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Surgical Proctoring for Gynecologic Surgery

Heit, Michael MD, PhD

doi: 10.1097/AOG.0000000000000076
Contents: Current Commentary

Surgical proctoring allows a hospital's credentialing committee to objectively monitor, regulate, or oversee surgical privileging for its medical staff to ensure the safety and quality of care for its patients. The surgical proctor does not participate directly in patient care and does not establish a patient–physician relationship before the procedure and therefore is under no obligation to intervene if an intraoperative complication occurs or substandard care is witnessed. Good Samaritan legislation enacted in every state should provide immunity for the proctoring physician if intervention is necessary. Teleproctoring may become the most cost-effective method for institutions that are unable to identify a local proctor for surgical privileging.

Surgical proctoring is a peer-review process ensuring the safety and quality of care for patients undergoing a procedure at a local institution.

Urogynecology Associates, Indianapolis, Indiana.

Corresponding author: Michael Heit, MD, PhD, Urogynecology Associates, 1633 N Capital Avenue, Suite 436, Indianapolis, IN 46202; e-mail:

This clinical commentary is not intended to provide guidance on the credentialing requirements for specific surgical procedures, competency requirements for the applicant surgeon, or preceptorships designed to teach a surgical procedure in anticipation of a privileging request. Guidance toward competency and credentialing requirements for some surgical procedures can be found in documents created by national and international professional societies responsible for the specialties activities. This document is focused on concurrent proctoring where the proctor actually observes and assesses the applicant's technical and cognitive skills during a surgical procedure to satisfy privileging requirements. Guidance for prospective or retrospective proctoring of patient charts is not included in this document.

Financial Disclosure The author did not report any potential conflicts of interest.

© 2014 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.