Where to Go for Outpatient Surgery

One of the most important choices outpatient surgery patients have is where to have their procedure. The three types of facilities each represent a different level of care. Most surgeons practice at more than one site and can tell you the advantages and drawbacks of each based on your circumstances.

• Hospital outpatient departments offer heavily regulated outpatient care. It may cost more and be more difficult to schedule outpatient surgery in hospitals than in other types of facilities, but the full medical backup will be available if needed—units of blood, teams of doctors, emergency drugs and equipment. In addition, it may be easier for a surgeon to change course and admit you overnight if it turns out you’re not well enough to go home.

• Free-standing ambulatory surgery centers tend to offer specific specialty surgeries. The number of ASCs has exploded in the last 20 years, now accounting for nearly 40 percent of outpatient procedures. Some advantages: Usually patient-friendly, convenient and less expensive than hospitals. Though regulatory requirements aren’t as stringent as those for hospitals, accreditation by the Accreditation Association for Ambulatory Health Care, the American Association for Accreditation of Ambulatory Surgery Facilities or the Joint Commission means the ASC meets basic safety and quality standards. Should you need an overnight stay, you may have to be transferred to a hospital by ambulance. Most ASCs are at least partly owned by the surgeons who practice there. Critics see this as a conflict of interest that could drive up use, but proponents argue that it gives doctors more autonomy to organize efficient, patient-centered care.

• Doctors’ offices are increasingly used for outpatient procedures, some minor and others requiring general anesthesia. Many cosmetic, dermatological and oral surgeries are now performed in doctors’ offices, offering easy access (and sometimes lower costs) for patients and low overhead for doctors. Though states have been pushing in recent years to regulate office-based surgeries, oversight still varies. If considering an office-based procedure, check for accreditation by one of the agencies mentioned above and inquire about the credentials of the surgeon and anesthesiologist.