8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J A N U A R Y 2 0 1 7
I
t's common for both surgeons and anesthe-
siologists to supervise more than one case
at a time, but the practices are suddenly
under scrutiny.
When a surgeon operates on more than one
patient at a time, switching between cases
while residents and fellows handle the more
routine tasks, it's called simultaneous, concur-
rent or overlapping surgery. "Double-booking"
lets a hospital's top surgeons do more procedures and gives its sur-
geons-in-waiting real-world experience.
When anesthesiologists oversee 2, 3 or even 4 CRNAs at once, moni-
toring the course of anesthesia administration at frequent intervals, it's
called medical supervision. Jay Horowitz, CRNA, and John
Dombrowski, MD, debate medical supervision's place in medicine in a
point-counterpoint on page 6.
Meanwhile, "double-booking" has come under national scrutiny
after a Boston Globe exposé of problems related to overlapping
cases at Massachusetts General Hospital (see "Has Double-Booking
Surgery Gone Too Far?" at osmag.net/6zdapg). The U.S. Senate
Finance Committee is looking to explicitly ban surgeons from divid-
ing their attention between patients.
The alleged problems are ghastly: surgeons failing to respond to emer-
gency situations, not showing up at all or leaving anesthetized patients
waiting. The practice has led to several malpractice suits involving
Mass General. The Boston Globe reported that little scientific research
has been done on concurrent surgeries, and that "there is no consensus
Double Standard on Double-Booked Surgeries
If anesthesiologists can supervise multiple ORs, why can't surgeons?
Editor's Page
Dan O'Connor
