Ghosts in the Surgery

Ravic saw only the covered patient; he knew only the narrow, iodine-stained area of the body bared for the operation. He very often did not even know on whom he operated. [Someone else] gave him the diagnosis and he began to cut . . .

The ghost surgeon in this case was the hero of Erich Maria Remarque's bestseller about prewar Paris, Arch of Triumph, but medical ghosts walk not only in fiction. They perform operations in U.S. hospitals every day. It works this way: the family doctor tells a patient that an operation is necessary and either says flatly, or strongly implies, that he will do it himself. But after the patient is under the anesthetic, in comes a more skilled specialist in surgery. He may know nothing of the patient's history and never see his face. Before the anesthetic wears off, he is gone. The family doctor splits his fee with him.

Led by Dr. Paul Hawley, the American College of Surgeons has been urging county medical societies to crack down on ghost surgery and fee-splitting. Last week the San Diego society did so. It slapped a one-year suspension on Physician Egbert Morris Hayes of Palm City and Surgeon Wesley Walters of Chula Vista. This would not keep them from practicing, but barred them from leading hospitals in the country.

When Dr. Hayes told Mrs. Charles Howarth in November, 1951 that she should have part of her stomach removed, he added that for the operation he would need Dr. Walters' help. In fact, he telephoned Walters while Mrs. Howarth and her husband were present. But months later, she learned that instead of Surgeon Walters' assisting Physician Hayes, it had been the other way round. Because she had not known in advance that Walters would perform the actual operation--and since he had never examined her--this was a violation of medical ethics.

Since Mrs. Howarth had at least known that Dr. Walters was being called in, the case was not the worst example of the evils of ghost surgery. But the San Diego society evidently agreed with Dr. Hawley, who said last year: "No surgeon should do any cutting until he has examined the patient himself. [A] ghost surgeon simply cuts where he is told to cut and takes no responsibility for anything that happens afterward."

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