The pitfalls of regulating office-based surgery by state legislatures and boards of medical examiners.
Many surgical specialties currently provide their patients with cost-effective surgical procedures that are performed safely in an office-based setting. However, the growing number of procedures performed in this setting has lead many state legislatures and boards of medical examiners to the belief that these procedures must somehow be regulated to ensure patient safety. The first pitfall is demonstrating that a problem with safety exists, in spite of the fact that numerous published, peer-reviewed articles have proven that there is no problem. While it is relatively easy to develop a set of criteria to meet in order to certify a facility in which office surgery is to be performed, it is exceedingly difficult to determine similar criteria or scope of practice definitions that can be used fairly and accurately to determine which physicians are qualified to use those facilities. The use of hospital privileges, board certification, transfer agreements or extramural certification of facilities all have been recommended at one time or another as methods to determine physician qualifications, but no single standard has been developed that accurately reflects a fair and impartial method of determine physician qualifications.