BLOG: Why office-based surgery can reduce patient anxiety and build reassurance
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Before COVID-19, most patients — even those undergoing elective ophthalmologic procedures in ASCs or hospitals — experienced some level of anxiety, ranging from mild unease to severe panic attacks.
When we reach the other side of the valley, there will likely be increased anxiety with concerns over safety. Performing such procedures in an office-based surgery (OBS) setting can provide reassurance and a less stressful patient experience.
Off-site multispecialty ASCs or hospitals can be an overwhelming experience for patients. They are surrounded by commotion from neighboring patients who are being treated for a range of procedures, all while being cared for by a medical staff that they have never met. When procedures are performed within the surgeon’s practice, the number of people that patients and staff are exposed to is limited. The clinic also has flexibility to schedule appointments further apart to reduce the number of patients in the office at one time. Plus, they are dealing with staff they already know — and benefiting from having the same staff member with them for the initial exam, in the operating room, in recovery and for the postoperative exam — which can greatly reduce patient stress and anxiety.
The reality is that, today, many patients do not anticipate they would need to go to an off-site ASC or hospital for elective procedures. As Lance Kugler, MD, of Omaha, Nebraska, who performs cataract, bilateral cataract and refractive lens exchange surgery in his OBS suite, said, “Patients expect their procedures to be done in the office,” adding that, “Surgeons are used to taking patients to a third-party ASC and consider it routine, but for patients it’s a big deal to go to another entity that is new to them. Moving procedures into our own facility has removed that barrier.”
“It is amazing how well patients do with simple topical anesthesia and an oral sedative,” Dr. Kugler said. “In the past when I used IV anesthesia routinely, patients seemed more anxious. I suspect that was because they were in an ASC setting, which feels much more ‘medical’ to them and induces anxiety. In the office setting, they are much more comfortable.”
Another way that OBS reduces patient anxiety is that the exam and surgery can be performed on the same day, using the same charting system. With less travel back and forth and the elimination of redundant preop work, patients experience a more relaxed, convenient and overall shorter surgical process.
While not always recognized as a source of anxiety associated with surgical procedures, patients are often anxious about the cost of surgery and further worry that costs will escalate beyond what they had expected. When procedures are performed in an ASC or hospital, costs for co-pays and anesthesia are often unknown or not disclosed to the patient before surgery. In contrast, with surgeries performed in the office, all costs are quoted upfront to the patient as a single fee to the surgeon.
So, while it may not be possible to eliminate all patient anxiety, we can reduce it with more control over the surgical environment. Performing routine cataract surgeries in an office-based setting can go a long way in creating a more relaxed, premium patient experience.
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