Surgery at the Doctor's Office: What You Need to Know

IMAGE Surgeries that were once performed only in a hospital or surgery centers are becoming more common in converted exam rooms and surgical suites in physicians' offices. Many of these procedures require general anesthesia or IV sedation. Yet, in some states, there are few standards, regulations, or accreditation requirements for surgeries performed in physician offices. Considering the complexity of some surgery, and the anesthesia used, you may wonder if this trend is a safe one. If you have a doctor who wants to use the office for your next surgery, here is some information to get you started.

Safety Concerns

Without the same safety regulations as hospital surgery, office-based surgeries could cause serious complications. There have been reports of deaths resulting from the following situations:
  • Staff was unprepared and untrained to manage cardiac arrest, breathing problems, or other emergencies
  • Staff called emergency medical services too late or not at all, for fear of being reported
  • Drugs and/or equipment were outdated or unavailable
  • Lengthy surgery was done on a medically unfit patients
Regulation requirements differ among states. Make sure you check them before you have your surgery.

Why Have Surgery in the Office?

The trend toward office-based surgery is driven by several factors, including:
  • Cost
  • Patients' wishes for privacy and convenience
  • Flexibility in scheduling
  • Wider availability of smaller patient monitors and other surgical and anesthesia equipment
  • Newer anesthetics that work faster and wear off more quickly

Standards

Hospitals and surgery centers must meet strict state and federal licensing and accreditation guidelines. They also have medical boards that oversee practitioners' qualifications and credentials. On the other hand, inconsistent standards exist for office-based surgery. Some states have addressed the issue of office-based surgery and implemented regulatory requirements while others are relatively unregulated. There are efforts to standardize surgical safety for office-based procedures. For example, the American Society for Anesthesiologists has created guidelines for office-based anesthesia. Also, the Institute for safety in Office-Based Surgery (ISOBS) created checklists which cover items from the preoperative period through discharge to help keep patients safe.

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