A recent article in the Boston Globe raised the topic of surgeons multitasking, which is to say participating in multiple surgical procedures simultaneously. Below is an excerpt from it (see: When Surgeons Multitask: The Little-Known Practice of Concurrent Surgeries; Double-booked surgery is a troubling form of multitasking);
When you go to the hospital for an operation, did you know your surgeon might also be performing a procedure on another patient, in a different operating room, over the same scheduled time period? This practice – “two patients, two operating rooms, moving back and forth from one to the other” while relying on assistance from general surgeons or trainees – is called concurrent surgery. It’s an open secret in hospitals, but patients rarely hear about it. The Boston Globe recently investigated concurrent surgery at Massachusetts General Hospital (MGH), as well as the broader conflict in the medical community over the ethics and safety of double-booking operations....(see: CLASH IN THE NAME OF CARE). The No. 1 reason that’s given by hospitals is around efficiency and access to care, so that there's no wasted time in the operating room....It not only allows more cases in one day, but the hospitals also said, for some of these star surgeons who might have long wait lists, you can get greater access to them because they are doing more surgeries. But some doctors question its ethics....One is that there were concerns and complaints raised to him by anesthesiologists over the issues of what they considered were patient safety, and concerns around whether patients were getting the best medical care possible. And then the separate issue of patient consent -- that this practice was just known by the doctors and the nurses and the anesthesiologists and the billing clerks and everyone else. The only one who didn't know about it was the patient. It’s hard to tell how common it is because there’s scant data and hospitals aren’t talking.
Frankly, multitasking by surgeons strikes me as a new name for a historic and well-accepted practice. It surprises me, at least according to this news account, that the hospital spokespersons are not defending the practice more actively. Certainly in teaching hospitals, it has long been the practice for senior surgeons to move through multiple operating rooms with support by surgical residents and junior faculty. Often the senior surgeon would perform the most delicate parts of a procedure with the younger members "opening" and "closing" the incisions. This is precisely how surgical training programs are supposed to work. A similar system occurs in in anesthesiology with the senior anesthesiologists supervising a team of nurse anesthetists and residents in multiple ORs. The excerpt above does raise the issue of patient consent and knowledge that the senior surgeon with whom one may have consulted will not be present in the OR at all times and that residents may be performing part of the operation. I have been under the impression, perhaps naive, that most patients being cared for in teaching hospitals are aware of such arrangement. If not, such a discussion should be an obligatory part of preoperative discussions.