Office Surgery – A Forgotten Art?

 

Not so long ago to practice of podiatry was almost exclusively an office practice.  Podiatrists were not on medical staffs and when they were they could not do surgery in the hospital or day surgery. In those days podiatric foot surgery consisted of simple surgeries on the toes and occasionally a bunion.  The interesting thing is that a great percentage of foot surgery is still surgery on toes or bunions. Those are simply the things on our feet that cause us a lot of trouble!

Fast-forward to the present and podiatrists are on almost every medical staff and work at almost every hospital and surgery center.  Now those simple, effective surgeries that were performed so routinely in the office are now rarely performed in the office. Today office surgery is generally only performed by more senior podiatrists who have the experience, equipment, and physical set up in their office to perform office surgery.

I was trained in office surgery and performed office surgery for a number of years prior to joining medical staffs and moving most of my surgery into the surgery center and hospital. It is my feeling that more complicated surgery on patients with medical problems is much more safely done in a hospital or surgery center. But uncomplicated minor surgery on toes can be done safely with much greater convenience and much less cost in the office.  Sometimes I am absolutely shocked at the bills patients get for the surgery center and the anesthesiologist for a procedure which is roughly the equivalent of having a cavity done at a dentist’s office.

The simple toe surgeries can be incredibly satisfying for both the patient and the doctor.  Just yesterday I had someone tell me that the little corn on her baby toe which I surgically removed about five years ago was the best thing she ever did and was so happy she had it done! That just makes your day!