By getting involved in Pereiras case, Burke had embarrassed the trauma service, Rubash said. Then in April 2011, Skates helped arrange a meeting with Burke and Torchiana and the three of them gathered in Torchianas office on the second floor of the Bulfinch Building at 6:30 a.m. Torchiana was not about to simply bow to Burkes demands. MGH concluded that none of the injuries was the result of double-booking, but the hospital declined to provide details to the Globe. Upon returning after World War II in 1947, Dr. Barr succeeded Dr. Marius N. Smith-Peterson as the chief of orthopedic surgery at the Massachusetts General Hospital, having become a member of the staff in 1930. As an assistant stitched up the patient, DeBakey would scrub into the next operating room, where another open chest awaited him. MGH has no such mandate listed in its policy, but hospital officials say they have taken some steps that the Brigham has not, like specifically barring some procedures from being double-booked at all. Long afterward he learned that Wood had a second spinal surgery going at the same time as his. Boston Medical Center spine surgeon Dr. Tony Tannoury occasionally runs two operating rooms, overlapping his cases by several hours in what the hospital describes as a tightly monitored program that enables him to do his operations more safely and during daytime hours. Previously, Dr. Harris served as the chief of the Orthopaedic Trauma Service at Brigham and Women's Hospital (BWH). I am surprised to find this out from the schedule. We do not allow an attending to be in two rooms at a time. Secure online access to your health information whenever you need it. Learn about the many ways you can get involved and support Mass General. Dr. Kirkham WoodKirkham Wood, M.D.Spine surgeon, chief of spine 2004-2013, in a deposition last year, described the scheduling of Tony Mengs surgery to run concurrently with another complex case as a way to make efficient use of his time and expertise; it is the most commonly cited goal of hospitals that have adopted the practice. Was that really too much to expect?, Lillemoe bristled that Burke had alerted state agencies and disagreed that internal efforts had been ineffective. (Lillemoe later said he had misspoken.). - A primary care provider (or PCP) is a doctor or in some cases, a nurse practitioner or physician assistant, who sees patients for everyday medical issues, such as colds and annual wellness visits. Burke met twice with Stern in July 2011. 5 Blossom St The French womans case contributed to Shervins difficulties at MGH, where she was placed on probation in 2007 for alleged shortcomings. Soon after the meeting, Burke found out that MGH had engaged Donald Stern, a former US attorney in Massachusetts and one of the best-known lawyers in Boston, to investigate Burkes concerns. Leader of orthopedics research program at the National Institutes of Health. If you have any questions, contact Megan Leelman at I do not have one regret over coming forward. In court papers, a medical expert hired by Jenks disputed the hospital account, noting that Wood was listed as the surgeon in charge of a second case that completely overlapped Jenkss. Speaking generally, Warner wrote, The suggestion that I am not managing all my patients care while they are in the operating room is both untrue and malicious.. named new co-directors of the HSS Women's Sports Medicine Center. Eighteen minutes later, Dr. Wood started another case down the hall a cervical corpectomy on Tony Meng. Wood said in later testimony that he handled all the critical parts of the operation, but he wrote in his operative report that he was present for the entire case.. My eighth annual Chief's Report for the Orthopaedic Journal at Harvard Medical School will highlight a tremendous year of growth and productivity in the Department. Learn more about our surgical optimization program, which will help you plan and prepare for your upcoming procedure. Joseph H. Schwab, MD, MS. Chief, Orthopaedic Spine Surgery. Our multi-disciplinary spine team uses non-operative therapies and advanced surgical techniques to treat all spine conditions and disorders. Or more directly: Does a patient have a right to know that he could be sharing his surgeons focus and skills with the patient down the hall? Wood said he did nearly all of Mengs surgery himself and did not even scrub in for the second part of the other patients procedure, leaving it to the surgical fellow. We have remained at the forefront of medicine by fostering a culture of collaboration, pushing the boundaries of medical research, educating the brightest medical minds and maintaining an unwavering commitment to the diverse communities we serve. Its not the right thing to