Question

A friend of mine wants to have liposuction done to help with her appearance. She says the doctor will do it in his office. It will be cheaper and more convenient. But I've heard that this isn't a good idea.

What should I advise her?
 

Answer

Tell your friend to insist that any surgery involving a general anesthetic should be done in a hospital or an ambulatory surgery center (sometimes called a same-day surgery department). It's true that as many as one in five so-called elective procedures are being done in doctors' offices, this is not always a good thing.
 

A study from Florida has shown that "adverse incidents" (i.e. something going wrong) occur in 66 per 100,000 office and only 5.3 per 100,000 ambulant surgery procedures. The death rate was 9.2 patients per 100,000 in offices vs. 0.78 per 100,000 in surgery centers. (The study is referenced below).
 

Why this 10-fold difference in risk? Probably because there is (or has been) lack of oversight of doctors offices, and, indeed, of the doctors themselves who do office surgery. The doctors may be inadequately trained, or working outside their specialty, or have inferior equipment.
 

Your friend should check the doctor's credentials with her state medical board, find out if the office is state-licensed for surgery, enquire who will be giving the anesthetic, and ask how emergencies are handled. Only if she is totally satisfied with the answers should she agree to an office-based procedure.
 

Study reference: Vila H, Soto R, Cantor AB, Mackay D. Comparative outcomes analysis of procedures in physician offices and ambulatory surgery centers. Arch Surg 2003;138:991-995.