Concurrent ORs: The debate rages on — 5 key notes on a US Senate Finance Committee inquiry

Practice Management

At hospitals and healthcare facilities around the country, orthopedic surgeons are running concurrent operating rooms to train residents and maximize efficiency; however, the strategy is controversial.

Now the U.S. Senate Finance Committee is reviewing a fact-finding letter investigating the practice, according to a Pittsburgh Post-Gazette report.

 

Here are five key notes:

 

1. Twenty hospitals and health systems in the United States were asked to describe their policies for concurrent surgeries with detailed information about monitoring and oversight during those cases. The providers are also asked whether patients know the surgeon is working concurrent operating rooms.

 

2. Running concurrent operating rooms could mean the surgeon is unavailable during urgent situations in one of the operating rooms or patients are under anesthesia for suffer damages from being under anesthesia for extended periods while surgeons make the switch, according to the report.

 

3. CMS allows surgeons to bill for concurrent surgeries under certain circumstances and requires an attending physician's presence during critical portions of the operations.

 

4. The attending surgeon is often left to decide whether the resident assisting with a procedure can safely hand the procedure independently. Being in charge of portions of an operation is important for the resident's training, according to the report, however training is inconsistent.

 

5. A study from the University of Virginia shows surgeries overlapping for up to 45 minutes don't have a statistically significant negative impact on patient outcomes.

 

The American College of Surgeons is updating principles for the physician's responsibilities in the operating room to hopefully drive consistency in the future. Current standards allow surgeons to delegate portions of the surgery, but also say the physician should be in or near the OR for the entire procedure and patients should be told about the situation before undergoing surgery.

 

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