The Pros and Cons of Outpatient Surgery
-Win Pound, M.D.
When my father started our practice in 1961, surgery was exclusively
done on an in-patient basis. As time went on and techniques
improved, my father suggested to the leaders at the hospital where he
worked that we could do a lot of our surgery on an out-patient basis.
No one believed that that was really a viable option so, together
with a couple of other surgeons, they started their own outpatient
surgery center. Now, outpatient surgery is a common way to do almost
all cosmetic surgery. In fact, many plastic surgeons have even
progressed to having surgery suites within their own offices. There
are benefits and risks to this.
The advantage of out-patient surgery is that patients can recover in
the comfort of their own home. This also removes them from proximity
to other patients who may have more serious and possibly contagious
illnesses. As long as there is a responsible adult serving as their
“nurse” this works very well. In my practice, I tell patients
that I am just a phone call away if they have any questions or
problems so, in essence, there are two people taking care of the
patient – the immediate caregiver and, more remotely, me.
The risk of home recovery is that the family member providing care
for the patient is not trained in patient care. They may not know
what to look for as far as possible problems. They are not taking
vital signs periodically as might be done in a hospital. This is why
it is important for the doctor to communicate to the caregiver
specific instructions about what to look for post-operatively.
He/she should also be available by telephone if questions or problems
arise. Fortunately, cosmetic surgery is elective. Patients
undergoing cosmetic surgery are generally younger, healthier patients
for whom post-operative risks are lower. Even those who are older or
have medical issues can be managed so that they are in the best
possible condition prior to surgery.
Another risk of out-patient surgery is that some doctors have abused this concept. Doctors who may not have privileges to do certain procedures in a hospital may bypass this problem by performing surgery in an out-patient center or office surgical suite where oversight by regulatory bodies may be more lax. Credentials are important. Patients should always check to ensure that the surgical facility is accredited. They should also check to make sure that the surgeon is certified by the appropriate board and has privileges to perform his surgery in a hospital.