Is the physician office the wild, wild west of health care?

Elective, office-based surgery has captured the interest of consumers and, more recently, the attention of state health care regulatory agencies. In most states today, patients can undergo cosmetic surgery, liposuction, endoscopy, colonoscopy, microlaparoscopy, and various other procedures requiring sedation or anesthesia in physician offices even though no regulatory safeguards that would ordinarily benefit patients in accredited or licensed facilities exist. Media accounts of deaths and serious injuries associated with liposuction and anesthesia performed in physician offices resulted in legislative and regulatory initiates, such as those in California and New Jersey. Increased regulatory oversight, changes in patterns of reimbursement, and greater consumer awareness of safety and quality-of-care issues should aid in reducing the risks of office-based surgery.