do, he said of surgeons trying to do two operations that overlap significantly. Congratulations on this new journey in your professional career. collected, please refer to our Privacy Policy. After getting a call at his Beacon Hill home, WoodKirkham Wood, M.D.Spine surgeon, chief of spine 2004-2013 said in his deposition that he returned to the hospital to review the images and a few hours later operated again on Meng with two neurosurgeons assisting. If I had known, I wouldnt do the surgery.. Copyright 2007-2023. Rubash blamed the resident for what happened and for calling Burke, who had had nothing to do with Pereiras treatment. at a meeting of the orthopedic surgeons. Raj Gala, M.D. Dr. Christopher Bono Director, HCORP The Harvard Combined Orthopaedic Residency Program has existed for more than 100 years, and we are proud of the rich tradition of educating outstanding clinicians and leaders. Michael Daubs, M.D. Meet our team Conditions & Treatments 617-724-8636 Contact Information Phone: 617-724-8636 Request an appointment At Lahey Hospital & Medical Center, you can trust our orthopedic surgeons to provide expert, personalized and compassionate care. When I have access to the dynamic schedule upon arrival to MVH, I will check the times for accuracy. Rubash, in written statements, said there was no connection between the Meng case and the leadership change. Bassem Elhassan MD, Co-Director - MGH Shoulder Service, Boston Shoulder Institute Fellowship Program Director, Professor of Orthopedic Surgery, Harvard Medical School Jon J.P. Warner MD, Co-Director - MGH Shoulder Service, Director Boston Shoulder Institute, Acting Chief, MGH Sports Medicine Service, Chair for Quality and Safety for Orthopedics, Professor of Orthopedic Surgery, Harvard . Cases with procedural overlap, involving at least one patient with an open incision while the second case is underway, account for 3 percent of the total about 1,000 cases a year. We are committed to providing expert caresafely and effectively. Associate Professor of Orthopaedic Surgery, Harvard Medical School. General: One quarter of all surgical procedures have some overlap, compared to 15 percent hospitalwide, MGH figures show. James P. Rathmell, M.D., Susan A. Vassallo, M.D. Im very proud of my department and our surgeons and our care.. The family called for an ambulance and headed to the emergency room at Mass. His name is Andrew Freiberg, M.D. Several anesthesiologists and surgeons, as well as a doctor who served on the committee that assigned OR time, told the Globe that, under Rubash, the orthopedics department increasingly allowed surgeons to schedule two surgeries at once. Copyright 2007-2023. The two cases overlapped for about seven hours, but Wood wrote in his operative note in Mengs surgery that he was present for the entire case. Meng woke up paralyzed. For the doctor to get informed consent, you have to tell the patient anything thats material about their surgery, and material is defined as what might cause a patient to change his or her mind, to say, I dont want surgery, said Annas, director of the Center for Health Law, Ethics & Human Rights at BUs School of Public Health. He felt he had failed in his long-running effort to sway his colleagues. In emergencies, when cases can overlap by more than an hour, he added, then the attending surgeon must have a second attending surgeon immediately available.. Assistant or Associate Professor of Medicine (Division of Population Sciences) Dana Farber Cancer Institute/Brigham and Women's Hospital Date Posted: 11/17/2022. Elliot Bracket (1911-1918), Robert Bailey Osgood (1919-1922), Marius Smith-Petersen Dr. Freiberg earned his undergraduate degree from Northwestern University, and he graduated from the University of Cincinnati College of Medicine. The Orthopaedic Oncology Service is led by Dr. Henry Mankin, a leader in the field of connective tissue oncology. His stature and roster of well-known patients would prove no protection against what was coming. Hospital officials have declined to share the document, even with state regulators, citing attorney-client privilege and promises of confidentiality to staffers interviewed. The General Hospital Corporation. Dr. Bridwell is the Co-Director and Founder of the Pediatric/Adult Spinal Deformity Service. He called Mengs sudden plight, a devastating sort of picture., In 2013, Wood stepped down from his post as chief of spine surgery because he never felt completely comfortable in his abilities to communicate with and lead the division, RubashHarry E. Rubash, M.D.Chief of orthopedic surgery said in a written statement to the Globe. I see things that are not right and thats not the way we practiced medicine for a long time.. He then returned to