New guidelines say surgeons should inform patients of concurrent procedures

The American College of Surgeons issued new standards Wednesday for surgeons performing procedures simultaneously. While the ACS doesn't prohibit the practice outright, the guidelines do suggest informing the patients involved.

According to the ACS standards, "A primary attending surgeon's involvement in concurrent or simultaneous surgeries on two different patients in two different rooms is not appropriate." That said, there are two circumstances in which portions of two procedures may overlap.

The first scenario, and most common, is when the most critical parts of the first operation have been completed and there is no foreseeable need for the primary attending surgeon to return to that operation, so a qualified practitioner performs noncritical components of the first operation while a second procedure is initiated elsewhere.

The second scenario is when critical elements of the first operation are done and the primary attending surgeon is performing key or critical portions of a second operation in another room. In this case, the primary attending surgeon must have another attending physician with immediate availability assigned to the first operating room.

"The patient needs to be informed in either of these circumstances," according to the standards. "The performance of overlapping procedures should not negatively impact the seamless and timely flow of either procedure."

L.D. Britt, MD, DSc, a past president of the ACS and current chairman of the Eastern Virginia Medical School department of surgery in Norfolk, told The Boston Globe the guidelines should serve as a wake-up call for surgeons who have ignored rules prohibiting overlapping critical parts of surgeries.

"The patient needs to know what's going on. It's their body being operated on," Dr. Britt told reporters. "They should know when you're not going to be the surgeon. That's part of the contract."

The issue of concurrent surgeries made national headlines last fall, due to a report from The Globe's Spotlight Team that examined the practice at Boston-based Massachusetts General Hospital. The report spurred several investigations and led to the termination and resignation of several top physicians.

An MGH spokeswoman addressed the new ACS guidelines in an email to The Globe, saying "They are similar to the policy we adopted in 2012. We will carefully review our policy in light of these guidelines and consider clarifications or modifications as seem appropriate."

Still, the practice of overlapping surgeries draws criticism from people who say it is dangerous and unethical. Some critics even say the ACS standards will do little, if anything, to curb the progress.



More articles on concurrent surgeries:
Feds seek information on concurrent surgeries at 20 medical facilities: 7 things to know
US Senators to inquire about concurrent surgeries policy
Mass. ruling addresses concurrent surgeries: 5 things to know

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