Surgeon impresses upon physicians the value of outpatient surgery

Patients are happier going home than staying in a hospital postsurgery. (Getty/jacoblund)

Richard Berger, M.D., an orthopedic surgeon at Midwest Orthopedics at Rush, has performed more than 10,000 outpatient joint replacement surgeries. 

Now, he's trying to get more physicians to do more outpatient surgery themselves. 

Joint replacement patients who go home the same day of surgery are as happy, if not happier, than those who remained in the hospital, according to a study out of Rush University Medical Center led by Berger.

Earlier this year, Berger presented the study at the American Academy of Orthopedic Surgeons annual meeting examining patients' satisfaction when they are given a choice between same-day discharge and an overnight stay in the hospital. 

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Researchers partnered with Press-Ganey, a leading patient satisfaction survey company, to ask questions about each aspect of the surgery.

The team hypothesized that patients would be happier if they chose to stay overnight, but instead, satisfaction rates were higher for those choosing to leave the day of surgery.

Most patients (93%) also reported being happy with pain management and medication communication before leaving the hospital.

Berger says there were no demographic differences in the patients who went home the day of surgery and those who stayed overnight in the hospital. In fact, patients in both groups ranged from young to old and had different body mass indexes—some were very healthy with no underlying conditions, and others had comorbidities.

“We were amazed by how quickly patients recovered with this new minimally invasive hip and knee replacement surgery performed on an outpatient basis—and how they could walk (even up and down steps) and leave the surgery center just a few hours after the procedure,” Berger told FierceHealthcare. “We didn’t expect the difference in inpatient versus outpatient response to education about taking pain medications post-surgery. The patients who went home the day of surgery were more satisfied and happier with their discharge team’s thorough explanation of pain control, including the side effects of pain medication; ways to control the pain by altering types and dosage; and how that can enhance recovery and improve outcome.”

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According to Berger, the fact that both outpatients and inpatients were extremely satisfied with their experience was a welcome result and shows how well the surgery teams were able to care for patients in either environment. 

Therefore, he is left with questioning why this new minimally invasive surgery is not more universally adopted by others. 

“The outcomes are so good and the patients recover so quickly—all patients should have their surgery done this way,” he said. “While I have performed over 10,000 outpatient total joint procedures now, my goal is to educate other physicians and encourage them to learn the process. I hope to accomplish that in the near future.”