the University of Michigan, where he was promoted to the rank of Assistant Professor of Orthopedic Surgery and was later named Chief of Adult Reconstructive Surgery at the University of Michigan Hospitals and Chief of Orthopedics at the Ann Arbor VA Medical Center. General to many teaching hospitals where surgeons in training are integral contributors to the surgical team. American Academy of Orthopaedic Surgeons: Spinal Cord Blood Supply and Its Surgical Implications, The use of Autologous Free Vascularized Fibula Grafts in Reconstruction of the Mobile Spine Following Tumor Resection: Surgical Technique and Outcomes. Consider Nicholas Gregory. He then went to the University of Toronto, Sunnybrook Health Science Center, for his fellowship in Orthopaedic Spine and Trauma in 1990, followed by a fellowship in Orthopaedic Spine and Trauma Surgery at Queen's Medical Centre in the United Kingdom in 1994. Both men, wearing scrubs, sat at a formica-covered table in the middle of the room, according to Burkes recollection of the encounter. Read more about some of the patients who have seen our Spine team and gotten back to the things they love. Please join us in congratulating the 13 Mass General orthopaedic surgeons named Top Doctors by Boston magazine for 2022. I will f/u with harry to hear from him how this is goign to work from their perspective given the nature of the cases and the need to have attending oversight during much if not most of the procedure. Check appointments, communicate with your provider and pay bills online 24/7. One Patient at a Time was the way Mass. Boston, MA02114 I cant say enough great things about Dr. F. The level of confidence he gave me was so invaluable after a bad experience. Candidate must be an arthroplasty fellowship-trained, board-certified orthopaedic surgeon with an exemplary record that exhibits the . Thats when he bumped into Dr. W. Gerald Austen, the 85-year-old retired chief of surgery and a founder of Partners HealthCare, the parent company of MGH. Doctors could not be the attending surgeon for three rooms simultaneously, something already prohibited by Medicare rules. He began the meeting by reminding the men of the obvious, that Mass. While he was a medical student at Loyola University outside Chicago, orthopedic surgery appealed to him because it combined medicine and mechanics. With more than 25 years of experience in academic orthopaedic surgery, Mitchel B. Harris, MD, has been named chief of the Department of Orthopaedics at Massachusetts General Hospital, effective October 1, 2017. SmithR. Down the hall in room 64 was Woods other patient, an elderly woman awaiting her own complex surgery, a spinal fusion that would also require precise work spanning much of the day. Wood, in later testimony, described the hole in the dura as large and that he couldnt pinpoint when it had torn open or what was the cause. There is no known connection between the complications and deaths and the double-booking, but none of the patients and family members interviewed had any idea that the surgeons were involved in a second operation at the same time. Search for condition information or for a specific treatment program. As the internal controversy stirred by Burke and others escalated, Dr. Peter Dunn, medical director of the hospitals OR, began looking for ways to improve the departments performance, including a review of the hospitals guidelines for concurrent surgeries. He can rattle off relatives who have been treated at MGH and says he wouldnt dream of going anywhere else. Ron is so worked up that he doesnt know whether to go to the Boston Globe or the FBI about this stuff, Torchiana told Burke, according to Burkes notes, which he gave to the Globe. Generals president, said during an interview in the hospitals historic Bulfinch Building. Overall, patients at MGH share their surgeon for some part of the case 15 percent of the time, figures provided by the hospital show. For more information about these cookies and the data So when things went awry in some operating rooms with double-booked doctors, it was often anesthesiologists writing e-mails to hospital administrators and sharing information with Burke, whom they knew was willing to take their concerns to the top. Explore fellowships, residencies, internships and other educational opportunities. He was recently promoted to full professor at Harvard Medical School. Meng awoke from the surgery unable to move his arms or legs. AustenW. The risks are real; the benefits can be huge. He said he got emotional, especially when he recalled for Stern a time when his wife was a patient at Mass. We use cookies and other tools to enhance your experience on our website and Meng relied on the surgeons unambiguous-seeming