This blog has been dedicated to an impassioned and balanced view based on evidence surrounding medical errors. I am not one for histrionics or grandstanding. But when I read the Boston Sunday Globe Spotlight article revealing that Massachusetts General Hospital surgeons are routinely doing two operations at once, I nearly choked on my bagel. I had just returned from visiting my father after his heart surgery in Phoenix and, among all of the questions I asked the doctors about his surgery, it never occurred to me that I should have asked, “Will you be doing another operation at the same time as you will be doing my father’s?” Before reading the article, I would have imagined that the surgeon would have laughed in my face at such a preposterous question. It would be like asking a pilot if he is going to be flying two planes at once. While that’s physically impossible, whereas doing two surgeries at once technically is not, they both seem equally incomprehensible.
We are not living in a country where medical errors are decreasing. Errors and deaths are increasing at an alarming rate every year. Currently, there is a much greater chance of death from a medical error than from a car accident. There is simply no rational argument that double booking decreases those odds.
Concurrent surgeries indisputably increase the risk of complication. If something goes wrong, and the attending surgeon is not there, the patient must remain under anesthesia longer, increasing the risk of death. Furthermore, most surgical patients are not even aware that they are consenting to a resident doing their operation. A resident is a “doctor in training”. So, things can, and often do, go wrong. Some of these are small and can wait a while until an attending surgeon intervenes to correct the problem. Some require immediate attention and correction. When that happens, you want the pilot there immediately to take over the controls.
Who among these surgeons who double-book would permit a surgeon operating on their daughter, son, mother or father to do the same? Surgical patients have a right to the undivided attention of those who literally have their life in their hands. These surgeons are doing these procedures for two reasons: one because they want to heal others with their skills; two, because they make a good living doing this.
No one is disputing that skilled surgeons deserve to make a good living. They work exhaustively under extreme circumstances treating patients with complicated, sometimes life-threatening conditions. But it is for these exact reasons that double booking should be absolutely prohibited. These circumstances already make the patient extremely vulnerable to suffering from a mistake. Hospitals should be trending toward decreasing, not increasing these risks.
The only argument by MGH in the Globe article for permitting this is to increase “efficiency.” Is there anyone who doesn’t understand that “efficiency” means the ability to make more money? Making more money is not a sin, but it is when its at the expense of risking a patient’s life. Under these circumstances, when things go wrong and the patient has been harmed, the physician and the hospital are asking for a lawsuit.
In Massachusetts, we enacted a law prohibiting texting while driving so that others do not get killed or harmed by drivers failing to give the road their undivided attention. Do we really need to do the same to force physicians to do this during surgery? Do we need a law requiring them to do what is ethically and morally right? If so, enlist me as an advocate for such a bill. I promise it will get my undivided attention.