D E C E M B E R 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 9
rays. My femur and tibia, bowlegged as croquet wickets in the pre-op
film, are now as ramrod straight as football goal posts. An unexpected
bonus: I'm a half-inch or so taller. My knee cartilage had totally worn
down so that I was bone-on-bone, the end of my femur sitting precari-
ously on my tibia. Not only did surgery straighten my legs out, but the
implants created joint space where the cartilage used to be.
At my first clinic visit, I told my terrific surgeon, Eric B. Smith, MD,
of the Rothman Orthopaedic Institute in Philadelphia, that I was edi-
tor of Outpatient Surgery. I even brought a copy of the magazine
with me. No, he said, my surgery would not be "outpatient" because I
wouldn't be discharged the same day. That got me wondering how
many others equated outpatient with same-day discharge. Yes, I spent
a night in the surgical hospital where Dr. Smith performed my surgery
and then a week at a rehabilitation hospital (with an ultra-sensitive
bed alarm!), but my surgery was still an outpatient procedure. As
alternate-site facilities such as surgical centers and surgical hospitals
host more complex and invasive surgeries that require an overnight
stay, we can no longer confine "outpatient surgery" to procedures
with a same-day discharge.
I was also struck by the barrage of bills that came in the mail in the
days and weeks after surgery. Everybody had their hand in my out-of-
pocket: the surgeon, the surgical hospital, the orthopedic institute, the
medical group and the anesthesia group, which failed to submit its
charges to my insurer. I even owed the kindly psychologist who
stopped in to see me at the rehab hospital a $22 copay. Here, I
thought she was just being nice when she stopped by to chat.
Thankfully, I didn't get a bill for disabling my bed alarm with one good
yank.
OSM
