Are outpatient ambulatory surgery centers as safe as hospitals?

From my experience as a Houston, Texas medical malpractice attorney, I cast a wary eye at outpatient or ambulatory surgery centers.

They’re popping up all over the place. In fact, there are now more ambulatory surgery centers in America than regular acute care hospitals.

If you pay attention to much of their advertising, you’d think that having a surgery in an ambulatory surgery center versus a hospital is an apples-to-applies comparison.

That’s simply not true, though. Hospitals are equipped and staffed with medical professionals to handle any type of emergency that happens during surgery. When patients go into respiratory arrest or cardiac arrest, or have a reaction to anesthesia, a code gets called and throngs of providers from different specialties jump into immediate action. Of course, they don’t always meet the mark, but that’s the way it normally happens.

At the typical ambulatory surgery center, if a serious complication occurs, they call a code and then dial 911. While the patient lingers between life and death, they do the best they can while waiting for EMTs (emergency medical technicians) to arrive and transport the patient across town to a hospital. I’ve seen multiple medical malpractice lawsuits that I’ve handled, dealing with procedures from plastic or cosmetic surgery to shoulder repairs.

This brings me back to a question about patient safety. Why would any patient agree to have a serious procedure at an ambulatory surgery center when a hospital is another option?

Make no mistake. Ambulatory surgery centers are profitable businesses for their owners. And, by the way, many surgeons who recommend ambulatory surgery centers over hospitals are at least a part owner in them.

Knowing this, it’s no surprise that we’re seeing these outpatient centers handle increasingly complex procedures that are done under general anesthesia

The Joint Commission accredits some ambulatory surgery centers

As a former hospital administrator and now a medical malpractice plaintiffs’ attorney, I’m a fan of The Joint Commission. It is the oldest hospital and healthcare accrediting organization in the United States.

When I was a hospital administrator, one of my assignments was to be the hospital’s Joint Commission compliance officer. From that experience, I know that The Joint Commission doesn’t just hand out a certificate in exchange for a check. No, there are all kinds of standard and goals, which are updated annually, that facilities must meet to obtain or keep their recognition.

In addition to accrediting ambulatory facilities, The Joint Commission offers certification in Advanced Total Hip and Total Knee Replacement (THKR).

Now that outpatient surgical facilities are handling these procedures, this program of The Joint Commission offers ambulatory surgery centers the opportunity to set their quality-of-care goals high and to show the public their commitment to competence and patient safety by voluntarily meeting the standards.

The Joint Commission recently announced an even higher recognition, called Blue Distinction Specialty Care, which requires a surgery center to be accredited in the Ambulatory Health Care Program, hold THKR certification, and an active and continuous member of a national registry for joint replacement.

What you can do

If you or a loved one faces an elective surgery, I recommend that you don’t automatically the surgeon’s recommendation to do the procedure at an ambulatory surgical center. Before making this important decision, ask questions like:

· Does the surgeon have hospital staff privileges?

· Could the surgery be done at a hospital instead?

· Is the surgeon an owner of the surgery center?

· What type of accreditation and certification does the surgery center have?

· Would an anesthesiologist (a medical doctor) handle the anesthesia, or a certified registered nurse anesthetist (CRNA, a nurse)?

· What happens if there’s a respiratory or cardiac arrest at the surgery center?

In my opinion, surgeons who are having a legitimate informed consent conversation with their patients should cover all of these details without prompting by the patient. From conversations with many of my clients, I realize that this is seldom done. Therefore, speak up!

We are here to help

If you or a loved one has been seriously injured or even died because of poor surgical or medical care at a hospital or surgery center, then the experienced medical malpractice attorneys at Painter Law Firm, in Houston, Texas, are here to help. Click here to send us a confidential email via our “Contact Us” form or call us at 281-580-8800.

All consultations are free and, because we only represent clients on a contingency fee, you will owe us nothing unless we win your case. We handle cases in the Houston area and all over Texas. We are currently working on medical malpractice lawsuits in Houston, The Woodlands, Sugar Land, Conroe, Dallas, Austin, San Antonio, Corpus Christi, Bryan/College Station, and Waco.


Robert Painter is a medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits against hospitals, physicians, surgeons, anesthesiologists, and other healthcare providers. A member of the board of directors of the Houston Bar Association, he was honored, in 2018, by H Texas as one of Houston’s top lawyers. Also in 2018, the Better Business Bureau recognized Painter Law Firm PLLC with its Award of Distinction.

Robert Painter
Article by

Robert Painter

Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm Medical Malpractice Attorneys in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits all over Texas. Contact him for a free consultation and strategy session by calling 281-580-8800 or emailing him right now.