Monday, June 13, 2011

Legislators Gone Wild: A Bill Requiring All Operations To Be Recorded

Last month the New York State legislature threatened to pass a law banning doctors from wearing neckties. This was based on some research that showed that bacteria can be found on ties. No link to any disease caused by a tie has been reported. It appears that the proposal did not become law.

Now comes news that lawmakers in Massachusetts are considering a bill that would give patients the right to have their operations videotaped if they pay for it. The story claims that this could be done without a videographer being present in the operating room. And, get this, if a hospital refused to allow the videotaping, it could be fined $10,000.

Who thinks up this stuff? Can you think of any problems with this plan? I can.

It would not be difficult to record laparoscopic and arthroscopic procedures since they are already being performed using video equipment. There would be added expense because many hospitals have not purchased the necessary DVD recorders. However, open surgical procedures are not routinely videotaped and video equipment is not readily available to do so. Even when experienced videographers are present, it can be difficult to see what the surgeon is seeing.

Who would pay for the installation of video equipment in every operating room of every hospital in Massachusetts?

A comment on the article points out that the taping of all surgical procedures would be complicated, distracting and might cause surgeons to perform differently [possibly detrimentally] when they know they are being watched.

Sometimes things happen during a case that might seem untoward to a lay person. For example, due to magnification by the laparoscope, a few milliliters of blood can look like a hemorrhage. Occasionally, gallstones or bile may be spilled. Although this rarely results in complications, it could be construed as a “mistake” by a devious [is there any other type?] lawyer.

This would of course be a boon for plaintiffs’ attorneys. Wait, aren’t most legislators also attorneys? I wonder if there is a connection?

In summary, this plan is misguided, ill-conceived and stupid. Since it is being discussed in Massachusetts, it just might pass.


Elaine Schattner, MD said...

This doesn't seem like a good idea for patients. Others watching can distract the operator. Also, some doctors get nervous (i.e. shaky) on-camera, as on-stage, but are otherwise calm while doing their work.

Kevin B. O'Reilly said...

Thought you might be interested in my recent coverage of these topics.

Massachusetts bill would give patients the right to film surgery:

New York bill seeks physician dress code to cut infections:

Skeptical Scalpel said...

@Elaine I agree completely

@Kevin Excellent articles. Thanks for posting them.

Martin Young said...

I raised this possibility two years ago on KevinMD as a blog post, saying the advent of cameras into the OR was inevitable.

Now here it is. Doctors might have had two years to prepare a better response than to be caught shortfooted.

But, as I write in a new post to come out next week on the same blog, prophets are never welcome in their own countries!!

Skeptical Scalpel said...

Having thought about this for a month, I am now convinced that the expense of installing and maintaining video equipment in every OR in the country would be prohibitive. It is never going to happen.

Todd J. Scarbrough, M.D. said...

Skeptical Scalpel said...

Todd, that's an excellent post. Too bad it will never happen. Legislators aren't into evidence-based anything.

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