Newspaper article Pittsburgh Post-Gazette (Pittsburgh, PA)

Hospitals Asked about Doctors Operating on More Than One Person at a Time Senate Seeks Details on 'Concurrent Surgeries'

Newspaper article Pittsburgh Post-Gazette (Pittsburgh, PA)

Hospitals Asked about Doctors Operating on More Than One Person at a Time Senate Seeks Details on 'Concurrent Surgeries'

Article excerpt

A national discussion has emerged over an operating room issue many patients may not even be aware of: Is it all right for a surgeon to operate on more than one patient at the same time?

Federal officials have asked 20 U.S. hospitals and health systems to spell out their practices and policies concerning "concurrent surgeries" in which a surgeon performs operations on two or more patients at the same time.

The Feb. 16 fact-finding letter from the U.S. Senate Finance Committee, a draft copy of which was obtained by the Pittsburgh Post-Gazette, does not accuse any health system of wrongdoing nor does it say any hospital is under investigation.

It does ask for detailed information about the centers' monitoring and oversight of the practice and, in particular, whether patients are told if they're sharing their surgeon with someone else.

"We are especially concerned by reports that in some cases, steps have been taken to actively conceal this practice from patients," stated the letter, signed by committee chairman Orrin Hatch, R-Utah.

The recipients, according to published reports, include major national centers Massachusetts General in Boston and the Cleveland Clinic. Locally, Allegheny Health Network spokesman Dan Laurent said AHN did not receive the Hatch letter, while UPMC spokesman Paul Wood declined to say if UPMC did.

"We're aware of the Senate Finance Committee letter but will leave it up to the committee to release the names of the hospitals it was sent to," Mr. Wood said.

The letter appears to have been prompted, at least in part, by stories published in the Boston Globe over the past several months. In those reports, the newspaper detailed disagreements within the medical community about the propriety of doctors performing multiple surgeries at the same time.

The Globe also reported instances of medical staff not being able to reach surgeons when an urgent need arose at a second site, as well as instances in which a patient was kept under anesthesia for an extended period or suffered complications because the surgeon was not present.

The Centers for Medicare and Medicaid Services does allow surgeons to bill for concurrent surgeries under certain circumstances but requires that the attending physician is "present during all critical and key portions of both operations."

Surgeon Matthew Indeck, president of the American College of Surgeons' central Pennsylvania chapter, said he "certainly would not support [concurrent] cases being done in distant hospitals" or keeping a patient under anesthesia longer than necessary.

But he acknowledged that a line delineating what's appropriate and what isn't "is very fuzzy."

Leaving a resident surgeon in charge of portions of an operation is a critical part of their training, he said, and it's left to the attending surgeon's judgment to decide what the resident can safely handle. …

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