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American Morning

House Call: Office Surgeries

Aired September 09, 2003 - 08:35   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


SOLEDAD O'BRIEN, CNN ANCHOR: Surgery performed in doctor's offices is far riskier than procedures that are done in outpatient clinics. That is the conclusion of a new study. And Dr. Sanjay Gupta joins us with the disturbing details.
Just how much more risky are we talking about here?

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Well, significantly more risky, according to the study. You know, just to back up a second, most people think of operations being performed in operating rooms and hospitals. But in fact, in the '80s that, started to change. These things called ambulatory care settings started to crop up, sort of these outpatient settings.

But even more remarkable to most people is that a lot of operations, over a million or so about a year are done in actually doctor's offices, all sorts of different procedures. There are no regulations, national regulations anyway, to sort of overseeing these sorts of procedures.

Sort of interesting, there was a study done in Florida, as you mentioned, Soledad. This was just done in Florida, I'll mention that, and was actually looking at office-based procedures versus hospital operating rooms.

And what they found actually is if you actually look at the numbers of injuries and the numbers of death, the numbers are actually 10 times higher in offices versus operating rooms in hospitals. That's both for injuries and for deaths.

Now the numbers, I should tell you, are small overall for both. The number of deaths as a result of an operating room procedure or in a doctor's office, still going to be very small. But certainly, a lot higher if you're actually in an office versus an operating room.

O'BRIEN: So what goes wrong? Give me a sense of the injuries you're talking about here.

GUPTA: Well, a lot of times it has to do with the actual anesthesia itself. If you look at the all sorts of procedures that are actually done in doctor's offices, again, people are sort of surprised at what actually gets done in doctor's offices. Cosmetic surgery, including abdominalplasty, liposuction, endoscopies. Oftentimes those require general anesthesia as well. Biopsies are another type of procedure. Abortions as well, hernia repairs, all sorts of operations. But the thing about it is, usually the anesthesia not being administered by an anesthesiologist, being administered by the doctor, him or herself.

Oftentimes, there's not a plan to actually get the patient a the hospital if something goes wrong.

O'BRIEN: When they were counting injuries, were they counting every little minor injury that -- something that got infected and was easily cleared up -- or are you talking about serious, life- threatening injuries?

GUPTA: The injuries for the most part are going to be anything that's reported. So minor infections probably won't get reported. But, for example, a perforation of the colon during a colonoscopy, for example, more likely to be reported. Deaths, obviously, are the deaths.

O'BRIEN: Then what do you advise your patients to do? I mean, can you go your doctor? I can't imagine that you're going to get an unbiased answer when you say, gee, should I be doing this surgery in your office, and they're going to say, you know, go to a hospital with somebody else.

GUPTA: Yes, you know, it's interesting, because, I mean, There are advantages to getting it done in an office, for both patients and doctors. Patients oftentimes like the privacy, they like the ease. Oftentimes, it's less expensive.

But I think there are series of questions to go ahead and ask you're doctor is you're going to go ahead and have the procedure done in her office. Is the doctor performing the surgery actually board certified to perform this particular sort of operation? And that's an important thing. There's a lot of primary care doctors that are doing these sorts of procedures.

O'BRIEN: Is there a place you can go to find out your doctor's track record?

GUPTA: There is actually. There is a Web site now where you can find out not only your doctor's qualifications, but also if there's ever been any malpractice lawsuits against your doctor as well.

O'BRIEN: Interesting information. Sanjay, as always, thanks. We're going to check in with you as well later.

GUPTA: I'll be back in about an hour.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com






Aired September 9, 2003 - 08:35   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
SOLEDAD O'BRIEN, CNN ANCHOR: Surgery performed in doctor's offices is far riskier than procedures that are done in outpatient clinics. That is the conclusion of a new study. And Dr. Sanjay Gupta joins us with the disturbing details.
Just how much more risky are we talking about here?

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Well, significantly more risky, according to the study. You know, just to back up a second, most people think of operations being performed in operating rooms and hospitals. But in fact, in the '80s that, started to change. These things called ambulatory care settings started to crop up, sort of these outpatient settings.

But even more remarkable to most people is that a lot of operations, over a million or so about a year are done in actually doctor's offices, all sorts of different procedures. There are no regulations, national regulations anyway, to sort of overseeing these sorts of procedures.

Sort of interesting, there was a study done in Florida, as you mentioned, Soledad. This was just done in Florida, I'll mention that, and was actually looking at office-based procedures versus hospital operating rooms.

And what they found actually is if you actually look at the numbers of injuries and the numbers of death, the numbers are actually 10 times higher in offices versus operating rooms in hospitals. That's both for injuries and for deaths.

Now the numbers, I should tell you, are small overall for both. The number of deaths as a result of an operating room procedure or in a doctor's office, still going to be very small. But certainly, a lot higher if you're actually in an office versus an operating room.

O'BRIEN: So what goes wrong? Give me a sense of the injuries you're talking about here.

GUPTA: Well, a lot of times it has to do with the actual anesthesia itself. If you look at the all sorts of procedures that are actually done in doctor's offices, again, people are sort of surprised at what actually gets done in doctor's offices. Cosmetic surgery, including abdominalplasty, liposuction, endoscopies. Oftentimes those require general anesthesia as well. Biopsies are another type of procedure. Abortions as well, hernia repairs, all sorts of operations. But the thing about it is, usually the anesthesia not being administered by an anesthesiologist, being administered by the doctor, him or herself.

Oftentimes, there's not a plan to actually get the patient a the hospital if something goes wrong.

O'BRIEN: When they were counting injuries, were they counting every little minor injury that -- something that got infected and was easily cleared up -- or are you talking about serious, life- threatening injuries?

GUPTA: The injuries for the most part are going to be anything that's reported. So minor infections probably won't get reported. But, for example, a perforation of the colon during a colonoscopy, for example, more likely to be reported. Deaths, obviously, are the deaths.

O'BRIEN: Then what do you advise your patients to do? I mean, can you go your doctor? I can't imagine that you're going to get an unbiased answer when you say, gee, should I be doing this surgery in your office, and they're going to say, you know, go to a hospital with somebody else.

GUPTA: Yes, you know, it's interesting, because, I mean, There are advantages to getting it done in an office, for both patients and doctors. Patients oftentimes like the privacy, they like the ease. Oftentimes, it's less expensive.

But I think there are series of questions to go ahead and ask you're doctor is you're going to go ahead and have the procedure done in her office. Is the doctor performing the surgery actually board certified to perform this particular sort of operation? And that's an important thing. There's a lot of primary care doctors that are doing these sorts of procedures.

O'BRIEN: Is there a place you can go to find out your doctor's track record?

GUPTA: There is actually. There is a Web site now where you can find out not only your doctor's qualifications, but also if there's ever been any malpractice lawsuits against your doctor as well.

O'BRIEN: Interesting information. Sanjay, as always, thanks. We're going to check in with you as well later.

GUPTA: I'll be back in about an hour.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com