Lawmakers Ask Hospitals to Stop Simultaneous Surgeries

It’s a widespread practice that apparently has been going on for quite some time: One surgeon overseeing multiple surgeries at the same time.

It’s called “simultaneous surgeries,” but since The Boston Globe shined a spotlight on the practice in a series of stories last year, it’s clear that most Americans have but one word for it: Scary.

And apparently, the U.S. Senate agrees. As such, the Senate Finance Committee launched its own inquiry into simultaneous surgeries and released a report Tuesday. Members of both chambers of Congress are demanding reforms as it relates to the practice. Some are calling for an end to the practice altogether.

“In the absence of empirical data or research, when the Committee began its inquiry the hospital administrators, surgeons, and other healthcare professionals were largely skeptical of concerns regarding the safety of the practice of concurrent surgeries,” per the Senate report. “Since that time, Committee staff observed a shift in attitudes among many organizations and recognizes the steps that hospitals and medical professions have taken in a relatively short timeframe to address many of those concerns. Nonetheless, the frequency and consequences of the practice of concurrent or overlapping surgeries remain unknown.”

In a response to the stories published in the Globe, which focused on how the practice worked at Massachusetts General Hospital, MGH stated: “Overlapping surgery involves the close coordination of procedures for a surgical team so that preparation for one patient – draping, positioning, anesthesia – begins in one operating room as the care of another patient finishes in another room. At MGH, any type of overlap occurs in 15 percent of surgical cases, but in only a minority of these (3 percent) is there any overlap of the surgery itself. Under all circumstances, the patient’s surgeon remains responsible for the care. The practice, managed thoughtfully and carefully, benefits patients, families and staff.”

The statement goes on to explain that during times of disaster, such as the Boston Marathon bombing and Rhode Island Station nightclub fire, simultaneous surgeries even save lives.

“The Joint Commission, which accredits hospitals, received an anonymous complaint, considered our practice, and recently informed us it has closed its review with no action required,” MGH said in the statement. “Similarly, the Massachusetts Department of Public Health, also responding to an anonymous complaint, assessed our practice and policies and issued a report calling the allegations ‘invalid.’ Beyond these investigations, the American College of Surgeons called Mass. General’s overlapping surgery policies ‘best practice’ and noted they ‘exceeded standards.’”

Yet according to the Senate report, the ACS has stated, “The primary attending surgeon’s involvement in surgeries on two different patients in two different rooms when the critical or key components of the procedures are occurring all or in part at the same time is not appropriate.” But again, MGH explained that only 3 percent of the time is there ever any overlap of the actual surgeries themselves.

In May, a study by seven health care professionals at the University of Virginia, Charlottesville and one at Memorial Sloan-Kettering Cancer Center, New York, concluded, “In academic cardiothoracic surgical practices that rely on surgical support from fellowship training, the practice of running simultaneous operating rooms can be efficient and does not appear to increase operative duration, dramatically impact operating room starting or closing times, or negatively affect patient outcomes.”

The study examined 1,748 cardiac and 1,800 general thoracic surgeries from July 1, 2011 to July 1, 2013. “Due to concerns for both patient safety and hospital cost, increased scrutiny has recently been placed on the common practice of attending surgeons’ running simultaneous operating rooms at medical centers,” the authors reported.

However, the study only examined the practice at one hospital – University of Virginia, Charlottesville.