The Economics of Overlapping Surgeries

We study the widespread practice of assigning a single surgeon to two operating rooms (ORs), which is known as overlapping surgery. We first describe the fundamental trade‐offs that motivate hospitals to employ the practice. Then, we conduct a mathematical analysis for the completion of a set of elective operations under an overlapping surgery policy and a more traditional, serial scheduling policy. We use this analysis, along with a cost function that considers surgeon idle time and total OR time, to derive two models for predicting environments where overlapping surgery is preferable. We use insights from our modeling efforts to provide objective evidence that supports or opposes claims made in the medical trade literature regarding the use of overlapping surgery. In particular, we show that contrary to claims in the medical trade literature, overlapping surgery does not allow a hospital to increase total surgical volume. Finally, we show that hospitals interested in employing overlapping surgery are best served by focusing efforts aimed at reducing time requirement uncertainty on turnover times instead of procedure times.