Massachusetts Cracks Down on Simultaneous Surgeries

After an investigation by The Boston Globe exposed problems when surgeons were double booked, typically without patients’ knowledge, the Massachusetts Board of Registration in Medicine yesterday approved a rule to regulate the practice.

It is believed to be the first time a state agency has tried to put rules in place to govern double-booking, which has caused controversy around the country. While doctors are encouraged to disclose the practice, there is often no requirement that they tell patients that they will be sharing the surgeon's time with another patient.

The newspaper’s report, which appeared in October, detailed how practice of double-booking surgeons has grown not only in Boston but nationwide, as surgeons who specialize in key procedures will move in and out of the operating room, leaving other surgeons or trainees to open and close.

The practice is designed to allow in-demand specialists to maximize the number of procedures they can perform in a day, which brings more revenue to the hospital. But when something goes wrong, problems can occur if there are problems locating the surgeon who performed the key part of the operation.

The Globe reported on a former spine surgeon at Massachusetts General Hospital who is being sued by 3 patients, including former Boston Red Sox pitcher Bobby Jenks. Each patient said he had no idea that the surgeon who was listed at the attending physician on the operating room schedule was also listed on another overlapping operation.

In a lawsuit against MGH, Jenks asserts that the practice of double-booking contributed to a botched surgery on his spine that ended his career and led to pain that later caused him to develop substance abuse problems.

The rule will require 2 things: documentation of the attending surgeon’s presence in the operating room, and designation of the backup surgeon who will fill in when the surgeon steps out.

Critics of double-booking previously told The Globe that it was unethical for patients to be in the dark about the practice. One surgeon who spoke with the newspaper was dismissed.