USA Today reports that over 60% of all surgeries, operations, and procedures are now being handled at independent surgery centers, rather than hospitals. While that’s good news for physician and surgeon profits, it doesn’t come without significant risks to patient safety.
Here are some highlights of differences uncovered in research comparing the quality of care at ambulatory surgery centers and hospitals:
• Over one-third of surgery centers use physicians who aren’t board certified. Board certification requires vigorous written and oral testing performed by medical specialty organizations. Board certification is a good indication that a physician knows what he or she is doing in a given area of medical specialization.
• At doctor-owned surgery centers nationwide, over 11% of physicians aren’t certified in Pediatric Advanced Life Support (PALS). If a child is having surgery or a procedure and there’s a serious complication, having a PALS-certified doctor on-hand could mean the difference between life and death.
• Unlike hospitals, whose licensure and accreditation standards require strict infection control practices, less than 20% of physician-owned surgery centers have programs to promote the correct use of antimicrobials and antibiotics.
Another area of concern that I’ve identified in my practice is that ambulatory surgery centers tend to over-rely on certified registered nurse anesthetists (CRNAs) to provide operating room anesthesia care. In many—perhaps most—situations, one anesthesiologist physician is medically supervising five CRNAs in five different operating rooms (ORs) working on five different patients at once.
Of course, this means that anesthesiologists at many surgery centers spend most of their time shuffling among five different operating rooms, rather than focusing on providing direct care to any given patient.
Then there’s the issue of the delay that occurs when there’s a life-threatening complication in one OR. CRNAs don’t have the same level of training to handle airway/respiratory or cardiac emergencies in the operating room and need the immediate presence and assistance of an anesthesiologist should they occur.
Even more alarming, though, is what happens when there’s only one anesthesiologist on site at a surgery center and there are two critical emergencies at once. While that rarely happens, I believe that patients have a dramatically improved likelihood of survival in a hospital, rather than an ambulatory surgical center, because hospitals typically have ample staffing, equipment, and supplies to handle medical emergencies.
If your surgeon recommends doing a procedure at a surgery center instead of a hospital, consider asking these questions:
• Is having surgery at a hospital an option?
• How long has the surgery center been in operation?
• Is the surgery center doctor-owned or part of a hospital?
• Will a board-certified anesthesiologist or CRNA be handling the anesthesia? If a CRNA is involved, how many cases will the anesthesiologist be supervising at once?
• Are all OR staff members certified in Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS)?
• If there’s a respiratory or cardiac emergency, does the surgery center have a transfer agreement to send patients to a specific hospital?
• What type of pre-operative workup does the surgeon have in mind before the date of surgery?
If you’ve been seriously injured because of poor medical care in a surgery center or operating room, then contact a top-rated experienced Houston, Texas medical malpractice lawyer for advice about your potential case.
