The escalating healthcare costs in America have led to a surge in ambulatory, or same-day, surgery centers. These centers, which began as a single entity in Phoenix in 1970, now number over 5,600 across the country.
Unfortunately, as the number of procedures performed in these centers has increased, so too have the risks of medical complications. The infamous lawsuit involving Dr. Paul Mackoul will be discussed in detail but similar cases are common.
A joint investigation by renowned news outlets has revealed a disturbing lack of oversight, inadequate staff training, and insufficient accountability in these centers.
The Dire Consequences of Inadequate Training and Equipment
In the last decade alone, more than 260 people have lost their lives following outpatient procedures at surgery centers across the country. At a center in Arkansas, for example, two fatalities and a case of severe brain damage occurred within just four months due to anesthesia complications. Alarmingly, Arkansas is one of 17 states that does not require surgery centers to report patient deaths following a procedure.
The criteria for reporting to Medicare are also lackluster, allowing surgery centers considerable leeway in disclosing the number of patients they transfer to a hospital. Such transfers often signify that the center was unable to manage a serious complication that arose during a procedure. A mere third of these centers voluntarily disclose their emergency department transfer rates. Even industry advocacy groups have called for better reporting and transparency.
The Issue of Physician Ownership
In larger hospitals, committees and administrators oversee doctors, ensuring accountability and quality control. However, many of these surgery centers are partly or entirely owned by the physicians who work there. This can lead to a conflict of interest between the financial gains of the doctor-owner and their willingness to report and address mistakes.
A notable lawsuit is that of Dr. Paul Mackoul, a gynecologist who lost his hospital privileges after a review of his professional conduct and competence. He now operates his own surgery center with his wife. In 2015, a patient under his care died following a procedure for which Dr. Mackoul was not certified. Despite a lawsuit alleging that his mistake led to the patient’s death, he continues to perform surgeries.
How to Safeguard Yourself
Given the high volume of procedures performed annually at these centers, it’s crucial to know how to vet them effectively. Here are some steps you can take to minimize the risk of complications:
- Choose a center that is accredited. This list of approved accrediting organizations is provided by the Centers for Medicare and Medicaid.
- Consult with people you trust about their experiences. If you know someone who has undergone the same procedure, ask them about the facility and staff.
- Opt for a facility and surgeons that regularly perform your procedure.
- Research patient reviews online before scheduling your surgery.
- Ensure your chosen center is near a hospital in case of an emergency.
The rise in popularity of surgery centers is understandable given the escalating healthcare costs. However, it is vital to be aware of the potential risks and to take steps to ensure your safety and well-being.
It is alarming that a physician such as Dr. Paul Mackoul with a prior a lawsuit can continue to operate. This serves as a stark reminder of the importance of thoroughly vetting any healthcare professional or facility before entrusting them with your health.
As we continue to rely more heavily on these centers for our healthcare needs, it is crucial for the industry and regulators to take steps to ensure their safety and accountability. Improved reporting requirements, better oversight, and stricter regulation of physician ownership are all measures that could help prevent tragedies like those that have occurred in the past.