State consider limits on office-based surgeries

The Board of Medical Examiners is set to vote Tuesday in Nashville on whether to require lengthy surgeries be conducted in a hospital or other accredited surgery center.

“It’s a new set of regulations to basically establish some standards statewide for people who do office surgery,” said Dr. George Eckles, a Murfreesboro, Tenn., surgeon who is on the board.

The proposed regulation would require hospital or outpatient surgery for procedures lasting longer than six hours or that use general, moderate or complex anesthesia. Some surgeries could continue in a doctor’s office if the physician and the facility become accredited by various national organizations.

Supporters of the limits say the issue is safety. But some doctors are concerned the change could be inconvenient and more expensive for patients.

Dr. Michel McDonald, an officer of the Tennessee Dermatology Society, said the new rules would require certain types of skin cancer surgery be performed in hospitals at “exponentially” higher cost.

“I don’t think there’s any proof that this’ll make it safer,” the Nashville-based dermatologist said. “It will limit access to very safe office procedures and create difficulty for patients to have access to these procedures.”

Board members said they have been debating the measure for several months. It is driven by increasing numbers of doctors who perform surgery in specially constructed facilities at their offices.

“It’s less expensive than the hospital setting, it’s more convenient for the patient and the doctor and it’s more private,” Eckles said of the trend toward office-based surgery.