promise before the operation. We use cookies and other tools to enhance your experience on our website and Zimmer Gets a Chief Medical Officer For the First Time. Dr. Freiberg, an expert in adult reconstructive surgery with an emphasis on hip and knee arthroplasty, says he wasnt looking for a change. Then the chief stood up and left, Burke recalled. He also gave Burke a tour of MGHs cardiac care unit. When contacted by the Spotlight Team, Bhattacharyya did not refer to Pereira by name, citing patient privacy rules, but he stressed he performed all the critical parts of the surgery myself, without any kind of delay.. We offer the full spectrum of orthopaedic care and are the best and most comprehensive orthopaedic surgery department in New England. We offer diagnostic and treatment options for common and complex medical conditions. The question: Is it right or safe for surgeons to run two operations at once? Though often called simultaneous surgeries, they do not, of course, involve the attending surgeon working directly on two patients at once. I always felt like the [treatment] plan was built for me, and it was like a three-legged stool: It was an ongoing conversation between myself, the physical therapist and the doctor. See video animations for common spine conditions and treatments. He took his complaints outside the chain of command, and then outside the hospital, putting his career at risk. and he is the renown orthopedic surgeon who has led the hip and knee service at Massachusetts General Hospital (MGH) in Boston for over 20 years. At MGH, that raised eyebrows and hackles. Thats when, Vassallo said, she did something for the first time in 25 years of medicine: She went looking for the surgeon. MGHs rules satisfied those federal regulationsMedicare rules are designed in part to keep the government, which pays teaching hospitals to train residents and fellows, from overpaying for patient care. The Department of Orthopaedic Surgery at the Massachusetts General Hospital (MGH) is seeking a Chief of the Arthroplasty Service. It had to be done, Burke told the Globe. More broadly, MGH officials say their analysis of hundreds of orthopedic cases from 2013 and 2014 found no significant difference in complication rates between overlapping and non-overlapping cases. Rubash helped introduce an incentive system that paid doctors more if they generated more profits. For more information about these cookies and the data BostonMA, 02114. The patient was reduced to tears, started to have a full blown panic attack, wrote WollmanLisa T Wollman-Kliman, M.D.Anesthesiologist. Vivek Babaria, DO, RMSK has joined DISC Sports & Spine Center as its first osteopathic physician. 4 We bring together the clinical professionals with the most appropriate skills to deliver your care. Access to sports medicine experts when you need them most. collected, please refer to our Privacy Policy. Subscribe today for full access to in-depth investigative reporting. Now director of Orthopedic Trauma Services at Suburban Hospital in Bethesda, Md. The role they crafted involves my ensuring that the perspective of the surgeon and patient is always taken into consideration., Zimmer Biomet has a new CEO, orthopedic group president, and many of the management team members are new as well. Zinner explained the philosophy that drives the limits on concurrent surgery at his hospital. Madelyn "Maddy" Pearson, DNP, RN, NEA-BC, is chief nursing officer and senior vice president of patient care services at Brigham and Women's Hospital. They describe the practice as an extension of the teaching hospitals team approach, pairing senior doctors with residents surgical trainees and fellows, who have finished their general orthopedic surgery residency and are training in a subspecialty. In medicine it is called concurrent surgery, and the practice is hardly unique to Wood or MGH. MGH, in a statement, said the vascular surgeon did not plan to do two procedures at once, but responded appropriately to an unexpected emergency.. Ultimately, Smith agreed to the patients request and the woman calmed down. His ties to MGH go back to childhood. I was concerned at that time that there was a major disconnect between the views of a very prominent and capable orthopedic surgeon here and what we were hearing from our OR leadership, said Slavin, the hospital president. It is, however, hard to verify the comparison as some of those peer institutions, such as The Johns Hopkins Hospital, Stanford University Medical Center, and Mayo Clinic, declined to provide the Globe with copies of their policies or to discuss them in detail. RubashHarry E. Rubash, M.D.Chief of orthopedic surgery said in a recent interview that he never pressured his staff to do