Did you know that only 21 states require medical offices where doctors perform surgery to be accredited or licensed? Offices that are accredited or licensed are required to have certain life-saving emergency equipment and drugs; comply with strict record keeping, anesthesia, and cleanliness protocols; and be subject to inspection.

Because cosmetic surgery has become more popular and profitable, and because of the decrease in insurance payouts, doctors in other specialties are being tempted to branch out into new, potentially risky procedures in which they have not be formally trained. And while insurance companies and hospitals generally prohibit doctors from practicing outside of their specialties, office surgery facilities are unregulated in more than half of states including Michigan, Illinois, Massachusetts, Maryland, and the District of Columbia.

As reported in a recent USA Today exposé, what’s being called “practice drift” can have serious, sometimes fatal consequences:

  • Three patients of a former Arizona ER doctor died after undergoing cosmetic surgery at his office. The doctor was convicted of two counts of second-degree murder and one count of manslaughter and sentenced to 25 years in prison in September.
  • A North Carolina ear, nose, and throat surgeon had his license suspended indefinitely based on patient complaints regarding substandard cosmetic surgery procedures, and another North Carolina doctor – a general practitioner – also had his license suspended due to concerns over his cosmetic surgery practice and the fact that he operated on family members and prescribed drugs to himself.

Cases such as these have prompted North Carolina and other jurisdictions to adopt position statements calling for doctors who expand their practices to be held to the same standards as more extensively trained physicians and to ensure that they have enough education and training.
“With cosmetic surgery, procedures are almost always done in the office, often without necessary and appropriate arrangements for emergencies,” says North Carolina medical board spokeswoman Jean Fisher-Brinkley. “Doctors who drift typically do not have hospital privileges to do the procedures they are doing in the office (so) if complications do arise, the doctor often cannot even accompany the patient to the hospital.”

If a state doesn’t have formal guidance or a law covering office-based surgery and the doctors who practice it, “more people are going to get injured,” says Sidney Wolfe, a medical doctor and director of Public Citizen’s Health Research Group.

So what steps should you take if you’re considering cosmetic surgery? First, find out where your doctor is licensed and if he or she is board certified in plastic surgery. Determine whether your doctor has been the subject of any disciplinary actions, which can be done by ordering a full physician profile and disciplinary history report. Search the American Association for Accreditation of Ambulatory Surgical Facilities (AAAASF) and Accreditation Association for Ambulatory Health Care databases (AAAHC) databases for the office in which your proposed surgery will be performed.

It’s up to you take control of your health!