Weird Al told The New York Post in 2011:

Madonna was talking with a pal of hers. “Like a Virgin” was everywhere on the radio and she said “I wonder when Weird Al is going to do ‘Like a Surgeon.’ ” Madonna’s friend knew my manager, who got back to me with it. I was like “Good idea, Madonna. Thanks!”

In 2014, Al spoke to Vulture about shooting this song’s music video:

We shot that in an actual hospital that had closed down and was mostly used as a hospital set. My biggest memory was we actually had a live lion on the set for those scenes where there’s a lion roaming the hallway. At that point we lost a lot of extras because they were saying, ‘You know, my day rate is not worth this’ [laughs]. It was just fun to be writhing around on a hospital gurney in a music video because I normally do that in my everyday life, so it was nice to be able to do that in public for a change.