Surgeon touts in-office surgical suites

WAILEA, Hawaii — Some refractive surgical procedures can be safely performed in an in-office surgical suite, according to one speaker here.

Paul Dougherty, MD, said transferring phakic IOL implantation and other refractive procedures into the office setting represents a “great and exciting practice enhancement.” He outlined his reasons for making the change in a presentation at Hawaiian Eye 2006.

He said moving some refractive surgical procedures to an in-office surgical suite makes sense in terms of efficiency, time and finances.

“I look at this similarly to the debate that went on 20 years ago about moving from the hospital to an outpatient center for intraocular surgery,” he said.

To make the transition, surgeons must adhere to federal guidelines — both physical and procedural — and “keep the focus on the quality of care,” Dr. Dougherty said.

He argued that surgeons are more comfortable in their own offices, have better control over their environments and can work with their own staff. Furthermore, patients are more comfortable because they see some of the same faces on the day of surgery as they have on previous appointments.

From a financial standpoint, the surgeon does not need to pay fees to an outside facility. Also, it is easier to fit in other appointments around the scheduled surgeries, Dr. Dougherty said.

He noted that most physical changes that must be made are minor; however, the surgeon must purchase all appropriate equipment, including a surgical chair, operating microscope, oral sedatives, a pulse oximeter and an EKG monitor.

Dr. Dougherty said that getting the facility accredited is not technically necessary for some refractive procedures because insurance generally does not pay for refractive surgery. However, he recommended seeking accreditation from the Accreditation Association for Ambulatory Health Care if possible.

Finally, Dr. Dougherty said it is imperative to “notify your malpractice carrier in writing of what you are doing.”