Posted by John Ager on 23 November 2015.

Increasingly, our society calls for ever increasing efficiency.  From business to our personal lives, the demand for greater productivity never seems to end.  We talk on the phone, shave,  or do makeup while we drive.  We answer texts during office meetings or while talking with friends and family.  We make dinner while we help the kids with homework and clean.  Unfortunately, we often sacrifice quality for quantity in the attempt to do as much as we can in as little time as possible.

Medicine is no exception.  Doctors and other health care providers are not immune from the increasing pressure brought by employers, insurers, and perhaps self-interest to do more in less time.

Unfortunately, that pressure often affects quality, putting patients at risk.

This point was made recently when a surgeon at Massachusetts General Hospital reported to the press that surgeries were being scheduled so that surgeons could work on two patients at once.  The procedures were not necessarily emergent or routine, but often involved complicated, elective, non-urgent  procedures.  The hospital justified the practice as one which “increased access to highly sought after surgeons.”  As if there were a shortage of those Massachusetts.  Patients were often unnecessarily left under general anesthesia for long periods of time or without competent care during critical or unexpected surgical events.  The report was preceded by medical malpractice cases alleging the practice as a cause of bad outcomes, a red flag which likely helped raise the issue.

So, what happened?  Reform?  An acknowledgement that something had gone wrong with the system? Recognition that an experienced and respected surgeon had the courage to step up and do the right thing?  The answer is “D” – None of the above.  Instead, the reporting surgeon was fired for being “disruptive.”  The curtain of medical secrecy in action.

The operating room is no place to cut corners.  While patient safety should always be paramount, at no time is it more critical than during surgery, a time when a patient is most vulnerable.  Unfortunately, the culture of greed is strong.  Until it costs providers and their liability insurers more to pay for the costs of patient harm than they can generate by double booking surgeries, things will probably stay the same.  The price of efficiency is paid by the patient.