concurrent procedures. Double-booked surgery patients often didnt at the time, and sometimes still do not. Wood later testified that he performed this particular procedure only once or twice a year, working in a delicate space where the difference between recovery and ruin is sometimes a scalpels width. Concurrent surgery is also relatively common in trauma, cardiac, brain, and vascular operations. He said he had reached a breaking point, that he felt he had no choice now but to contact state regulators the Board of Registration in Medicine and the Department of Public Health. This is why we are one of the best in the US. And it isnt over yet. The three surgeries overlapped for a total of 13 minutes, records show. Meet Dr. Joseph Schwab. I am completing an advanced pain management fellowship and have a patient who has a diagnosed metal allergy/sensitivity/toxicity that is being treated in clinic, but orthopedic community has not responded or are in agreement with research related to Titanium. Learn about career opportunities, search for positions and apply for a job. Frank X. Pedlow, Jr., M.D. Indeed, the issues go far beyond Mass. Our orthopaedic specialists see patients at many locations, including Boston, Waltham, Danvers, Newton-Wellesley and Foxborough. He was happy to put himself in the care of Wood, a doctor who was recruited by MGH as chief of its orthopedic spine service in 2004 and who would draw many plaudits from patients. Bono CM, Leonard DA, Cha TD, Schwab JH, Wood KB, Harris MB, Schoenfeld AJ. Dr. Pedlow is a board-certified, fellowship-trained spine surgeon, specializing in the surgical treatment of disorders of the adult spine. Required fields are marked *. SlavinPeter L. Slavin, M.D.MGH president, in a hand-delivered Aug. 12 letter, accused Burke of improperly providing hundreds of the surgeons own medical records to the Globe, violating hospital rules and, potentially, federal privacy law, even though the records Burke shared had names and other identifying details blacked out. The fellow, Dr. Philippe Phan, had worked for a year as a general orthopedic surgeon and had begun specialty training at MGH days before. The existing rules, outlined in a 2002 hospital memo, did little more than require surgeons to be present for the key portions of the case, leaving it to the surgeons to decide what that meant. Learn about career opportunities, search for positions and apply for a job. This site uses Akismet to reduce spam. PCPs often are your first point of contact for your general health concerns. When the 70-year-old woman returned a week later for another operation by Dr. Wood, she was again one of two simultaneous spine cases that overlapped for more than eight hours, despite the concerns of a senior anesthesiologist, according to e-mails and finalized operating schedules obtained by the Globe. Surgeons are encouraged and expected to tell patients when theyll be absent for part of the surgery, an MGH spokeswoman said, but they are not explicitly required to do so. But then, one Saturday night in June 2008, the phone rang in his home. Previously, Dr. Harris served as the chief of the Orthopaedic Trauma Service at Brigham and Women's Hospital (BWH). But the Globe, through dozens of interviews and a review of hospital records, court filings, and hundreds of e-mails shared by current and former medical staffers, pieced together a portrait of this remarkable and revealing episode, one which changed surgical practice and procedure at the hospital and resulted in double-booking being raised as an issue in malpractice lawsuits. SunderNeelakantan Sunder, M.D.Anesthesiologist would later retire, in part because he was fed up with the battle over double-booking. Jon has a tendency of counting operating time versus actual case time. 5 History of the Fernstrom Ball, BAK and Spine-Tech Part I, Orthopedic Surgeon Sues NY Health System for $24.7M, Ortho Surgeon Whistleblowers Sue Erlanger Health System, Dynamic Digital Radiography Better for Shoulder Injuries, Orthopedists Happiness Declined After Pandemic. Double-booking also fit well with the business-like approach that Dr. Harry Rubash brought to Mass. At Mass General, the brightest minds in medicine collaborate on behalf of our patients to bridge innovation science with state-of-the-art clinical medicine. Some surgeons complained about pressure to perform more operations, but others were delighted at the chance to increase their pay through extra work. Read the draft version. Orthopedics in some ways is well suited to the practice, proponents say, because many procedures unfold in fairly predictable fashion, allowing surgeons to plan their movements with reasonable precision. Learn about the many ways you can get involved and