First, there was “snow drift;” now there is “practice drift.” Just like a huge blanket of snow that drifts where you may least want it, there are doctors who “drift” into medical areas in which they do not belong. No, they are not saving lives on a remote mountain top; they are operating out of unregulated office surgery facilities. “Why?” Because it’s lucrative.  Into what medical area is the wind blowing them? Plastic surgery.

According to USA Today, December 29th, 2011, “As cosmetic surgery surges in popularity and insurance payouts to doctors decline, the temptation for physicians to branch into new, potentially risky procedures has never been greater.”

Only 21 of our states require licensing and/or accreditation of offices in which surgery is performed.  Until all states demand proper licensing and accreditation, unqualified doctors will simply drift to states in which there is big demand and no oversight.  In the states that are lax, surgery is frequently performed in a facility that has no reliable backup plan in case of emergency. Further, doctors who drift usually don’t have hospital privileges to perform procedures that they do in the office, so, in case of complication, these doctors cannot even accompany patients to the hospital.

Unfortunately, it is human tragedy that draws our attention to these unsafe practices. After three patients of a Phoenix emergency room doctor died following cosmetic surgery, the doctor was sentenced to 25 years in prison. North Carolina suspended the license of an ENT who practiced plastic surgery after more than 50 of his patients complained that the ENT misrepresented his background, failed to use sterile equipment and let people who were not doctors perform liposuction.

Other medical areas in which to beware of doctors who practice without specialist certification are pain management and erectile dysfunction. An oncologist, Daniel Brookoff, drifted into the pain management field in Denver. After he treated Leslie Fishbein for back pain with 30 powerful injections of Marcaine, Fishbein died of a heart attack. Another of Brookoff’s patients died and three others suffered brain injuries.

The good news is that states such as New York, Tennessee, Florida, Alabama and Washington are making efforts to regulate office-based surgery. In Florida, a newly-passed bill remedies the problem of facilities that avoid safety precautions by using pills and injections instead of anesthesia.

To ensure that you do not drift into the hands of a “drifter,” make sure your surgeon is board-certified in the specialty in which he is treating you and that the surgical facility in which you are operated is state licensed or accredited. If your state does not regulate surgical facilities, tell your local political representative that such regulations can be lifesaving.