Safety of office-based surgeries questioned

Medical leaders said a new study shows the need for more regulation, greater oversight of these procedures.

By Damon Adams, AMNews staff. Nov. 3, 2003.

During a two-year span, patients in Florida were 10 times more likely to die or be injured in surgeries performed at doctors' offices than those performed at surgical centers.

Hector Vila Jr., MD, and fellow researchers detailed the rate in the September issue of the Archives of Surgery. While their study focused solely on Florida, Dr. Vila suspects that more states have office-surgery problems.

"There would be no reason to believe that it would be better [in other states]," said Dr. Vila, lead author of the study on surgeries in doctors' offices and ambulatory surgery centers.

In response to the findings, some physicians and consumer advocates are calling for closer scrutiny of office-based surgeries, saying state medical boards should do a better job of regulating such procedures to reduce deaths and injuries.

"It certainly is an eye-opener when you discover there is a tenfold increase in mortality. It does point out a need for greater oversight for that portion of medical care," said James Thompson, MD, chief executive officer of the Texas-based Federation of State Medical Boards. "My guess is what we're going to see is an increase in the number of states requiring reporting of office-based procedures and perhaps greater oversight."

About 1.2 million office surgeries are performed each year, Dr. Vila said. In the 1980s, surgical procedures previously done in hospitals were being offered at surgery centers, he said. A second shift occurred in the 1990s, when more doctors started performing procedures in their offices. While surgical centers are highly regulated by agencies, doctors' offices are not, the study said. In the past decade, deaths and injuries in office-based settings raised public awareness and prompted action.