by Richard D. Urman, MD, MBA, and Fred E. Shapiro, DO
Economic realities of health care reimbursement and growing consumer demand have shifted health care delivery: from in-hospital to outpatient settings, and recently to physicians’ offices. The number of offices, patients, variety, and complexity of procedures continues to increase with 12 million office-based procedures performed in 2009. This is due to decreased cost and improved provider patient access and convenience, without regulations similar to those at hospitals or ASCs (Ambulatory Surgical Centers) Office personnel often are not prepared for complications. An increased incidence of adverse events in office-based surgery has caught the public’s attention due to highly publicized fatalities, such as the death of Kanye West’s mother and of young, healthy patients undergoing routine procedures.