With “Clash in the name of care,” the Globe’s Spotlight Team exposed an open secret at American hospitals: doctors sometimes start a second operation before the first is finished, meaning that patients are, in effect, sharing their surgeon. And the Globe found one remarkably consistent pattern in its investigation: Patients seldom know, depriving them of a chance to say “no” beforehand.
The first story detailed the extraordinary internal debate at Massachusetts General Hospital, one of America’s best hospitals, where a handful of doctors and other staff for years objected to surgeons shuttling back and forth between two patients. Relying on hundreds of internal emails, surgical schedules and medical records, and dozens of interviews with current and former staffers, the Spotlight Team showed that critics of double-booking had raised concerns about at least 44 separate incidents between 2005 and 2015. These allegations involved cases with patient complications, including the deaths of two elderly patients; cases where surgeons were out of the operating room attending to another patient when an urgent need arose; cases where surgeons didn’t show up to operations, leaving the work to a resident or fellow; and cases of patients lying under anesthesia for prolonged periods waiting for a doctor to arrive or return.
MGH hired a former federal prosecutor to conduct an internal inquiry but has refused to share his report with regulators or the Spotlight Team.
In December, the Spotlight team published the findings of a national survey it conducted of 47 hospitals about the practice of surgeons running two rooms. While it is common for doctors to start a second operation before the first is complete, few hospitals call on surgeons to explicitly tell their patients when their operations are double-booked. The survey also revealed that there is little consensus or scientific research on what surgical procedures are appropriate for double-booking, the allowable degree of overlap, and the proper role for surgical trainees.
Disputes over surgeons running simultaneous cases have erupted at hospitals across the country in recent years, from Rush University Medical Center in Illinois to Vanderbilt University Medical Center in Tennessee. The conflicts were, at the time, treated as local and separate events, and simultaneous surgery remained unknown to much of the public.