The Statistics

Jonathon Rutkauskas

Fred E. Shapiro

Provision of surgical services on an outpatient basis and particularly in an office-based setting has risen dramatically during the last decade. According to the American Society of Anesthesiologists (ASA), an estimated 10 million procedures were performed in doctors’ offices in 2005—twice the number of office-based surgeries performed in 1995 (see Figure 2.1). The trend toward office-based surgery parallels the growing trend ambulatory surgery experienced a few years ago, and now approximately one in ten surgeries are performed in physicians’ offices (1). This correlates with a strong need for competent anesthesiology personnel to perform services in office-based settings. But what types of procedures are being performed in physicians’ offices?

Most procedures that can be performed on an outpatient basis can also be performed in a physician’s office. Unfortunately, no adequate data collection exists to pinpoint exactly how many office-based surgeries are performed, a number that shifts depending on how one defines office surgery. A list of the more common outpatient procedures, all of which are also commonly performed in physician’s offices, can be found in Box 2.1.

Figure 2.1. Office-based procedures. (Source: Based upon 2003 Medicare Data Federation for Ambulatory Surgery in America.)

Table 2.1. Most common outpatient procedures, 2004

Name	Volume
Colonoscopy	239,630
Extracapsular cataract removal with insertion of IOL technique	208,352
Upper gastrointestinal endoscopy with biopsy	176,940
Colonoscopy with removal of tumors, polyps, or other lesions	90,944
Injection of diagnostic or therapeutic substances epidural or subarachnoid; lumbar, sacral	90,862
Colonoscopy with biopsy—single or multiple	87,092
Lens; laser surgery	68,553
Colonoscopy with removal of tumors, polyps, or other lesions by electrocautery	66,505
Fetal nonstress test	49,396
Debridement; skin and subcutaneous tissue	41,604
Transfusion—blood or blood components	36,601
Introduction/injection of anesthetic agent, diagnostic or therapeutic, lumbar or sacral, single level	34,531
Upper gastrointestinal endoscopy	34,134
Arthroscopy of the knee; with meniscectomy	29,071
Spinal injection	23,026
IOL, intraocular lens.
Source: This information is from “FHA Eye on the Market: Outpatient surgery report, September 2005,” which includes data on individual hospitals.