What exactly is an ASC, anyway? – Dr. Kristine
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 ASC – What do these letters stand for?  Is that some cheapie way to have surgery?  Is it more expensive to have such personalized treatment?  Does the patient have to stay overnight?  Are all ASC’s created equal?

To many, the letters ASC don’t mean much.  They stand for AmbulatorySurgeryCenter.   Eye Surgery Institute has its own ASC, right down the hall from the clinic.  The ESI ASC is dedicated to doing only eye surgery.  So, what are the advantages?  Are there disadvantages?

Surgery can be performed in two basic settings:  at the hospital, or at an ASC.  Here are some basic comparisons:

1.  Cost:  on average, it costs four times more money to have eye surgery done at the local hospital.  Unfortunately, some of that cost is transferred to the patient, in the form of co-insurance and deductibles.  Hospitals are reimbursed differently than ASC’s.  This reimbursement is determined by CMS (Medicare).  It had been decided that (among other factors) the overhead is higher at hospitals.  In addition, hospitals charge per item; in an ASC contract, an ASC receives a ‘bundled’ fee for any given surgery, so there are no extra charges for individual items.

2.  Ease:  At the hospital, and some other ASC’s, the patient has to check-in, change out of their clothes, put on a gown, have an IV placed, be sedated and undergo observation in recovery after surgery.  This process can take several hours.  In contrast, at ESI’s ASC, the patients are very lightly sedated, so that they may eat and drink prior to surgery.  In addition, they are able to stand and walk immediately following surgery.  There is no change of clothing, and no IV (unless specifically requested by the patient).  The process from check-in to leaving after surgery is very streamlined – it takes less than two hours, on average.  It is designed to minimize the inconvenience for the patient and the people who come with them.

3.  Viewing Room:  At the ESI ASC, the patient’s family or friends have the option of being in the viewing room.  In the viewing room, the surgery coordinator explains the cataract surgery, which is visible on a large screen television, as well as through the large window.  The surgery is optionally recorded, and given on a DVD as a memento.

4.  Staff Training:  At ESI ASC, only eye surgery is performed.  As the adage goes, “Practice makes perfect.”   The flow of equipment and the experience with the technical aspects are surgery are second nature to the technicians and staff, who participate in 20-35 cases each surgery day.  Since the staff is focused only on eye surgery, they become very proficient.   Practice making perfect allows for:  swift turnover, predictable results, lower infection rates and an overall efficient, lower-risk process.

5.  Personalized Care:  The patients that arrive for surgery are greeted by the same staff that assisted them during their surgical work-up.  They are greeted by name.  Fresh coffee, snacks and juice are available while they wait for surgery, and for family or friends.  After surgery, a specially trained staff member reviews the post-operative instructions with the patient and their attendants.  And, finally, the doctors call their patients on the evening of surgery to ensure that all is well following surgery.

So, are there disadvantages to having surgery at an ASC?  No, there is no downside, only upside.  Of note, the ESI ASC does not provide for surgeries that require general anesthesia. 

In conclusion, the eye surgery process at our ASC is:  easier for the patient, less expensive, more personalized and the staff are specialized.  It saves money (for the patients and healthcare); it reduces hassle and complications.  In addition, having a small, specialized ASC allows the owners to have more control over the personalized aspects of the surgical experience, which is a win-win for everyone!