Overlapping surgery or double-booked surgery has been a controversial practice that some U.S. hospitals have subscribed to for years. Teaching hospitals have been the most common to allow it. But it often brings into question matters related to ethics and safety, especially since the people most affected – patients undergoing surgery – may not even be aware that this practice occurs
As it may turn out, the surgeon scheduled to perform your surgery may spend little time in the operating room, leaving some of the work performed by a resident or fellow. Such a practice may lead to unnecessary complications that could prove fatal.
Safety risks related to anesthesia
The troublesome practice of overlapping surgery occurs when a doctor operates on two patients in different surgery rooms, switching from room to room during the same period. Hospitals decide whether to allow this practice, which is suspected to be most common in cardiac surgery, neurosurgery and orthopedics.
Critics, including some surgeons and safety advocates, have derided the double-booking practice, claiming it adds needless risk leading to surgical complications. Proponents claim the practice is safe, while providing necessary training for qualified junior doctors, improves efficiency, provides better use of a surgeon’s time and allows more patients to receive care.
However, things can go terribly wrong when a resident or fellow performs an unsupervised surgery. For example, the accidental cutting of arteries and nerves may occur. Another major concern includes patients having to wait under anesthesia for lengthy periods, while residents and fellows perform the unsupervised surgeries because the senior surgeon cannot be found.
Many patients unaware it occurs
Overlapping surgery provides the patient and their loved ones with the illusion that the senior surgeon performed the entire operation. Its practice may come as a surprise to some patients who may not even learn that it happens until something goes wrong.
An online survey conducted in 2017 by Harvard researchers disclosed that many people were not in favor of overlapping surgery. Of the 1,454 respondents, just 31% supported the practice. Also, 95% said patients should know in advance whether this practice occurs. Finally, only 4% even knew about overlapping surgery.
Ask questions and advocate for yourself
Patients must advocate for themselves, inquiring whether the doctor will remain present in the operating room during the entire length of the surgery. If the physician is evasive or non-committal, ask for another surgeon. Pin them down and get exact details. This is your life, and you know that you must protect it.