As outpatient surgery centers continue to pop up across the country, they may seem very enticing to patients and their doctors because of their ability to offer procedures at a lower cost and the convenience of a doctor’s office setting.

But as federal regulators approve an increasing number of more complex procedures these centers are allowed to perform, the number of deaths and serious injury to patients may be vastly underreported, according to recent investigative reports published by and USA TODAY Network, among others.

Since their inception more than 50 years ago, ambulatory surgery centers (ASCs) have touted the ability to provide a cost-effective alternative for patients requiring minor procedures with the ease and simplicity of a doctor’s office visit.

These days, ASCs outnumber hospitals. They are growing in popularity as the healthcare landscape changes and federal regulators sign on to reimburse an ever-growing list of procedures in an effort to cut costs typically associated with operating out of hospitals.

Each year, these surgery centers call 911 thousands of times in response to complications that arise during or after surgery, but there is no national authority tracking these outcomes, according to report by the USA TODAY Network. Along with Kaiser Health News, the media outlet discovered that since 2013, more than 250 deaths had occurred after outpatient procedures in patients of all ages undergoing everything from spinal surgery to colonoscopies and tonsillectomies.

While many of the procedures performed at ASCs are perfectly safe and successful, these investigations do bring to light the importance of something that surgery centers are lacking: emergency care protocols.

So what can you do to protect yourself? Well, even with the most skilled doctors and medical staff, there are always risks involved in any surgical procedure. But there are certain things you can look for in a surgical center, should you choose to go that route.

  1. Make sure your doctors are board certified and check out their experience prior to booking your procedure. Some of the examples cited in and USA TODAY’s reports included doctors who had only ever served as “freelance physicians” meaning the totality of their experience was in an operating room at a surgical center where they often don’t have resuscitation plans or emergency protocols in place if complications arise. Hint: You may not want to put your life in the hands of a medical team whose emergency plan includes calling 911.

  2. Does the surgical center have life-saving equipment and post-surgical monitoring equipment on-hand? Many ASCs lack some basic life-saving equipment used by hospital personnel and emergency medical technicians to stabilize patients in the event of surgical complications. The report published on included the story of a patient who stopped breathing after a routine colonoscopy. The operating medical staff called 911, who sent EMTs with a piece of life-saving equipment meant to open the airways of a patient experiencing breathing problems. But the precious time lost between having to wait for first responders to arrive and intubate the patient proved too much and the patient died two days later, according to court documents.

  3. Check to see if there is a resuscitation protocol in place. It seems so simple, but many of these surgical centers don’t need to be licensed and therefore, are not held to the same standards/regulations as hospitals. Again, you don’t want the experts working on you to have to call in someone else to save your life in the event something goes wrong. Anesthesia hampers your ability to breathe normally, which is why breathing problems some of the most common issues seen after surgery. Therefore, it would make sense that anyone utilizing anesthesia, even for the most minor surgeries, should have a protocol in place should the patient need to be resuscitated. But, unfortunately, this is not the case at some surgical centers, and even though Medicare requires these centers to have a hospital lined up for emergencies, the time lost getting a patient to the hospital can be crucial. So it’s best to check into it before going under the knife.

  4. Get medical clearance from your doctor or specialist! At hospitals, this is a must before surgery. It’s standard operating procedure for patients to undergo EKGs, bloodwork and often even chest X-rays before entering the OR. But at outpatient surgical centers, they don’t always have protocols for presurgical testing. A case referenced in’s report told of a man who should have been cleared by his cardiologist prior to undergoing a simple endoscopy procedure because of heart disease and other health problems. He was never cleared by his cardiologist before surgery and wasn’t given the opportunity to speak to his anesthesiologist before his procedure, his family alleges in court filings. The patient never woke up from surgery.

  5. Do your due diligence in vetting your doctor. Make sure the doctors performing your procedure are board certified, and don’t just blindly take the word of your doctor for a referral to a center. I know, in a perfect world, we want to be able to trust our doctors completely with our medical care, but the truth is, surgical centers are very lucrative business for doctors who invest in them, and some doctors may refer patients for financial gain, which, to me, is clearly a conflict of interest. I would even argue it hinges on violating anti-kickback laws in place to prevent this very sort of thing from happening.