Preferably Not My Surgery: A Survey of Patient and Family Member Comfort with Concurrent and Overlapping Surgeries.

BACKGROUND: Concurrent and overlapping surgical procedures are a timely topic. The 2 largest publications on the topic were limited to a journalistic overview and a government committee report. Since then, a recent survey of paid individuals found that they disapprove of overlapping surgical procedures in many cases. Still, we are aware of no work that specifically polled patients and their family members about their beliefs on concurrent and overlapping surgical procedures. We hypothesized that patients and family members will be uncomfortable with 1 surgeon performing overlapping or concurrent surgical procedures. METHODS: A survey about concurrent and overlapping surgical procedures was given to 200 patients and their family members at a single, urban academic medical center. Participants were asked to respond to questions about their knowledge of concurrent and overlapping surgical procedures, their comfort with different surgical scenarios, and their beliefs on possible reasons for such surgical scenarios. Individuals were approached about the survey until 200 patients and family members responded. RESULTS: On average, respondents were neutral with surgical procedures involving overlap of 2 noncritical portions and were not comfortable with overlap involving a critical portion of 1 or both surgical procedures. They agreed that hospitals allow overlapping surgical procedures to increase revenue. CONCLUSIONS: Patients undergoing a surgical procedure at an academic medical center and their family members were neutral or uncomfortable with concurrent or overlapping surgical procedures, affirming the hypothesis. Knowing these preferences is relevant to surgeons' practices and to informed consent discussions. It appears beneficial for surgeons to address the advantages and disadvantages of overlapping surgical procedures with their patients if applicable.

It All Depends on Who Does What: A Survey of Patient and Family Member Comfort With Surgical Trainees Operating.

OBJECTIVE: To measure patient and family member comfort with surgical trainees of varying levels performing different portions of surgery. DESIGN, SETTING, AND PARTICIPANTS: An electronic survey dividing surgery into 6 steps (prepping and positioning, initial incision, deep dissection, critical portions, deep suturing, and closing incision), differentiating surgical trainees by 4 levels of experience (medical student, intern, resident, and fellow), and specifying whether or not an attending surgeon is in the operating room (OR) was given to 200 patients and family members in the surgical waiting area of a single academic medical center. Responses were on a 7-point Likert scale from "Not Comfortable at All" to "Completely Comfortable". RESULTS: Patient and family member comfort significantly increased as trainee experience increased. It reached a nadir for all trainees performing "critical portions" of surgery. However, their average response was "Comfortable" for residents and fellows performing any surgical step when the attending surgeon is present in the OR. The percentage of "Comfortable" responses was significantly lower for all trainee levels performing any surgical step when the attending surgeon is absent from the OR. CONCLUSIONS: Patient and family member comfort with surgical trainees operating varies based on the trainee's level of experience, the step the trainee performs, and whether or not the attending surgeon is present in the OR. Patients and family members are on average "Comfortable" with surgical residents and fellows performing any surgical step when the attending surgeon is present.