The American College of Surgeons has released a Statement on Principles on the responsibility of the primary surgeon during surgery. Recent news reports had raised questions about the primary surgeon initiating a second surgery before the first surgery was fully completed. These reports led to a larger discussion of the reasons why surgeons may leave an operating room during the course of a surgery and the appropriate actions that need to be taken to inform the patient and ensure continued safe care. ACS states: “The primary attending surgeon is personally responsible for the patient’s welfare throughout the operation. In general, the patient’s primary attending surgeon should be in the operating suite or be immediately available for the entire surgical procedure. There are instances consistent with good patient care that are valid exceptions. However, when the primary attending surgeon is not present or immediately available, another attending surgeon should be assigned as being immediately available.” For the full Statement on Principles, see the ACS website. In a joint statement, AHA President and CEO Rick Pollack and Association of American Medical Colleges President and CEO Darrell Kirch, M.D., lent their support to the principles, saying, “We commend the ACS for issuing guidance that reinforces the practices of hospitals around the nation and recognizes the need for residents to train under appropriate supervision. The guidance’s emphasis on the surgeon’s primary role in assuring the patient’s welfare, and in effectively communicating with patients about the team who will participate in the surgical procedures, will be a useful yardstick for every hospital. The AHA and AAMC will share ACS’ guidance with all hospitals and encourage them to use it as a foundation for reviewing their own policies and practices and to stimulate discussion with their own medical staff about other ways to enhance their ongoing efforts to improve quality, safety and patient communication.”