Surgery: Is Your Doctor Really There?

Standard

A news article about a New York State law suit settlement raises question about surgical ben_franklinpractices that even I would never have thought to ask.

Here’s the account from Becker’s Hospital Review:

A New York Supreme Court judge ruled this week that a neurosurgeon was retaliated against by his former employer for objecting to a policy that allowed another surgeon to oversee two spine surgeries at the same time, according to The Boston Globe.

The judge ruled that University Hospital in Syracuse, N.Y., illegally forced James Holsapple, MD, out of his job after he objected to a policy that allowed Ross Moquin, MD, a specialist in complex spine surgery, to oversee two surgeries simultaneously. Dr. Holsapple raised concerns about the policy because although junior surgeons would assist Dr. Moquin when he was overseeing two surgeries at the same time, they were not qualified to perform the procedures, according to the report.

Dr. Holsapple alleged that on one occasion when Dr. Moquin was double-booked he was delayed in one operating room, which meant two unqualified surgeons had to finish the procedure being performed in the other room. Dr. Holsapple alleged the patient subsequently suffered a serious spinal fluid leak.

Double-booking surgeries may be a relatively common practice among senior surgeons. There was another lawsuit this spring regarding a double-booking at Massachusetts General Hospital, and there’s a law firm in Cleveland that is promoting its experience with lawsuits regarding double-booked surgeries.

There are known risks associated with this practice:

  • Longer anesthesia time for patients waiting for the attending surgeon who was delayed in the first procedure;
  • Lack of patient awareness (consent) regarding what portions of the surgery are performed by which surgeons or practitioners involved in the procedure;
  • Inadequate supervision of surgical residents and scope of practice creep with surgical assistants when the primary surgeon leaves for a second procedure;
  • Operating Room (OR) nurses reporting fears of “patient abandonment” to administration; and
  • Inadequate pre-procedure briefings and the absence of surgical debriefs. (2)

The practice of double-booking surgeries raises questions for patients and payers:

  • Should you be asking your surgeon about his booking practices and use of junior surgeons? How transparent should doctors and hospitals be about this practice?
  • If you (or your insurance) are paying for a senior surgeon and he’s not in the room, for what exactly are you paying? Should there be a rate reduction if the surgeon is only present for part of the procedure? Or do you want a doctor who will be with you the full time?

Sources:

  1. Alya Edison, “Physician who raised concerns about concurrent surgeries at NY hospital wins retaliation lawsuit,” Becker’s Hospital Review, 25 May 2017. http://www.beckershospitalreview.com/legal-regulatory-issues/physician-who-raised-concerns-about-concurrent-surgeries-at-ny-hospital-wins-retaliation-lawsuit.html
  2. “Concurrent (overlapping) surgery: addressing the risks,” Healthcare Risk Management Review, 26 September 2016. http://www.hrmronline.com/contributed-article/concurrent-overlapping-surgery-addressing-the-risks
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