Office-Based Surgery

According to the National Center for Health Statistics, an estimated 63 percent of all surgeries are performed in outpatient settings. In fact, a 2002 study conducted by the AAD found that an overwhelming majority of Americans who have undergone surgical procedures in a physician’s office were satisfied with the experience and felt the setting was reassuring.

The American Academy of Dermatology Association Board of Directors approved the following policies relating to Office-Based Surgery:

Medical Office Accreditation

AADA Policy

• AADA members providing surgical and procedural services utilizing anesthesia that significantly impairs the patient’s life protective reflexes should have demonstrated competencies in moderate and deep sedation and airway management. Achieving accreditation by an appropriate agency may be one method to demonstrate facility preparedness and staff competency.

Message Points

• The AADA believes that dermatologists who use higher levels of anesthesia that result in partial or total loss of consciousness should be appropriately trained and experienced. Accreditation by an appropriate agency may be one way to demonstrate the competency of the facility and staff.

• Accreditation is a process of assessing the quality of a medical facility, such as a hospital, ambulatory surgery center or office.

• The process, which is voluntary, consists of an accrediting organization inspecting the physical environment and facilities, and interviewing staff regarding issues such as clinical records and health information, patient rights, governance, administration and quality management and improvement.

• Several states are considering requiring the accreditation of medical offices where surgical procedures involving higher levels of anesthesia are performed.

• Patients considering an office-based surgical procedure should ask about what type of anesthesia services are provided, and ask about the quality of equipment, facility and qualifications of the staff to handle a possible medical emergency during a procedure.

Adverse Patient Incident Data

AADA Policy

• The AADA supports the passage of state legislation and/or the implementation of state regulations calling for the mandatory reporting of adverse patient incidents.

• The AADA supports state legislation and/or state regulation to ensure that adequate privacy protections are adopted along with reporting regulations so that members and other office-based physicians are not made vulnerable to malpractice challenges unnecessarily.

• Basic information in adverse incident reports pertaining to the procedure, setting, type of anesthesia utilized, physician specialty, and outcome should be made available to appropriate researchers.

• The AADA only supports medical office regulations that are fair, reasonable and appropriate and based on factual medical evidence.

Message Points

• Patient safety is the dermatologist’s top priority and procedures performed in the dermatologist’s office have an excellent safety record.

• The AADA supports state legislation or regulation that requires mandatory reporting of adverse incidents – complications that might result in injury or even death after a medical procedure – so that these medical complications can be identified and analyzed.

• The AADA believes that analyzing and understanding these adverse incidents can help prevent them in the future, thus improving patient safety

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