Is it Safe for One Surgeon to Oversee Two Operations Concurrently?

In a previous News Blog I advocated a ‘Taylorised’ (i.e. assembly plant) type of approach to bariatric surgery,[1] where a small number of (expensive) surgeons and anaesthetists would oversee a workforce of (less expensive) physician’s assistants / auxiliary medical personnel – figure reproduced below for your convenience. The argument was that bariatric surgery was the only really effective treatment for obesity resulting in greatly improved long-term outcomes, yet surgical resources, as currently deployed, could not meet the demand. No News Blog reader wrote in to ask “but is it safe to operate in this way?” A recent study, based on over half-a-million operations suggest that the answer is “yes it is” – complications were no greater when bariatric operations were concurrent than when they were done strictly in series.[2] CLAHRC WM News Blog reader Tim Jones has recently visited an eye hospital in Hyderabad, India, where a Taylorised approach is taken to cataract surgery with massive efficiency gains and complication rates even lower than those in the UK. I have written before saying that medicine cannot and should not be Taylorised.[3] Real medicine lies in diagnosing, explaining and consoling. But procedures are ripe for massive efficiency gains.

An Operations Director oversees a Surgeon and two Anaesthetists who oversee six technicians operating on six patients

— Richard Lilford, CLAHRC WM Director

References:

  1. Lilford RJ. Bariatric Surgery – Improve Five-Year Outcomes. NIHR CLAHRC West Midlands News Blog. 23 June 2017.
  2. Liu JB, Ban KA, Berian JR, et al. Concurrent bariatric operations and association with perioperative outcomes: registry based cohort study. BMJ. 2017; 358: j4244.
  3. Lilford RJ. The Future of Medicine. NIHR CLAHRC West Midlands News Blog.23 October 2015.
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