The Tennessee Hospital Association, which lost a court battle two months ago over new state guidelines governing office-based surgery, will now ask state lawmakers to overturn the new rules that officials say will greatly expand the kinds of procedures performed outside of hospitals, creating new safety risks for many patients.
Craig Becker, president and chief executive officer of the association, says the guidelines, which took effect in mid-October 2005, will increase the kinds of procedures allowed in doctors' offices, including complicated Level III surgeries that last as long as six hours and require as much as 12 hours of recovery time. Two months ago, the Davidson County Chancery Court rejected the association's request for a temporary restraining order to overturn the guidelines. The next step, Becker says, is the political process.
"The battle is still going on," Becker says. "Basically, we're going to the Legislature and take the battle there ... we are certainly concerned about this, and we think the Legislature will share those concerns."
The guidelines, established by the state Board of Medical Examiners, could endanger patients by increasing the number of office-based surgeries requiring anesthesia, Becker says. He says no one can accurately predict the rate of increase in complicated office-based surgeries, but says the new rules are almost certain to boost physicians' business at the same time it reduces revenue at local hospitals.
"That's what it's all about-revenue," he says. "It drains commercial-paying business from hospitals at the same time we're seeing a tremendous increase in charity care."
Yarnell Beatty, director of legal and government affairs at the Tennessee Medical Association, argues that the rules would actually decrease the number of office-based surgeries because the rules add additional oversight and regulations for any use of anesthesia. "These are rigid guidelines," he says.
State officials say it was necessary to change the regulations because many complex medical procedures, including face-lifts, were routinely being performed in doctors' offices without any oversight at all.