Overlapping and concurrent surgery: A professional and ethical analysis

Paul E. Levin, Daniel Moon, Diane E. Payne

Research output: Contribution to journalReview articlepeer-review

20 Scopus citations


Overlapping and concurrent surgeries form a continuum of simultaneous surgical practice in which a single surgeon has 2 or more patients in operating rooms at the same time. Undeniably, in an acute life-orlimb-Threatening presentation, it may be essential for a surgeon to care for 2 individual patients simultaneously. These situations are different from scheduled elective surgery. Concurrent surgery is defined as the attending surgeon not being present for "critical and key" portions of a procedure. Billing for concurrent surgical procedures is a violation of the U.S. Centers for Medicare & Medicaid Services guidelines. The American College of Surgeons Statement of Principles (April 2016), adopted by the American Academy of Orthopaedic Surgeons, judges the practice of concurrent surgery to be "inappropriate." Overlapping surgery, although permissible under regulatory guidelines in the United States, presents substantial professional, bioethical, and legal concerns, and threatens our obligation as orthopaedic surgeons to respect the primacy of patient welfare and an individual's autonomy.

Original languageEnglish (US)
Pages (from-to)2045-2050
Number of pages6
JournalJournal of Bone and Joint Surgery - American Volume
Issue number23
StatePublished - 2017

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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