Is There a Proctor in the House?

A surgical proctor can generally be described as a surgeon-observer who is responsible for the assessment of the skills and knowledge of the surgeon-learner during the initial phase of the learning curve. See Kevin C. Zorn, 182 J Urol 1126-32 (2009). The proctor reports his or her findings to the applicable governing body in charge of evaluating the subject surgeon, and provides recommendations based on his or her findings. Proctoring can also involve responding to questions about the surgical equipment being used without participating in the medical decision making involved in the procedure. Advanced technology has gone so far, through the use of teleproctoring, as to creating situations where the surgeon is not physically on site with the patient. Accordingly, a proctor is generally not involved in any medical decision-making or in the actual performance of the procedure being observed.

In a review of the limited law on this issue, a surgical proctor who acts only as an observer should not have any medical malpractice liability if a procedure is performed below the standard of care. The reasoning behind the legal system's reluctance to hold proctors liable for the treatment of those they observe is that there is a lack of a physician-patient relationship between the proctor and patient. However, those defending surgical proctors should be aware of the
distinctions that courts have used to find that malpractice liability did not exist so that they can frame their cases to mirror these factual scenarios.