While the American College of Surgeons agrees that itinerant surgery is a “bad idea,” it is important to note that there is a difference between itinerant surgery and locum tenens, which was the subject of the Wall Street Journal story.

Although the ACS has yet to issue guidelines on locum tenens – a practice in which hospitals hire general surgeons on a temporary basis -- we emphasize that locum tenens surgeons must practice in a setting in which the full scope of a patient’s surgical care is under the direction of a qualified surgeon. That means in addition to performing the operation, the care the surgeon provides the patient must also include providing preoperative diagnosis, discussing the risks and benefits of the operation with the patient, obtaining the patient’s informed consent, and overseeing the patient’s postoperative care. Especially given the critical shortage of general surgeons in this country, the College sees locum tenens as a necessary part of surgical practice today.

On the other hand, the ACS will discipline members who engage in itinerant surgery, in which surgeons perform a procedure and leave follow-up care to a non-surgeon. Disciplinary measures may include suspending or expelling the surgeon from the ACS. These rules do not apply to non-members, nor is it relevant to a surgeon’s state license to practice medicine.
Paul E. Collicott, MD, FACS, Director, Division of Member Services, American College of Surgeons

Unfortunately, with the economy slumping and hospitals needing to cut costs, this may continue.