The case against overlapping surgeries

The Boston Globe recently published an article on the dangers of overlapping surgeries at Massachusetts General Hospital (MGH).  I must say that it is a fairly gripping read.  It tells the story of an eminent orthopedic surgeon who essentially goes to war with his institution over the relatively common practice of concurrent or overlapping surgeries.  The charge is that not having an attending physician available for the entirety of a case is dangerous to patient care.  As evidence The Globe cites patients who have had complications, the orthopedic surgeon's strong opinions on the matter, as well as a smattering of anesthesiologists.

I thought the article was a fascinating behind-the-scenes look at a bitter family break up, but was incredibly short on actual evidence to back up their claims.  It is clear Dr. Burke and some anesthesiologists were troubled by the practice of concurrent surgeries, but is their evidence to suggest surgeries that have no overlap are safer?  A review by MGH and an independent former US attorney found no evidence to suggest overlapping surgeries were more dangerous.  In response to the allegations of complications being more common in overlapping cases, 25 overlapping cases with complications were examined and none of the complications were found to be due to overlapping.  The American College of Surgeons and the Massachussets Department of Public Health also find no basis for these allegations.

I am disappointed that none of the reviews of MGH practices, either done independently or internally are available for public perusal.  This, unfortunately, leaves the door open for conspiracy theorists to posit a grand cover up.  The unfortunately predictable (necessary?) response of MGH was that revealing or discussing patient information was a violation of HIPAA.  Boy do I love HIPAA. Also missing were opinions of more surgeons.  The whole article is based on Dr. Burke's strong opinion on the matter.  In the face of no evidence to buttress his claim aside from some anecdotes of complications, would it not matter if every other surgeon at MGH had another opinion?  Why not take a poll of the American College of Surgeons, or surgeons at another eminent institution?

The article is strongest when discussing the ignorance of patients to the idea that their physician may not be present for the entirety of their case.  It does seem improper that patients would not be aware of this.  The only problem with this problem is that MGH did revise their consent policy in 2012 to notify patients of the team based approach to care.  All the patient cases reported in the Globe apparently took place prior to this revision.

We clearly and perhaps always have lived in an age where the narrative matters more than the truth.
Journalism in the lay press has taken on a monotonous tone exemplified by Nick Ciubotariu's brilliant line by line rebuttal of a New York Times story on workplace practices at Amazon:

Step 1: Have biases
Step 2: Find ex-employees with anecdotal stories that fit in with your bias
Step 3: Gather old stories and criticism while glossing over changes made to improve on that, and completely ignore that it's still significantly better than industry practice
Step 4: Take half-truths and spin spin spin!!
Step 5: Publish article

It may be safer for all of us if the lay press stuck to covering the Kardashian's.