June 28, 2017
In December 2015, a Boston Globe investigation of Massachusetts General Hospital (MGH) sparked investigations into concurrent and overlapping surgery. Overlapping surgery refers to operations performed by the same primary surgeon such that the start of one surgery overlaps with the end of another. A qualified practitioner finishes noncritical aspects of the first operation while the primary surgeon moves to the next operation. This is distinct from concurrent surgery, in which “critical parts” of operations for which the primary surgeon is responsible occur during the same time. There is general agreement that concurrent surgery is ethically unacceptable and is prohibited for teaching hospitals under the Medicare Conditions of Participation. Overlapping surgery is common, ranging from having trainees open and close incisions to delegating all aspects of the operation except the critical parts.