left up to the surgeon. Defenders of the practice say that the level of patient care is unaffected and that running two rooms is an essential part of the training of new surgeons. Advocates of double-booking also claim that the practice allows more patients to obtain quality care.

Critics of the practice, including both doctors and patient-safety advocates, allege that double-booking adds unnecessary risks to the surgery and adversely impacts patient trust in their care givers. Critics also point out that double-booking primarily enriches specialists and not general surgeons. In addition, very few doctors will consent to double-booking for themselves or their family members.

A critical legal issue is whether double-booking prevents the patient from giving his or her knowing consent to the surgery. Double-booking has produced a few medical malpractice lawsuits, but the results are mixed. In April of this year, a Seattle jury awarded a patient $8.5 million for botched surgery that was performed by a surgical resident, not the surgeon in charge of the case. Studies of overlapping surgery are just beginning, and persons who are knowledgeable about the practice expect the number of malpractice suits to increase.

Source: California Health Line, "Double-Booked: When Surgeons Operate On Two Patients At Once," by Sandra G. Boodman, July 12, 2017

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