Recently, two East Coast hospitals settled lawsuits brought by the U.S. government claiming that there was illegal billing for double-booked surgeries. The lawsuits claimed that a particular urological surgeon would perform complex prostate surgeries using robotics while a urology resident performed less complex procedures in another OR.

The lawsuit alleged that the hospital illegally billed for the surgeries as if they were performed completely by the surgeon, rather than second and third-year residents. The lawsuits arose when three whistleblowers complained to Medicare about this practice. The hospital corporation paid over $12.3 million to settle the claims by Medicare and the whistle-blowers.

There was also a settlement involving Massachusetts General Hospital, in which it paid $13 million to a former orthopedic surgeon who was fired for raising safety concerns about colleagues performing multiple surgeries at once.

The issue of double booking surgeries was a focus of an [expose in the Seattle Times](https://www.seattletimes.com/tag/quantity-of-care/) two years ago when it wrote about neurosurgeons at Swedish Medical Center booking two surgeries in the same time slot. In the public uproar about this practice, it was revealed that this was a common practice at other hospitals that taught residents and fellows. The claim was that the key portions of surgeries were done by the attending surgeon, and that more routine work, such as closing the surgical excision, was done by residents or fellows. In some hospitals, this had been common practice for decades.

Some other hospitals did not do the same thing, and concern was expressed that, if an emergency occurred during a procedure when the attending physician was not physically in the OR, it could threaten the safety of the patient. Many hospitals that had double-booking practices, announced that they would change the practice in light of public concern.