Office-based surgical interventions: clinician and patient feedback
Lance Kugler, MD, a refractive surgeon in Omaha, Nebraska, talks about how office-based surgery is a win for patients, surgeons, and payers.
Question:
Can you talk about the latest news in office-based surgery for ocular indications?
Lance Kugler, MD:
I think that the movement from into the office for surgery is just part of a trend that we really started back in the ’80s when we moved from hospitals to outpatient hospital to ASC, and now we’re moving toward office-based surgery centers. It’s part of a natural continuum, and we’ve seen just an explosion in interest in office-based surgery because it’s really getting difficult for surgeons to find OR time in their current offerings. That’s a problem. Also with the shortage of anesthesia that’s facing everybody, it’s another alternative for people so that patients get access to care.
Question:
How has the technology and technique evolved to allow for these types of procedures?
Lance Kugler, MD:
The way that we do cataract surgery in an office-based surgery center is exactly the same as we do in an ASC. The only difference between an ASC and an office-based surgery center is what we call it. It’s all the same standards and the same way of doing surgery. The standard of care is just as high, if not higher, at an office-based surgery center because we can refine it specifically for eyes. It’s no different, it’s just a different name to where we’re doing it.
Question:
What are the impacts to practice and the field overall with increased reliance on office-based surgery?
Lance Kugler, MD:
It’s pretty rare in medicine to have a situation, a change that’s good for patients, for surgeons, and for payers. Everybody wins with the movement toward office-based surgery center. When those 3 things align, it’s a natural evolution, and so I think all those things are benefits to the industry.
Question:
How does patient and clinician preference factor in?
Lance Kugler, MD:
I think surgeons are looking for ways that they can provide really high-level care in a way that’s flexible for scheduling and for patient experience. They want their patients to have a really good experience, and they want to be able to control that experience. They want to be able to control the way that they’re delivering that care. I think surgeons have a lot of reasons why they’re attracted to office-based surgery centers. Patients just want, they want their surgeon to be the one doing their surgery in an environment they’re comfortable with. They’re used to coming into the surgeon’s office, they’re comfortable with the staff. To have the surgery done in that location is very comforting to those patients.
Question:
How is insurance and practice revenue impacted by office-based surgeries?
Lance Kugler, MD:
People that are doing office-based surgery, they’re getting paid. Insurance companies by and large are recognizing the office-based surgery center as a place that they can bill for surgery. It’s an evolving process and each payer treats it a little bit differently, but they’re certainly getting paid and there are ways to help educate the payers on what’s being done. Once they understand that, yes, we’re doing the exact same surgery that we’re doing anywhere else, the paying issues seem to go away.
