Cataract Surgery in the Office

 

Cataract Surgery Today

photo of corneal incision during cataract surgery

Corneal Incision During Cataract Surgery

Cataract surgery at this time is performed in a hospital or ambulatory surgery center setting. There have been a couple pilot programs where the cataract surgery is performed in the office.

Financial Considerations

As the government is looking for ways to decrease the cost of health care, there will be an incentive to lower the cost of performing cataract surgery. Cataract surgery is the most common operation that Medicare covers. More health care is going to be done by lower level personnel such as nurse practitioners and physician assistants. You may have already experienced this on one of your recent doctor visits. The government would pay less for cataract surgery if it is performed in the doctor’s office and probably bundle the eye surgeon’s fee with the cost of the operating room.

Factors Against Office Based Cataract Surgery

As of now most malpractice insurance companies would not cover an eye surgeon who does cataract surgery in their office. If a complication occurred even if it had nothing to do with the location of where the surgery was performed, it would put the doctor and the insurance company at risk. Operating rooms in hospital and ambulatory surgery centers have to meet very strict regulations. Hospitals and ambulatory surgery centers have to test and pay to have the diesel fuel in their backup generators certified weekly which is expensive as an example of the costs related to meeting the government regulations. What would the regulations be for eye surgeons performing surgery in their offices? Would it be any less than it presently is in the current facilities. Would the standard of care be the same in the office as it is in hospitals and ambulatory surgery centers? There might be more opportunity for doctors to try to cut corners in their office.

Factors for Office Based Cataract Surgery

Many doctors perform a variety of operations in their offices at the present time. Dentists perform surgical type procedures in their office every day. The doctor’s office would practice the same sterile procedures and policies as they presently do at hospitals and surgery centers. The offices would install the same air conditioning systems with the proper filters. There would be an increased efficiency and time saving associated with performing the surgery in an office setting. Many patients would have less anxiety as many have a fear of entering a hospital. If the government sanctions cataract surgery in the office, insurance companies will offer malpractice insurance. There will be increasing pressure to cut costs and this will be one area that the government will investigate.

Summary

photo of operating room for eye surgery

Typical Operating Room for Cataract Surgery

As there will be increasing demand for decreasing the cost of delivering health care in the United States, office based cataract surgery may be in the future. The regulations that hospitals and ambulatory surgery centers have to follow are increasing continuously. We now have to clean our already sterile hands before we sign the chart in surgery. The regulations are going to make practicing medicine impossible. If the government goes this route, hopefully they will not do the same thing to office based surgery.

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