2016 Knight Award for Public Service finalist

Clash in the Name of Care

Is it right or safe for surgeons to run two operations at once? Is it right that their patients may have no idea?

Judges comments

Truly well-reported, in-depth investigation into an interesting story. Nicely designed and great to see source material, alongside compelling photos.

About the Project

It’s the most important decision a patient makes when considering surgery: who the doctor is wielding the scalpel. But in hospitals across the US, patients make these decisions under false pretenses. They are led to believe — and they trust — that their attending surgeon will be attending them throughout the surgery. This fall, an investigation by the Boston Globe’s Spotlight team, revealed how misguided this trust is. In doing so, we prompted systemic change that affects the lives — and deaths — of countless patients.

For the Boston Globe it started with a whistleblower, a doctor who watched too many of his colleagues operate on more than one patient at a time, a practice called “concurrent surgery” that was little-known outside the medical world.

Dr. Dennis Burke, the whistleblower, had for years pushed Massachusetts General Hospital to set more stringent policies and guidelines about how and when surgeons could operate on two patients at a time. His colleagues largely ignored his criticism and warnings, continuing to book overlapping surgeries and bouncing from OR to OR throughout surgeries.

Surgery, especially complicated procedures, can go wrong any number of ways. That’s part of what made the reporting on Clash in the Name of Care difficult. It’s often impossible to say whether a patient’s bad outcome came from an attending surgeon not being present, complications that arose during a procedure, or any other likely scenario. But it is possible to say that patients like Tony Meng, who was left paralyzed by spine surgery and whose surgeon was operating in another OR during parts of Meng’s procedure, should have at least known who would be tending to them. Or that patients like Red Sox player Bobby Jenks, whose botched back surgery ended his professional baseball career, could have avoided pain and suffering with better care.

When contacted by the Boston Globe, many surgeons and hospitals defended concurrent surgeries, even in difficult and complex procedures, saying that it was entirely within a surgeon’s skill level to operate in several ORs at the same time. Dr. Burke’s records, and further reporting by the Spotlight team proved otherwise.

Through interviews, a trove of emails, scheduling data, and more, the Boston Globe Spotlight team established a pattern of concurrent surgery booking at Massachusetts General Hospital, one of the top hospitals in the US and a Harvard Medical School teaching hospital. The team talked to doctors and patients, within and outside the hospital, about the practice. And, upon publishing the first story on the subject, crowd-sourced a list of other hospitals in the US booking concurrent surgeries.

Since the Spotlight team’s investigation, concurrent surgeries have become more regulated. The American College of Surgeons, citing Clash in the Name of Care, issued guidelines for concurrent surgeries. The federal government subpoenaed Massachusetts General Hospital, the subject of the Globe’s investigation, for records on concurrent surgeries. And a US Senate inquiry was launched.

These outcomes are the result of deep watchdog reporting. It is work we are proud of at the Boston Globe, and work that we hope — and expect — saves lives. Not only because of the regulatory outcomes, but largely because our audience is made up of patients. And people who will be patients. And people who love and care for patients. Our work on Clash in the Name of Care is done in their names. So that they know to ask about who will be treating them. So that as they fall under anesthesia and surrender to the surgeon, they can trust that doctor.