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Independent Surgery Centers – Low Cost, Higher Risk

Surgery centers have been around for a while. They began as low costs alternatives for low risk out-patient surgery. In recent years, the number of surgery centers has grown enormously. This sounds like good news but it has not been the case for many patients and families.

Profits Over Safety

As the number of surgery centers has grown, so too have the number of doctors who have ownership interests in the centers. Ownership brings many economic calculations for surgeons that are not present in the customary hospital surgery situation. With ownership comes concerns over revenue and costs. These types of calculations are certainly necessary for any business including a surgery center. However, revenue generating and cost-cutting decisions in the surgical center can and do have grave consequences for patients and families.

In short, revenue minus costs equal profit to the surgeons/owners. The question becomes whether some surgical centers and their doctor owners are putting profits over the safety and well-being of their patients.  This is rhetorical of course.

Surgical Center Revenue for Some Means Excessive Volume

Most surgeons, like everyone else, are compensated based upon performance. In other words, they make more money if they bring in more money. In a surgical context, bringing in more money means doing more surgeries. Many surgeons get into trouble when they have too many surgeries. In the traditional hospital surgical environment, there are checks on surgeons through internal review, hospital privileges and basic management of surgeons and surgeries. Failure to supervise and properly manage surgeries and surgeons in fact forms the basis for many medical malpractice claims directly against the hospitals.  Hospitals almost universally have safeguards in place.  It is when they break down or are not respected that patient safety is put at risk.

Surgical centers have no such safeguards protecting patients from profit driven surgical volume. The owner or owners of surgical centers are the management. They oversee themselves. If they are strictly motivated by personal profit, then that is how the center is operated. In fact, this is exactly what seems to be occurring with some surgery centers. Surgery centers are no longer just for simple low risk out-patient surgery, they have begun taking on more and more complex surgical cases. They have also been taking on more and more high surgical risk patients.  They are too often ill equipped for either.

More surgeries, more complex surgeries and more high-risk patients is a recipe for certain disaster when conducted in surgery centers designed for simple low risk out-patient surgeries.

Surgical Center Cost Cutting Leads to Inadequate Staffing and Equipment

Hospitals are well equipped. They have numerous doctors, staff and other medical providers on site, inside and outside the operating room. When emergencies occur as they often enough do with surgery, hospitals have the personnel and the equipment to address an emergency. That is not the case with surgery centers. Far too often, surgery centers lack the equipment and highly trained staff necessary to deal with complications and emergencies. Worse still, many fail to plan for such emergencies. The result is that 911 is called thousands of times each year from surgery centers.
Emergency 911 response takes time even in the best of circumstances. In many surgical emergencies, there is no time to wait for 911 to show up and fix the mess created by the surgeon and the surgical center. As a result, patients die. Remarkably, nobody it seems know exactly how many patients die from these emergencies. It is known however that many if not most of the deaths could have been avoided with adequate staff and equipment. One preventable surgical death is too many.  Just ask a family who has suffered one.

The lack of equipment and staff is profit driven. The surgeon(s) owner(s) want to keep their costs down to keep their profits up. So be it if patient lives are put at risk.

Medical Malpractice for Lack of Preparation for Known Surgical Complications

It is interesting when reading about this emerging problem, you will find that the surgical centers and their doctors will categorically deny they did anything wrong when they are unable to meet an emergency. These denials come despite the accepted fact that they were not equipped to handle even common surgical complications. They will persist even when they had to call 911 who arrived too late to help the patient.

One common defense in all surgical malpractice cases is that the complication was a known risk. The defense of “known risk of surgery” is the go to defense for surgical centers as well. “Known risks” and “known complications” take on new meaning in the surgical center context. This is the topic of another article, but suffice it to say if the risk of complications is known, then surgical centers and its surgeons should be prepared for it. Failure to do so is medical malpractice.

If your loved one has been been seriously injured or killed as result, don’t expect any recognition of responsibility on the part of the surgical center.  You will not get it.  Unfortunately, the only way to hold these surgical centers and doctors responsible is through a medical malpractice claim.  And for this, you need an experienced medical malpractice attorney.  Collins & Collins, P.C. can be reached at (505) 242-5958.

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