support Mass General. General orthopedics ranks fourth in reputation among all US hospitals, according to US News and World Report. After more than two years, the board, according to MGH, recently informed several surgeons they were no longer under review. Great skill and stamina would be required for the long hours of medical ballet ahead, as Wood timed his moves between the two ORs to match the ordinary progress of each procedure and both patients needs. The surgical team, led by Wood, worked intensely to figure out why. Gitajn IL, Heng M, Weaver MJ, Casemyr N, May C, Vrahas MS, Harris MB. This summer, Wood said he would leave Boston to become a professor of orthopedic surgery at Stanford University in his native California, starting in November. She told Burke her understanding was that the patient might have to wait days for surgical relief. Burke and Austen had known each other since the early 1970s. Our orthopedic surgery team includes renowned surgeons who are highly skilled and experienced in their specialty area. Our Orthopedics Team Jessica P. Aidlen, MD Chief of Spine Surgery Specialty:Spine Surgery Location: Ambulatory Care Center 159 Wells Ave, Newton, MA Phone: (617) 831-7082 Kyle Alpaugh, MD Specialty:Joint Replacement Location: Kaplan Joint Center, 2014 Washington St, Dont lose hope, because we may have a solution, says Bassem Elhassan, MD, co-chief of the Shoulder Service. He would need all of his talent and confidence this day, and then some, as he planned to tackle two complicated spinal surgeries over the next many hours two patients, two operating rooms, moving back and forth from one to the other, focusing on the challenging tasks that demanded his special skills, leaving the other work to a general surgeon, who assisted briefly, and two surgeons in training. Dr. Allan Kirk, the head of surgery at Duke University School of Medicine, coauthored an article this year on concurrent surgery in the Annals of Surgery, a journal edited by MGHs chief of surgery, Dr. Keith Lillemoe. It is worth noting that Dr. Burke practices concurrent surgery himself, performing more of these overlapping procedures last year than any other hip and knee surgeon at MGH, according to a written hospital statement on March 27. [ Contact MGH Archives for use] Partners HealthCare Pathology Wood first went in through the front of Mengs neck and removed parts of vertebrae. According to Kirk and Harry, Kirk has the fellow manpower to do this. Warner, chief of MGHs shoulder service, earned just over $2.1 million between October 2005 and September 2006, making him the hospitals highest compensated employee at the time, according to financial documents filed by the hospital with the attorney general. When something goes wrong as statistically it will in a small percentage of cases the surgeons failure to disclose double-booking can seem to patients inexplicable and intolerable. If Burke had any doubts about the price he would pay for openly challenging Mass. We are committed to providing expert caresafely and effectively. Step away from the bed, VassalloSusan A. Vassallo, M.D.Anesthesiologist said she insisted. Watch the full documentary and learn more about concurrent surgeries at the homepage for Globe coverage of the issue. Our multi-disciplinary spine team uses non-operative therapies and advanced surgical techniques to treat all spine conditions and disorders. He told the doctors that the revised policy would ensure the highest quality of care and patient safety. To me that is what we were hoping to accomplish. Chief, Orthopedic Surgery Brigham and Women's Faulkner Hospital . Let me know. He said he had never, in his long career, encountered that particular complication. General orthopedics when he took over as department head in 1998. The form now emphasizes that medical care will be provided by a team and says my doctor or an attending designee will be present for the critical parts of the procedure. Brigham and Women's Hospital . He is an internationally recognized expert on the cellular and molecular mechanisms of bone regeneration and repair, locally applied antibiotics and minimally invasive fracture surgery. Burke was stunned, but pronounced himself unbowed. State Attorney General Maura Healeys office is also looking into the matter, and prosecutors have contacted Burkes former colleagues. ShervinNina ShervinOrthopedic surgery resident later testified that while he was gone, she helped mix the cement for the hip implant, but felt uncomfortable going further on her own. Learn more about our surgical optimization program, which will help you plan and prepare for your upcoming procedure. Mengs nerve signals began to fade at this point.
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