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Spotlight: 2015

A world-class hospital. A whistle-blower. A hard look at double-booked surgeries.

Should surgeons operate on two patients at once without telling them?

Dr. Dennis Burke raised the alarm about one surgeon overseeing operations in multiple rooms simultaneously.Dina Rudick/Globe staff/File

Spotlight Team: Scott Allen (editor), Jenn Abelson, Jonathan Saltzman, and Liz Kowalczyk

In summer 2014, Spotlight reporter Jonathan Saltzman took a call from a lawyer with a tip about one of Boston’s most revered institutions. Michael Mone, a medical malpractice attorney, charged that Massachusetts General Hospital was allowing its star surgeons to “double-book” surgeries — that is, one surgeon was overseeing two operations simultaneously, shifting between patients in separate rooms who were undergoing high-stakes procedures. What’s more, patients often didn’t know that their surgeon’s attention would be divided. Mone told Saltzman that he represented a whistle-blower, MGH surgeon Dr. Dennis Burke, who had gone to war with the hospital’s management to abolish the practice. But up to that point Burke had failed.


Burke would soon become, as then-Spotlight editor Scott Allen recalls, “the greatest whistle-blower I’ve ever worked with.” His decision to go public, which put his livelihood at risk, would spark one of the most impactful — and bitterly contested — Spotlight investigations of the past decade. His core contention was that MGH was betraying its own ideals, and placing patients in harm’s way, for profit.

MGH management saw things another way, and soon began pressuring the Globe to abandon or soften Spotlight’s investigation. Double-booked surgery was safe, MGH president Peter Slavin said. The hospital said it benefited patients by letting talented surgeons serve more people.

Slavin and his subordinates — including representatives of a crisis management firm the hospital hired to combat Spotlight’s reporting — argued that it was impossible to blame any bad surgical outcome on double-booking. Indeed, although the reporters discovered cases where patients left a double-booked surgery with horrendous problems—one man lost the use of his limbs—it was impossible to show definitively that the double booking itself was the cause. No one could prove that a scalpel had slipped because of distraction.


What the Spotlight team could show — thanks to a trove of internal e-mails and other MGH documents it obtained — was that Burke was hardly a lone voice. Nurses and other concerned doctors had been raising the alarm for years, in sometimes desperate terms. “Do you really think it is reasonable to do these two [overlapping] cases by the same primary surgeon?” one anesthesiologist had written to his superiors in 2010. “Is this how we are planning the future?”

The Spotlight Team’s report in 2015 prompted reforms locally and nationally, as well as a reckoning within the surgical profession. The Massachusetts medical board wrote new regulations requiring surgeons to disclose double-booking to patients. And the American College of Surgeons issued new guidance that, ultimately, helped curtail the practice.

MGH had already fired Burke, a move that would ultimately backfire. Burke soon secured a new position at Beth Israel Deaconess Hospital-Milton, which had prohibited double-booked surgery even before the Spotlight report. Then Burke sued MGH, arguing that his firing had constituted retribution (MGH said he was fired for leaking confidential patient information). In a settlement that followed, MGH paid Burke $13 million and established a new patient safety lecture series in his name.

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