Recently three of the nations top academic medical systems – Dartmouth-Hitchcock Medical Center, Johns Hopkins and the University of Michigan – are planning to stop low volume procedures from occurring in their systems.
You can read an article on the hospitals’ decision here:
[Dartmouth-Hitchcock, Johns Hopkins, University of Michigan to limit low-volume surgeries](http://www.healthcarefinancenews.com/news/dartmouth-hitchcock-johns-hopkins-university-michigan-limit-low-volume-surgeries)
Low volume surgeries are those that are done infrequently. As one might expect, surgeons who don’t frequently do a particular type of surgery unfortunately have patients who suffer a large percentage of complications, including death. So, these hospitals have decided, instead of continuing to infrequently perform surgeries, they will instead send them to institutions where the procedures are done more frequently.
The goal of this change is to help lower an estimated 1,300 patient deaths that occur each year in the United States that are attributable to such infrequent surgeries.
The hospitals here are giving up certain revenue from these surgeries, and that will likely be a barrier to other similarly-situated hospitals from doing the same. Additionally, they are likely to send such patients to hospitals that may not yet be equipped to deal with the increased patient load. But this is certainly a good and noble decision putting patients over hospital profits.
In the medical-legal context, unfortunately it is common for bad outcomes to occur as a result of a surgery performed by a surgeon with little experience – or infrequent experience – in the type of surgery. Also it is not negligent for a surgeon to perform surgeries infrequently, the surgeon’s experience may be relevant in a jury deciding whether he was acting prudently in the surgery itself, or the decision to recommend surgery.
Interestingly, in Washington, a surgeon has no duty to disclose to a patient his lack of experience in performing a particular procedure. For more information, read *Whiteside v. Lukson*, 89 Wn. App. 109 (1997) and later *Housel v. James*, 141 Wn. App. 748 (2007).
