Office-Based Surgery and How It Came To Be

My Journey with Amy Daggett, RN, ANP

Recently I was asked to write an article about office-based surgery for a leading medical journal.

FBThe process of writing caused me to reflect on 30 years in practice and how I was inspired by a wonderful mentor in Syracuse, New York that I happened to hear about during my intern year; Dr. A. Jefferson Penfield. Even in 1973 Dr. Penfield was doing what many would consider “cutting edge” today – laparoscopies in his office. He was a gentle man with a soothing and reassuring voice and reminded me of my own family doctor when I was a young boy.

Fast forward to October 1, 1986 when I opened the doors to my private office on White Spruce Boulevard. In those days I had a full time office manager, Debbie—she did the billing, cleaned and sterilized instruments answered the phone, made appointments and balanced the books. We had a part time nurse and that was it! Our office had 1000 square feet, but it was mine and my home away from home. I did the vacuuming after hours, dusted and polished furniture. I was 35 years old with a healthy combination of fear, energy and common sense.

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Office-Based Surgery and What it Means for You

My love affair with office based surgery began in 1976. That year an article was published in a distinguished medical journal by Dr. A Jefferson Penfield, from Syracuse, New York, who had performed over 1600 laparoscopies and tubal ligations in his small downtown office! Dr. Penfield had long ago recognized that women found the office environment less stressful and that by eliminating the intimidating environment of an operating room reduced the need for general anesthesia! The “Catch 22” goes like this: hospitals can provide general anesthesia. The bad news is that if you’re in a hospital you’re more likely to need it.

I tucked that in the back of my mind and in 1982, while at the Wilson Health Center, I wanted to learn more about Dr. Penfield’s method. Back then, as today, insurance companies were looking for ways to cut costs and so this seemed like something worth exploring. The day I spent with Dr. Penfield was truly a life changing experience. Instead of patients spending 4- 6 hours at a hospital for a tubal ligation or a laparoscopy they were generally in and out of the office in 60 or 90 minutes. The staff worked like a well-oiled machine – because they always worked together. How different from a hospital, where frankly, the staff can vary in a single day over the course of 2 or 3 cases. Patients seemed so much more relaxed in an environment in the relaxed atmosphere of an office.

In 1982 many physicians at local hospitals had not adopted laparoscopic surgery—mostly out of the natural fear of learning a new technique—and here was a gifted surgeon offering this alternative to women in his very own office.

Continue reading “Office-Based Surgery and What it Means for You”