A year after a Boston Globe investigation raised concerns about the safety and ethics of double-booking surgical procedures, a study has found that, at least from a clinical perspective, it’s a nonfactor.
According to a JAMA Surgery study published earlier this week, neither mortality, morbidity, nor functional status was worsened in patients who had been part of an overlapping surgery — that is, when a surgeon is carrying out multiple surgeries at the same time.
The finding may come as little comfort for patients, though. Recent surveys have found that 69% of patients expressed opposition to the practice, and 44% said they would choose a different surgeon if they knew in advance that their surgeon was double-booking.
Brian M. Howard, MD, of Emory University in Atlanta, and colleagues looked at 2,275 neurological surgeries in 2014 and 2015. Of that group, 972 were non-concurrent surgeries, while 1,303 were done simultaneously with other procedures. The study further broke down concurrent surgeries into subgroups: overlapping in-room time, “when the preparation phase of surgery for a second patient occurred simultaneously with the emergence phase of surgery for the first patient,” and overlapping skin-to-skin time, “when any portion of the operative time ran concomitantly with that of another patient operated on by a single surgeon.”
In no cases did the critical portions of surgery overlap, the researchers noted.
Overlapping surgeries did take longer. In-room cases took an additional 16 minutes, on average, while skin-to-skin overlaps took an additional 12.
But on measure after measure of safety, there was little difference between the two. Both approaches had 95% of patients with “good” disposition locations, both had 90-day morbidity rates of about 15%, and both had 30-day readmission rates of under 10%.