2014 has ended, but the world is still reeling from Joan Rivers’ sudden and unexpected death in late August after a minor outpatient procedure. Her passing has brought to light the potential risks and dangers of having procedures done at clinics instead of hospitals. Before taking part in an outpatient surgery yourself, there are a few things you should know.

Outpatient surgery, or ambulatory surgery, does not require the patient to stay overnight after the procedure. In most cases, you are free to go home after waking up as long as there are no symptoms or signs of complications. These procedures occur very frequently, but should still be approached cautiously. In Joan Rivers’ case, she was going in for something minor, and even though she (and her loved ones) believed she was in excellent hands, she ended up dying from complications shortly thereafter.  

What to Ask Clinics

When going in for a consultation, always ask if they are accredited. If they are, request to see the certificate and inquire about a tour of the facility. During this time, ask follow up questions. Who will be giving you anesthesia? Will it be a licensed and appropriate anesthesiologist or CRNA? Who is doing the actual procedure? Do they have privileges at a hospital? Sometimes, these professionals may not have those privileges and cannot work outside of their office; which could be a red flag.  

Many states do not require any type of oversight or accreditation, and medical professionals may not be aware of such leniency when they recommend you to nearby clinics. We trust our physicians, and the implicit direction to visit certain facilities could lead to choosing the wrong one. It’s important to ask the right questions, and if you are comfortable with the facility and the credentials check out, you are more likely to see excellent results.  

Are Hospitals the Better Choice?

Outpatient surgery is still surgery, and the risk factors are everywhere. These procedures can be done at hospitals, freestanding centers, and small offices.  Cosmetic procedures in particular are prevalent in small clinics, accounting for 75 percent of surgeries. This is largely due to a combination of improved technology, less invasive procedures, better monitoring equipment, and cost effectiveness.  

It makes sense to think that having an outpatient procedure done at a hospital is better. After all, if there is an emergency, extra staff will be readily available.

Under the right circumstances however, clinics can be a better choice. They are private and oftentimes provide dedicated staff members, who give you the time and attention you need.

In fact, there is a significantly lower rate of complications, infections and fatalities in accredited clinics compared to hospitals.

Robert Singer, MD, discusses what an ambulatory surgery is, why someone might have this type of surgery, and what you need to know before having one.