to medical and EMS records. By then,
the family claims, it was too late. Shah
was removed from life support at a
nearby hospital two days later. She
died on Christmas Day 2015.
The explosive growth of surgery
centers—which receive $4.3 billion a
year from Medicare—has taken place
under circumstances some medical
experts consider unseemly. Federal
law allows surgery-center doctors, un-
like others, to steer patients to facilities
they own rather than to the full-service
hospital down the street. In some
cases, doing so could increase the risk
to a patient but double a physician’s
profits: Doctors who own a share of
a center can earn their own fee plus
a cut of the facility’s fee, a meaning-
ful sum for operations that can cost
$100,000 or more. Prentice said phy-
sician ownership of surgery centers
is a good thing. “The physicians who
practice there are responsible for ev-
erything that happens in that surgery
center from the moment the patient
walks out of their car in the parking
lot to the moment they leave,” he said.
But several studies have shown
that surgery-center doctors who are
owners perform operations more fre-
quently than those who aren’t owners.
And in lawsuits across the country,
surgery-center doctors have been ac-
cused of taking risks with patients.
Larry Teuber, MD, a South Dakota
neurosurgeon who worked as an ex-
ecutive in the surgery-center indus-
try for 22 years, said he has watched
surgery-center owners take on in-
creasingly complex—and lucrative—
orthopedic and spinal surgeries,
undercutting a nearby hospital’s profits
for their own gain. “The money over-
shadows everything,” Dr. Teuber said.
The first surgery center in the United
States opened in Phoenix in 1970. In
1982, Medicare began paying for pro-
cedures at these centers, which helped
drive their expansion. Today, there aremore than 5,600 Medicare-certified
centers. The expansion has come de-
spite lingering safety concerns. In 2007,
Medicare noted that surgery centers
“have neither patient safety standards
consistent with those in place for hos-
pitals, nor are they required to have the
trained staff and equipment needed to
provide the breadth and intensity of
care.” Some procedures are “unsafe”
to be handled at surgery centers, the
report concluded.
While the thrum of a hospital con-
tinues through the night, some cen-
ters’ doctors keep bankers’ hours.
That means patients whose surgeries
end later in the day are sometimes left
in the care of one or two nurses for up
to 23 hours.“SHE WAS THE DRIVING
FORCE OF THE FAMILY.
WE DIDN’T EXPECT THE
WORST TO HAPPEN.”rd.com 111National Interest