Why your surgeon or anesthesiologist might not be the one working on you in the operating room

The doctor-patient relationship is one of trust. Many people do research on physicians or surgeons and even schedule preliminary appointments before deciding that they have the right fit. What many people realize, though, is that when it comes to surgeons what often happens in the operating room is not what the patient’s had in mind.

I like the way Dallas TV station WFAA phrased it in their reporting on this issue. They call it ghost surgery.

Ghost surgery is when there is a switch in operating room personnel between the people whom the patient thinks will be running the show and those who actually do the work. This not only happens with surgeons, but with anesthesia providers as well.

For surgeons, this is most commonly a problem at large academic medical centers. These are the types of hospitals and surgeons that doctors seek out because they want world-class, safe healthcare. But many of them don’t realize, though, is that part of the mission of these large hospitals is teaching. This means that there is an excellent chance that any given patient’s surgery will be at least in part teaching, which means that the patient is a guinea pig for the doctors who are still completing their training.

Now, to be fair, there’s no doubt that new doctors need to continue to develop their clinical knowledge through additional residency and fellowship training after medical school. That’s not the point. This arrangement is entirely legal so long as:

• A fully-trained attending physician or professor properly supervises the work of the resident or fellow physician who’s still in training

• They get the patient’s permission.

In my experience as a Houston, Texas medical malpractice attorney, academic hospitals and their physician faculty members often fail on both points. The surgeon hired by the patient to perform a surgery will be absent from the operating room for most of the surgery, but the patient is never informed of this fact other than vague language buried deep in a mound of informed consent and registration paperwork that most patients find too cumbersome and technical read.

Based on whistleblower data and investigative journalism, WFAA uncovered some particularly shocking examples. One surgeon left the operating room 13 minutes into a four-hour surgery. Another decided to leave after only five minutes had passed into an amputation surgery. Still another didn’t bother to stick around in the operating room before a lengthy surgery even began. One study found that the lead surgeons never even showed up for nearly 20% of the cases reviewed!

As I mentioned earlier, this operating room anomaly is unique to surgeons. Anesthesia providers do the same thing all the time, and not just at major academic hospitals.

According to standards of the American Society of Anesthesiologists, and anesthesiologist physician must perform a pre-operative assessment. The purpose is to make sure that it’s safe to proceed with surgery under anesthesia and to come up with an anesthetic plan. Practically, though, this is the time when patients meet the anesthesiologist and, understandably, expects that this is the physician who will be taking care of them while they’re asleep.

Little did they know, though, is that that could well be the last substantive time when the anesthesiologist will be involved in the patient’s care. Certified registered nurse anesthetists (CRNA), who have substantially less training than anesthesiologist and are much cheaper to hire, rule the roost in many operating rooms.

Meanwhile, one anesthesiologist physician is often left to shuffle paperwork and supervise five CRNAs at once. Theoretically, the anesthesiologist is supposed to be present at the most dangerous portions of the anesthesia, but that often doesn’t happen.

In a wrongful death medical malpractice lawsuit that I’m handling now, for instance, the anesthesiologist was busy taking care of one of the other four patients that she was responsible for during the last 27 minutes of my patient’s 40-minute surgery.

The anesthesiologist was too busy to be present in the operating room when there was a complication at one of the most dangerous points, emerging from anesthesia. Instead of being in the operating room, the anesthesiologist left things to CRNA who is a year out of school.

By the time she was called to help, she was in the dark about the operating room care that occurred in her absence and fumbled and mismanaged resuscitation effort. Sadly, now young man is deceased because of these errors.

What you can do

If you face a surgical procedure, before going in the operating room ask some point-blank questions to your surgeon and anesthesiologist, and make sure you’re satisfied with their answers.

First, ask if the surgeon will be performing the surgery and if he or she will be present during the entire operation. I’m handling a medical malpractice case against Baylor St. Luke’s Medical Center where a famous cardiothoracic surgeon left the operating room to allow residents in fellow still in their training to complete closure. Somehow, these inexperienced doctors and operating room nurses managed to leave an entire surgical towel in the patient’s abdomen.

Second, ask the anesthesiologist who will be providing the direct patient care and the operating room. Also inquire about how many cases are patients the anesthesiologist will be handling at the same time as your surgery.

We are here to help

If you’ve been seriously injured because of poor surgical or anesthesia care, then contact a top-rated experienced Houston, Texas medical malpractice lawyer for help in pursuing your potential case.

Robert Painter
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Robert Painter

Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm Medical Malpractice Attorneys in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits all over Texas. Contact him for a free consultation and strategy session by calling 281-580-8800 or emailing him right now.