Surgical facilities: assuming both are certified, what are the pros and cons of selecting hospital or in office facilities?

Most of the docs I'm looking at operate out of a hospital. However, there are a few that have great reviews but operate out of their own certified surgical facility. What are the pros and cons to the patient? Should this be a deciding factor when the patient is selecting a surgeon?

Doctor Answers 13

Hospital or private facility?

Good question and interesting to see the surgeons responses. However , I am one of the few surgeons who has done both extensively and can thus offer you a unique perspective. First of all the comment about germs is totally off base and in fact I feel the infection control at a hospital is much more stringent than many private facilities and is more closely monitored. I have been in a hospital setting for 15 years and have only had minor infections in less than a dozen patients ( out of around 3.000). In terms of the staff I get the same team at the hospital all the time and take my own nurse as well so the comments about consistent staff isn't necessarily accurate either. The comments about costs are correct. However , there is one issue that is significant and that is that most of the anesthesia at doctors offices is done by only a nurse anesthetist without a doctor around whereas at the hospital it is overseen by a board certified anesthesiologist. When I operated. In a facility where we had no MD supervision of the anesthetists we would have an occasional scare but once I moved into a hospital setting those went away. The bottom line is this. Who do you want as the last person between you and eternity? A Doctor or a Nurse?If you are going to an outpatient center where there is MD anesthesia then it would essentially be similar to the hospital. I hope this is helpful 

Birmingham Plastic Surgeon
4.5 out of 5 stars 11 reviews

Surgical facilities: assuming both are certified, what are the pros and cons of selecting hospital or in office facilities

I have a lot of experience operating both in a free-standing outpatient operating facility and in a hospital setting.  A board-certified anesthesiologist taking care of my patients in a hospital-based operating room with all the amenities on hand should any emergency arise is my preference.  Patients having longer surgeries at the hospital can also have the option of staying in the recovery room longer or being transferred to the floor for overnight care without having to be transported first.  If you select to have your surgery in an office-based operating room facility it is important that it is accredited so that you know it is meeting all the industry standards.  Best of luck!

Office or hospital surgery?

You ask a very good question and one that many othesr have asked.There are numerous "pro" and "con" aspects to both settings. In our area, the hospital charges for the same surgery vastly exceed what is charged at an ambulatory surgery center. Generally, for a healthy person with minimal or no medical problems, outpatient surgery is as safe if not safer than operations performed in a hospital setting. Some individuals require a hospital setting because they will be admitted overnight after surgery. Be certain to discuss your concerns with your selected surgeon and ask for statistics on outcomes in either setting in order to arrive at your comfort level.

Tad Grenga, MD, FACS
Norfolk Plastic Surgeon
5.0 out of 5 stars 11 reviews

Selecting a surgical facility

thank you for your question  My surgical facility is a licensed ambulatory surgical center. It 's licensed by the agency  healthcare administration.  This is one of the highest levels of certification in the country.  We are also licensed by AAAASF.  This provides a private, friendly atmosphere and surgical facility.  We have an outstanding surgical staff. They know exactly what to do for every type of surgery that we perform.  In addition  I operate on a lot of surgeons and they want an excellent doctor anesthesiologist to perform their anesthesia.  We have an awesome anesthesiologist. Hospitals are great but the people with infections go there. We do not operate on infected patients.  I have been told by the nurses and doctors, who-are my patients ,that we have the highest level of sterility.  It is important to know what type of certification the surgical center has. Make sure the surgeon has the same surgical privileges at their local hospital  ,this is a good indicator that they are properly trained in performing the surgery that you're interested in.

Joshua Halpern, MD, PA
Tampa Plastic Surgeon
4.8 out of 5 stars 54 reviews

Hospital vs Accredited Surgery Center

Pick based on the surgeon and the anesthesiologists. The result will be the same either way. Keep in mind that a board certified plastic surgeon with his own center must also have hospital privileges to do the same cases in order to be accredited and the same board certified anestheiologists can work with the surgeon at either facility. In my opinion the most important factor in office based surgery is accreditation and the anesthesiologist. I use only highly selected board certified MD anesthesiologists in my AAAASF accredited surgery and in 21 years with my own facility have seen no differences in outcomes at the hospital compared to my accredited center. As a patient it is usually far more convenient to have surgery at an office based facility and most of the time more affordable since hospital profits are largely driven by profits from the operating room.

