NCPA - National Center for Policy Analysis

OFFICE-BASED SURGERY

June 28, 2005

Free-standing (or office-based) surgical centers now account for almost one-in-five surgical procedures performed nationwide, says the New York Times.

Since their inception in the early 1970s, surgical centers have expanded their repertoire of procedures to include complex orthopedic, gastroenterological and gynecological surgeries, as well as breast biopsies and cataract removals. Even cosmetic surgeons use the centers for virtually all procedures that do not require a doctor's office.

The shift from hospitals to free-standing surgical centers continues to grow thanks to technological advances that allow for less invasive procedures, says the Times.

  • There are about 4,600 centers in operation, a 53 percent increase over the 3,000 five years ago.
  • Experts expect 8.8 million operations to be conducted at the centers this year.
  • Corporate chains like HealthSouth, Surgis and AmSurg are among the fastest-growing owners, followed by joint hospital-physician ventures.

Moreover, they offer a more cost-effective alternative to hospitals, says the Times. Even though office-based surgeries are bound by a specific category of regulation and restrictions, recent inspections have raised questions about patient safety:

  • Are certain high-risk patients better off in a hospital even for minor surgery?
  • Is the equipment clean, appropriate and in good condition?
  • Do the centers report complications promptly?
  • If needed, can patients be transferred quickly to a hospital?

The major concern is whether or not doctors are keeping to the appropriate kinds of surgery and that only the most appropriate people are being treated. But most regulators find that the centers maintain excellent levels of safety.

Furthermore, advocates and opponents contend that the centers provide an important service as long as patients consult their doctors and are aware of the limitations.

Source: Andr'e Brooks, "Walk Inside, Have Surgery. But Is It Safe?" New York Times, June 14, 2005.

 

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