A new study finds that the practice of overlapping surgeries for lead surgeons might put vulnerable patients at significantly higher risk of post-op complications, including infections, heart attack or death.
However, the less extreme practice of letting the beginning and end of surgeries overlap is still viewed by hospitals as an efficient means of deploying the skillful hands of their top surgeons. Mass General, which has continued the practice, is in the company of teaching hospitals nationwide.
This discrepancy, says Jena,"could occur because a surgeon is separating their mental effort between two cases or [from] literally being [in] two places at once. Those kinds of problems would have a measurable effect on high-risk patients." This study, he says, supports his sense that there is"a specific group of patients that probably has to be monitored more closely."
"If you're finishing an operation and you tell your resident, 'You can go ahead and close the incision,' they're more than competent enough to do that," he says."Then you leave, go to another room where a [surgical] fellow has started a case. That's an efficient use of time." Harbaugh estimates 15 percent of the surgeries done by doctors in his department overlap.
If they don't like the answer, Jena says,"At any point, the patient could say, 'I don't want care provided to me.'", a policy analyst and president of the National Center for Health Research, is doubtful many such conversations are likely to occur."Most patients wouldn't know to ask," she says.
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