The growing expense of health care in America is a huge problem. Small, very common operations that are done in a hospital might dramatically boost those expenditures. Thus, many patients are steered into ambulatory or same-day surgical clinics. In 1970, the first freestanding surgical facility was founded in Phoenix to offset growing healthcare expenses and offer more accessible, timely service for patients. The number of ambulatory surgical centers (ASCs) in the United States has skyrocketed since, approaching 5,600 presently.
As the number of procedures done in these clinics has increased into the millions, so have the dangers of medical problems. A new joint investigation by USA TODAY and Kaiser Health News shines a light on clinics plagued by weak governance, inexperienced or ill-equipped employees, and little to no accountability.
Patients are put at risk due to subpar training, tools, and procedures.
Since 2013, more than 260 patients have died following “in-and-out” treatments at surgical facilities throughout America. At Kandis Endoscopy Center in Arkansas, two patients died, and one had brain damage in four months following difficulties during anesthesia. Arkansas is one of 17 states that does not have an obligation for ASCs to report deaths following Surgery Center Regulators.
Medicare reporting standards aren’t stringent either, giving ASCs discretion on reporting the number of patients that are transported to a hospital unless more than half depart by ambulance. A hospital transfer signifies that a surgical facility could not manage a major problem that happened during an operation. Only one-third of ASCs willingly reveal how frequently patients are transferred to an emergency department. Even the ASC Quality Collaboration, an advocacy group led by executives in the business, asked that Medicare mandate improved reporting. It also produces an optional quarterly quality report.
And what happens when the physicians working at a facility are also the owners? In major hospitals, committees and managers are in place to monitor physicians. However, many surgical facilities are partly or wholly owned by the doctors who work there. This creates a conflict of interest between a doctor-owner’s financial interests and their readiness to disclose problems.
After a commission examined his “competence or conduct” as a doctor, gynecologist Dr. Paul Mackoul MD Lawsuit was stripped of his hospital privileges in 2001. He currently owns his surgical facility with his wife. In 2015, a uterine cancer patient died after Dr. Mackoul implanted a catheter into her chest, even though he was not trained to do any cancer surgery. Her family filed a lawsuit, claiming that the doctor’s puncture of a vein during installation led to blood accumulating in her chest and the collapse of a lung. Dr. Mackoul is still conducting surgery today.
Choosing Surgery Center Regulators: A Guide
With millions of operations or more conducted each year, you or a loved one might be sent to a surgical center in the near future.
What can you do to lessen the possibility of complications?
- Choose a facility that has accreditation. The Centers for Medicare and Medicaid give a list of certified accrediting bodies.
- Talk to trustworthy friends and relatives about their experiences. If you know someone who has had the same treatment, ask them about the surgical facility they used.
- Look for a hospital and surgeons who do your surgery on a regular basis.
- Customer reviews are your friend! Do your due homework and seek patient reviews online before you schedule your operation.
- Make sure your facility is near to a hospital simply in case an emergency happens.