A wide variety of office procedures, including arthroscopic knee repair, hernia repair and varicose-vein removal, are now possible in a physician’s office due to advances in surgical techniques and the use of less-powerful anesthetics.
The Institute for Safety in Office-Based Surgery reports that 12 million of 80 million outpatient surgeries are now performed in the office and that number is expected to grow.
But there is a lack of uniform standards on office-based surgery, said Richard Urman, MD, an anesthesiologist who is executive director of the institute.
So far, 25 states have rules, statutes or other guidelines for office-based surgery. In Arizona, for example, physicians who use general anesthesia in their office have to obtain a license from the department of health.
Daniel Aspery, MD, medical director for Blue Cross Blue Shield of Arizona, said the company covers surgery in the setting deemed by the physician to be most suitable “but we monitor it.” Surgeons using the office setting “need to provide for everything that would have been appropriate for the surgery had it been done in the hospital,” he said. “That means they’re going to have to have sterilized equipment, a sterilized environment, the right staffing.”
Robert Guyette, MD, DDS, who performs oral and maxillofacial surgery in his office, said he often calls unannounced practice drills. “What could go wrong? I think about that every day,” he said.
Read the Arizona Republic report on office-based surgery.
Read more coverage on office-based surgery.
