The surgeon is obliged to:
(1) confine activities to within the scope of the consent for the operation
(2) fully disclose relevant facts to the patient (or surrogate)
(3) utilize the best skills for the care of the patient
(4) abide by the contractual terms with the patient
A resident or other surgeon may be delegated to perform certain tasks if:
(1) the patient is informed and consents
(2) the surgeon provides participatory supervision (is scrubbed in)
If a senior surgeon will not be present to provide participatory supervision, then
(1) the patient must be informed and approve
(2) the consent should be so annotated
(3) the resident or alternate surgeon is considered the operating surgeon
Exception: If an emergency occurs or an unexpected finding is found at surgery, then it may not be feasible to get the patient's consent for another surgeon's participation. In this case the contracted surgeon will usually be in the operating room, and many consents include this situation as a possibility.
A separate issue is billing for services. If a surgeon is not the operating surgeon, then collecting the surgeon's fee would be fraudulent.
