Should Patients Be Left in the Care of a General Surgeon?

ETHICS DEBATE: NEIGHBORLY HELP OR ITINERANT SURGERY?

Monday, January 29
4:15 p.m. – 5:15 p.m.
Room 315

Robert M. Sade, MD

Ethics Debate explores  postoperative coverage

More smaller or remote health care facilities are requesting assistance from cardiothoracic surgeons at major hospitals, leading to controversy over what happens when the cardiothoracic surgeon leaves. Oftentimes, patient care is transferred to a less experienced general surgeon. During the 2018 Ethics Debate, two cardiothoracic surgeons will explore the pros and cons of this trend.

The American College of Surgeons states that the surgeon remaining at the hospital must be able to “render surgical care equivalent to that performed by the surgeon who performed the operation.”

“What does that mean?” asked STS/AATS Cardiothoracic Ethics Forum Chair Robert M. Sade, MD. “Does that mean that the surgeon who stays behind needs to be a cardiothoracic surgeon? There are people who believe strongly that is the case.”

James S. Allan, MD, of Massachusetts General Hospital, will argue that postoperative coverage by a general surgeon is an acceptable arrangement, while Alberto Ferreres, MD, PhD, of the University of Buenos Aires School of Medicine, will argue that a cardiothoracic surgeon must provide postoperative coverage.

“The best part of the debate is when we open the floor for discussion,” Dr. Sade said. “That is when sparks start to fly, and things get really interesting. We usually get a lot of comments from the audience.”

The situation of a traveling surgeon leaving a patient behind shortly after surgery is “a growing phenomenon” and an ethical quandary, he said.

“The debate is unlikely to provide a definitive answer to this question,” Dr. Sade said. “It is going to provide two different ways of thinking about it. Then, it will be up to whoever is in the audience to take that information and decide how they would handle it if it comes up.”

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