Hello, I am curious about the benefits or drawbacks of private surgical facilities. I know that they must be accredited but is the protocol for hygiene and sterilization more or less stringent than in a hospital where there are more personnel to oversee everything and more accountability? I have wondered how a private surgical facility is sterilized in between patients particularly if there is a quick turnover of patients. Are you more prone to superbugs such as MRSA in a hospital?
What Are the Advantages and Drawbacks of Private Surgical Facilities?
Doctor Answers 8
Private Office Surgical Facilities
Private office surgical facilities do provide some advantages, but it is important that you do your homework.
As you mentioned, all surgical facilities that a Board-certified Plastic Surgeon works in must be accredited by a recognized entity such as JCAHO or AAAASF. Finding out from the facility which accreditation they have will allow you to go to that website to review the requirements or contact them to find out if there have been any concerns regarding the facility. The accrediting body verifies that the sterilization techniques and cleaning routines meet appropriate standards, and that the staff follow rules for instrument cleaning and sterile technique during surgery. The accrediting body also reviews all cases performed in that facility.
Cosmetic surgical facilities often perform elective surgery on healthy patients, so the likelihood that an "infected" case was finished before a "clean" case is much less likely than in a hospital.
We have chosen to have Board-certified Anesthesiologists provide general anesthesia in our office surgical facility, The Centre for Plastic Surgery in Grand Rapids, Michigan, but you may find Certified Nurse Anesthetists performing anesthesia in some facilities.
The other advantage of an office surgical facility is confidentiality and staff who are very comfortable and familiar with common plastic surgery procedures.
Private Surgery Facilities for Plastic Surgery
Believe it or not, plastic surgery if often performed in non-accredited environments. Just like plastic surgery can be performed –legally, by pohysicians with absolutely no training in surgery and no hospital priveleges to perform the surgeries they perform, surgery is being performed in non-accrediated environemts. Look for Joint commission AAASF, or another type of certification.
It is also important to be sure that your plastic surgeon has hospital priveleges at local hospital in the event of an unforeseen medical issue that could possible require the expertise of other specialists. While this is a very rare occurrence with appropriate patient selection, it is important to cover every base for safety.
Most people, whether famous or not want their plastic surgery expeience rto be private. Even people who want to tell all their friends about their exprince don’t want to be stuck in a public elevator as they are coming out of surgery. At plastic surgery centers accustomed to treating high profile patients, privacy is not an after-thought. People wishing privacy want a single story private office with multiple private entrances and a private parking lot. In my plastic surgery practice are accustomed to dealing with high profile clients and patients, even having secure files and aliases for patients who request this.
What Are the Advantages and Drawbacks of Private Surgical Facilities?
I have had my own accredited surgical facility or been a part of one for over 22 years. I believe the folowing are benefits over non-owned surgical facilities or hospital based surgery.
- All employees and subcontractors in our facility sign NDA's that state they can't disclose any information about any patient or their employment is terminated. This offers more privacy over larger facilities or hospitals where there is not as much control. This protect against leaks for celebrities and high profile patients from having things leaked to the media about their procedures.
- I invite and hire anesthesia, OR scrub personnel based upon my belief that they will offer a superiuor level of care. In my mind aesthetic surgical procedures have a different form of anesthesia that is more patient friendly and frankly more difficult to deliver. This selection ability is not available at larger surgery centers or hospitals where the surgeon has little if any say in who provides anesthesia or scrubs in on the surgery. I for one want that control to ensure the best possible care and outcome for my patients.
- Increased ease of scheduling. Large surgery centers and hospitals have emergency cases that can delay or even bump elective cosmetic surgery cases. In our facility, we set the schedule and have far more room for flexibility. We have opened up the OR for celebrities on weekends and after hours.Hope this helps.
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Pros and cons of private surgical facilities
The first thing to check is the surgery center's accreditation status. If the surgery center is properly accredited then it should be a safe environment with qualified staff. You may want to check online reviews or ask other patient's about their experiences in the facility regarding friendliness, professionalism, and organization of the staff. Many times smaller facilities are much more organized and streamlined than larger hospitals. Infection rates should not be a concern.
Private Surgical Facilities
Private operating rooms
At my Austin, Texas plastic surgery practice I only practice in hospital operating rooms. I feel this is important for a few reasons.
1. Hospitals are safer in my opinion because you have access to more staff and more doctors in the unlikely event a problem occurs. You can also be easily kept overnight for less serious issues like nausea without a costly ambulance ride
2. Physicians who work in hospitals will always have the right training to do your procedures otherwise they would not have the ability to even post your case
3. In today's world both accredited private and hospital ORs should not have sterility issues. If you go to a private OR make sure it's a quad A facility
Hope that helps
The Myth of Superiority of Hospitals
There is a reason why many board certified Facial Plastic Surgeons and Plastic Surgeons choose have their own accredited surgical facilities: hospitals are often not very favorable places in which to operate. The accredited facility offers the Surgeon control over anesthesia providers, control over surgical staffing, control over patient privacy, and control of supplies and equipment. Hospitals have higher rates of nosocomial infections (MRSA), frequently non specialized staffing, and are much more expensive for the patient. Hospitals are community base facilities, requiring them to take all comers and handle a broad variety of medical situations. This is good for a community but not ideal for cosmetic surgery.
AAAASF is the largest accrediting body of office based Plastic Surgical facilities and requires stringent adherence to safety equipment, medications, protocols, staffing, and space requirements. Accreditation typically lasts for 3 years. These days, it is more of a rarity for a Facial Plastic Surgeon or Plastic Surgeon to be hospital based for their cosmetic work
Private surgical facilities
Advantages of a private facility are really just privacy and perhaps convenience. Hospital or other ambulatory facilities are simply bigger and have to accommodate a wider variety of patients. The infection rate should not be any different regardless of where you go, despite what you read about. I would any facility, whatever type, if they have a high infection rate. Disadvantages of a private facility are that you must make sure that they are accredited and compliant with the highest standards of safety. You must do your own homework for this.