Tennessee hospitals oppose office-based surgery rules

The Tennessee Medical Assn. supports the new rules because they establish a limit on the complexity of office-based surgeries.

By Mike Norbut, AMNews staff. Oct. 17, 2005.

Tennessee physicians should not be allowed to perform surgeries requiring general anesthesia in their offices, even though the state's Board of Medical Examiners regulates it, according to a lawsuit the Tennessee Hospital Assn. filed in September.

The THA is seeking an injunction to stop new board rules allowing some general anesthesia procedures from taking effect Oct. 17.

The hospital association also is asking the court to declare the regulations invalid. The THA claims that the new rules would drive business away from hospitals and ambulatory surgery centers, as well as create a patient safety issue.

"Of even greater concern is the fact that major surgery will be performed in doctor offices that are not properly regulated, and not properly staffed and equipped to handle the surgery," the lawsuit states. "The [Board of Medical Examiners] rules make hospitals the final safety net for these patients."

The rules, which the board created with physician and hospital input, create standards and definitions for surgeries up to a Level III classification. Level III surgeries, which require general anesthesia, can only last six hours, and any patient who needs more than 12 hours of recovery time "must be transferred to a hospital for continued postoperative care," according to the rules.

The Tennessee Medical Assn. supports the new rules because they "put a ceiling on the complexity of surgery that can be performed in an office," said Yarnell Beatty, director of the legal and government affairs division for the TMA.