Concurrent surgery under the microscope: Senate committee calls for 20 hospitals, health systems to release records

The American College of Surgeons is currently revising concurrent surgery guidelines

The U.S. Senate Finance Committee has requested that 20 hospitals and health systems release several years of concurrent surgery records amid a debate over the safety of hospitals' practices.

Specifically, the committee in a letter last month asked the organizations to detail the number of concurrent surgeries performed by specialty from 2011 to 2015, along with policies about informing patients prior to their surgery.

"We are concerned about reports of patients not being informed that they may be sharing their surgeon with another patient, and we are especially concerned by reports that, in some cases, steps have been taken to actively conceal this practice from patients," committee chair Sen. Orrin Hatch (R-Utah) wrote in the letter, which was obtained by the Boston Globe.

The letter does not accuse any health system of wrongdoing, according to the Pittsburgh Post-Gazette, which also obtained a copy of the letter. A committee staffer calls the information request a "fact-finding exercise."

Background on the controversy

The practice has come under scrutiny after a Globe investigation found that concurrent surgery is fairly common, but that some surgeons have raised patient consent and safety concerns about hospitals' practices.

Meanwhile, proponents of concurrent surgeries say that such "double-booking" allows hospitals to reduce wait times and have their most in-demand surgeons do more procedures, particularly during daytime hours.

Concurrent surgeries: What's the line between safe and reckless?

ACS: Finance committee staff 'very much trying to understand this issue'

The Finance Committee has already met with representatives from the American College of Surgeons (ACS).

"The staff people that we met with are very much trying to understand this issue," says David Hoyt, executive director for ACS. "They've come to understand that there's a lot of different opinions on definitions of things, and they're trying to get clarification."

ACS is in the process of creating new guidelines regarding concurrent surgeries. The current guidelines say that the surgeon "should be in the operating suite or the immediate vicinity for the entire surgical procedure," but allows for exceptions, and also says the patient should be told ahead of time if their surgeon will be performing concurrent operations.

According to Hoyt, the new ACS guidelines for concurrent surgeries should be released in a month.

Matthew Indeck, president of the ACS central Pennsylvania chapter, says establishing appropriate uses of concurrent surgeries "is very fuzzy," adding, "I think there has to be some concern about the lack of consistency across training programs in the [United States] and, for that matter, internationally. It would be nice to have a consistent approach" (Saltzman/Abelson, Boston Globe, 3/13; Twedt, Pittsburgh Post-Gazette, 3/28).

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