Why the convenience of outpatient facilities often comes with a steep safety cost

It wasn’t that long ago that if you needed health care that wasn’t available in a doctor’s office or urgent care clinic, your only choice was a hospital. Now, there are freestanding outpatient options for almost everything, including emergency rooms (ERs), ambulatory surgery centers, and diagnostic radiology imaging facilities.

You may have seen advertisements for these outpatient facilities. They often tout how they’re more convenient for patients than hospitals. While it’s true that freestanding ERs, surgery centers, and imaging facilities might be near your neighborhood or have shorter wait times, there hasn’t been much attention on how the care sometimes isn’t equivalent to what’s provided in a hospital setting.

Outpatient facilities have limited emergency capabilities

From my experience as a Houston, Texas medical malpractice attorney, I believe that it’s better for a person with a life-threatening emergency or complication to be in a hospital rather than an outpatient facility. I’ll give some examples why.

If a person has stroke symptoms and goes to a freestanding ER, they’ll do a CT scan and then send the patient to a hospital. Medical treatment with tPA for ischemic stroke is time-sensitive, and in some cases the time spent at the freestanding ER and getting transferred to a hospital can make a difference in outcome. In my view, it’s better to skip the freestanding ER and go straight to a hospital if you have stroke symptoms.

Ambulatory surgery centers are freestanding facilities for a variety of procedures, including orthopedic, bariatric/weight loss, and plastic surgery operations. These outpatient facilities are lucrative businesses for their owners. In fact, it’s common for the surgeons who refer patients to ambulatory surgery centers to be part owners of the outpatient facilities. At the same time, I think it’s rare for referring surgeons to disclose this financial arrangement to patients.

Most patients who have surgeries at an ambulatory surgery center survive and do fine. But what about those situations where there’s a complication? I’ve handled numerous cases where patients had anesthesia-related complications—things like not waking up from anesthesia or going into respiratory and cardiac arrest because of breathing problems.

From what I’ve seen in handling medical malpractice lawsuits, many ambulatory surgery centers don’t have appropriate emergency equipment and staffing to handle a respiratory or cardiac arrest. Instead, they’re set up to handle a high volume of surgeries going through their operating rooms each day. In fact, most surgery center policies and procedures require calling 911 to send the patient to a hospital when these things happen.

If your surgeon recommends having an operation at an ambulatory surgery center, I suggest asking about whether having the surgery done at a hospital is an option. It should be. If a family member or I were facing a surgery, I’d want to have it done at a hospital that’s equipped to handle any complication that may arise.

Hospitals have diagnostic radiology capabilities to perform CT scans and MRI scans. Many independent outpatient imaging facilities do CT and MRI scans as well. The scanning process for CTs and MRIs themselves isn’t invasive; however, doctors sometimes order scans with contrast. In these situations, the patient is asked to swallow a contrast medium, or a healthcare provider delivers it by an injection.

Some patients have reactions to contrast media. Some reactions are mild, but other patients have a full-blown anaphylactic reaction that can shut down their airway. I’ve written about these contrast medium-related complications with CT scans here and MRI scans here. When this happens, it’s a medical emergency that most freestanding imaging centers aren’t fully prepared to handle. That’s why most facilities have policies and procedures to call 911 and transport patients to the hospital when they occur.

No matter where it happens, if a patient stops breathing, it’s a life-threatening medical emergency. Hospitals have the emergency equipment and medical providers and specialists to handle these situations.

If you or a loved one has been seriously injured because of medical errors or poor health care, then contact a top-rated experienced Houston, Texas medical malpractice lawyer about your potential case.

Robert Painter
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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.