Office Surgery: Florida's Actions Have National Implications

New
York, NY (December 11, 2000) — Emergency
rules filed November 8th by the Florida
Board of Medicine in regard to office surgery
will expire on February 5, 2001. The rules
took the place of a 90-day office surgery
moratorium that expired that day and are
expected to form the basis for permanent
regulations. Nationally, only a handful
of states regulate office surgery, but action
has been seen in some 17 states, ranging
from preliminary hearings to formal regulations.

According to the American Medical Association,
20 percent of surgical procedures nationwide
are expected to be performed in office-based
facilities in 2001, and while some doctors
argue that regulations for office oversight
would eliminate the efficiency and cost
advantage of that setting, others take the
position that patient safety demands peer
review and formal accreditation of office-based
facilities.

The American Society for Aesthetic Plastic
Surgery (ASAPS) has provided numerous state
boards with recommended guidelines for office-based
surgery, and has gone on record supporting
mandatory facility accreditation.

Patient safety is paramount. The Society’s
position is that successful aesthetic surgery
begins with a plastic surgeon certified
by the American Board of Plastic Surgery
who 1) has hospital privileges for the procedure
being planned and 2) performs that procedure
in a surgical setting equipped in an equivalent
manner as would be necessary if the same
procedure were performed in an acute care
hospital. Published data confirm that when
performed in an accredited facility by properly
credentialed surgeons, office-based surgery
is a safe, convenient and cost-effective
option for properly selected patients.

Following is a summary of the rules
imposed by the Florida Board of Medicine:

Definitions

Facilities:

Level II – administration of intravenous
sedative or analgesic drugs

Level III – administration of general
anesthesia

Patients:

Class II – well-controlled status
where condition does not affect daily activities

Class III– condition status limits
daily activity

Rules

  1. No combination of abdominoplasty and
    liposuction; no liposuction simultaneous
    with other surgical procedures.

  • All Level II and III facilities must
    implement a risk management system.
  • Surgical logs must be forwarded to the
    Board monthly for data collection. This
    provision will expire in one year.
  • No Level III office surgery on American
    Society of Anesthesiologists (ASA) Class
    III patients.
  • For Level III surgeries, ASA Class
    II patients above age 40 must have an
    EKG and a complete workup; complicated
    patients must receive independent medical
    clearance, unless waived by an anesthesiologist.
  • Level II and Level III offices must
    adopt the ASA Standards for basic anesthetic
    monitoring.
  • About ASAPS
    The American Society for Aesthetic Plastic Surgery (ASAPS), is recognized as the world’s leading organization devoted entirely to aesthetic plastic surgery and cosmetic medicine of the face and body.  ASAPS is comprised of over 2,600 Plastic Surgeons; active members are certified by the American Board of Plastic Surgery (USA) or by the Royal College of Physicians and Surgeons of Canada and have extensive training in the complete spectrum of surgical and non-surgical aesthetic procedures. International active members are certified by equivalent boards of their respective countries. All members worldwide adhere to a strict Code of Ethics and must meet stringent membership requirements.

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