Concurrent surgeries: Critics and supporters weigh in

By Aine Cryts

At 47 hospitals across the country, it's common for surgeons to begin a second surgical procedure before the first surgery is done, according to The Boston Globe. The topic at hand is concurrent surgeries--and the American College of Surgeons (ACS) plans to develop a consistent policy to ensure that patients are kept safe and informed if their surgeon decides to be responsible for more than one operation at a time.

The practice has its critics and supporters. While L.D. Britt, M.D., chairman of the department of surgery at Eastern Virginia Medical School, described concurrent surgeries to the news outlet as a "formula for disaster," Keith Lillemoe, M.D., chief of surgery at Massachusetts General Hospital, where the practice of concurrent surgery ignited interest in the topic this fall, defends it.

In addition to the ACS, hospital administrators at nine hospitals--including Duke University Health System, Dartmouth-Hitchcock Medical Center and the University of Michigan Health System--are also taking a hard look at concurrent surgeries. The practice has drawn the ire of Senator Charles Grassley (R-Iowa), who asked the Centers for Medicare & Medicaid Services whether the current rules on concurrent surgeries are strict enough.

The question surgeons must wrestle with is whether to focus on the more complex aspects of a surgical procedure and leave simpler surgical tasks such as suturing to residents--and, thus, serve more patients--or be present with individual patients for their entire surgeries.

The type of surgery can also be a factor for surgeons to consider. For surgical procedures, there's a long period of time when other members of the surgical team are prepping the patient, David Sugarbaker, M.D., a thoracic surgeon at Baylor College of Medicine, told the Globe. Robert Pedowitz, M.D., former chair of orthopedics at UCLA Medical Center, used to run two operating rooms at the same time, but stopped after a few years.

"Over time I decided it was really not a very good practice for the sake of patients and I stopped doing it," Pedowitz told the news outlet. "It was too stressful for me because I wasn't able to be there for the whole surgery," he said, adding that he was uncomfortable knowing that there were mistakes he would be unable to prevent if absent.

Trauma care may be an instance where the benefits of concurrent surgery outweigh the risks, according to proponents. Many lives were saved after the Boston Marathon tragedy in 2013 because of concurrent surgeries, according to David Torchiana, M.D., CEO and president of Partners Healthcare, the parent organization for Massachusetts General Hospital.

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