If there’s one time you want your doctor’s full attention, it’s during surgery.
Most patients don’t realize that to maximize their income, surgeons often perform two surgeries at once. Most hospitals and Medicare allow the practice. It’s known as “double booking.”
Now a new study shows that double-booked surgeries put patients at risk.
Researchers in the Department of Surgery at the University of Toronto reviewed case histories of more than 90,000 patients. Each underwent either hip replacements or surgery for hip fractures in Ontario, Canada, between 2009 and 2014.1
The study found that a patient was twice as likely to experience serious complications within one year if the operation was “double booked.”
The longer the time period the surgeries overlapped, the greater the risk.
If the surgeon’s two operations overlapped for as little as 30 minutes, the complication rate still climbed by 80 to 90%.
Complications included infections, need for follow-up surgery, and longer hospital stays.2
Dr. Alan Zhang is an orthopedic surgeon at the University of California San Francisco. He wrote a commentary that accompanied the study. “This seems to be the first study to show an adverse effect from the practice of overlapping surgery,” Dr. Zhang wrote.3
The study recently was published in the Journal of the American Medical Association Internal Medicine.
The Other Double-Booking Danger
Doctors and hospitals want to double book surgeries. It makes them more money. Often the practice occurs at teaching hospitals, where medical residents handle some of the surgery…while the surgeon hops between two operating rooms.
Double-booking has brought patient lawsuits after botched surgeries. But hospitals and doctors are still reluctant to give up the extra profit.4
To add to the risk, an earlier study published in JAMA found that overlapping surgeries are an average of 219 minutes long versus 188 minutes for non-overlapping procedures.
This increased time under anesthesia increases the risk of complications—including death and functional decline—for seniors.5 They are the primary patients for hip surgery.
Protect Yourself Before Surgery
Dr. Zhang says the findings underscore the need for patients to demand full disclosure from their surgeon… And for surgeons to be transparent with their patients about the practice of overlapping surgeries.
Make sure to take these steps before you undergo surgery:6
- Ask your doctor if he is going to perform the entire surgery. If not, will he be there for the entire time?
- Put your request—that your doctor perform the entire surgery—in writing on the surgical consent form. This is a form that every patient signs.
- On the day of surgery, repeat to your doctor that he has agreed to be in the operating room for the entire procedure. Do this while an assistant or staff member is there to witness it.
- If your surgeon says that he will be “present” or “immediately available,” ask what that means. It could mean that he is nowhere near your operating room.
You should not feel out of place demanding that your surgery not be double-booked. Remember, your doctor works for you.
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References:
1 https://www.minnpost.com/second-opinion/2017/12/overlapping-surgeries-linked-increased-risk-complications
2 https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2663757?redirect=true
3 https://www.minnpost.com/second-opinion/2017/12/overlapping-surgeries-linked-increased-risk-complications
4 https://www.washingtonpost.com/national/health-science/is-your-surgeon-double-booked/2017/07/10/64a753f0-3a7d-11e7-9e48-c4f199710b69_story.html?utm_term=.92d4d685d412
5 https://jamanetwork.com/journals/jamasurgery/article-abstract/2661297?redirect=true
6 https://khn.org/news/double-booked-when-surgeons-operate-on-two-patients-at-once/