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Two patients, same time, no one the wiser?

December 10, 2015

Question:

Jennifer,

What are the risks you see with concurrent surgery - where two surgeries are in progress and a surgeon splits with his/her fellow back and forth.  Seems more places are doing this to get 10 procedures in instead of 5.  Double time!

Dr. P
Answer:

Yikes! Seems tremendously problematic with potential exposure all over the place!  First issue, informed consent.  Does the patient know they are signing up for the surgeon OR fellow? Probably not.  The patient probably presumes (and is led to believe that the experienced surgeon is providing the service, or at a minimum, the experienced surgeon will be present the entire time.  Second issue, reimbursement. Medicare and other payors will likely be billed for surgeon and assistant surgeon in this situation, and likely not care to reimburse for either if they knew the scheduling.  Huge exposure here with I'm sure major audit exposure.  Seems ripe for OIG.  Third issue, hospital or ASC accreditation issues related to patient care concerns.  I'm sure if public this scenario would be ripe for a Joint Commission inquiry and potential censure.  

2 musts with patients - better have informed consent, and better do what you bill for.  Where billing suggests you were present the entirety, I do not recommend being anything other than present.   

Hope this helps. 
 
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