Gregory J. Stagnone, MD
Dallas Plastic Surgeon
4.6 out of 5 stars 37 reviews

Why I prefer a private surgical facility for my patients

Plastic surgeons who have their own facility are still required to have hospital privileges for the procedures they perform, as part of the certification process for the facility. Here is why I prefer to use my own facility:
  • Greater privacy for the patient. 
  • I work with the same team every day for a consistent and predictable patient experience.
  • Hospitals are where sick people go so there is potentially more exposure to germs.
  • I can use my time more efficiently so there is typically less cost to the patient for a private pay cosmetic procedure compared to a hospital.
  • Our facility specializes in aesthetic plastic surgery so we are focused on what is important to those patients.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 45 reviews

Office vs Hosp

If you are otherwise healthy and a low risk patient for surgery and anesthesia and your planned surgery is not prolonged and the office facility is state inspected/certified the biggest practical difference to you is convenience/efficiency and cost. I also believe there is a lower risk of "system errors" in the office as all policies/procedures/accountability is direct and well controlled. Hospitals have more equipment, more back-up, more delays and more fees. So, there are advantages and disadvantages to each.

Robert H. Hunsaker, MD
Miami Plastic Surgeon
4.5 out of 5 stars 69 reviews

#plastic surgery #office based #surgery center

The most important factor in obtaining a good result from your cosmetic surgery is the surgeon you elect to perform it. Be sure you elect a board certified surgeon preferably a member of the American Society for Aesthetic Plastic Surgery.A real plastic surgeon has privileges to operate in both, in a hospital,  or some prefer to perform their surgeries in their surgeries suites at their offices,  what you have to check is the board certifications, cosmetic surgeons do not have privileges is hospitals, because they do not have the requirements to obtain privileges, so they push surgeries in their offices. The other big difference, which is also the reason why hospitals surgery centers are more expensive, is that they always have a board certified anesthesiologist on board, in a lot of office surgery suites, there is no anesthesiologist present, so when ever you make your decision, you have to check on your surgeon qualifications and also the qualifications of the anesthesia provider. Your surgeon needs to disclose those credentials clearly.

Victor M. Perez, MD, FACS
Kansas City Plastic Surgeon
5.0 out of 5 stars 23 reviews

Hospital or in office facility

Thank you for your question. When your surgeon works out of a hospital, the hospital has to grant him or her the priveliges to do so. There is a background check into their specific surgical and surgical subspecialty training and there is ongoing scrutiny to assure that the surgeon is providing safe and effective care. A hospital will also not allow a physician to practice outside of their specialty. Ie: an OB/GYN would not be allowed to perform a tummy tuck or an orthopedic surgeon would not be allowed to do brain surgery.  Determining if a surgeon has the credentials to perform the surgery that you desire in a  hospital is the best way to assure your surgeon is safe and is subject to peer review. Nowadays, many surgeons see plastic surgery as a great way to make a dollar. They may have trained in a different specialty, but now want to perform plastic surgical procedures to augment their income.  They may have taken a weekend course in how to perform a procedure and then declare themselves as an expert!In an office operating room, there is no scrutiny by a hospital to determine if the surgeon is safe and well trained to perform a particular surgery. Thus, an OB/GYN or a general surgeon can perform whatever procedures they want , such as breast augmentation or tummy tucks or facelifts,with no one looking over their shoulders. Now, having said that, many reputable well trained, Board Certified by the American Board of Plastic Surgeons surgeons, have their own office based operating rooms or surgery centers. These are typically certified by either Medicare or AAAASF which certifies the safety of the center. These are safe, efficient and discrete facilities to have your procedure.My best advice is to ask one question of your surgeon: Do you have priveliges to perform this procedure in the hospital operating room?  A reputable plastic surgeon, even if they have their own surgery center will have hospital priveliges to perform those procedures and will be active on the medical staff.  If your surgeon does not have priviliges to perform a procedure in a hospital that they want to perform in their office, you should ask "Why?"Best wishes, and Good luck!


Hello and thank you for your question. You will many answers to your question.  Both the hospital and office OR setting can be very safe in the appropriate setting.  The bottom line is that you should ask if a board-certified MD anesthesiologist will be present in the room at all times during your case.  In my opinion that is a must and will help ensure your safety.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.  The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 67 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.