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Editor's Page
Shaking the Stereotypes
Dan O'Connor
Publish Date: October 10, 2007

Dan O We're a nation of labelers. We love to label people and things. It's our way of compartmentalizing what's good and not-so-good, which gives us a strange sense of comfort. Reporters are especially good at perpetuating labels and minting them into stereotypes that stick like shadows.

Dan O Take the battle for outpatient surgery supremacy. If we are to believe the passion plays we read in the popular media, hospitals are the victims and freestanding ASCs are the villains.

Plain and simple. Good guys vs. bad guys.

An excellent case in point is "A Whole New Operation," a superbly written, thoroughly researched and yet terribly flawed article that ran in The Washington Post late last month.

The article chronicled the rise of "strip-mall surgical centers." It told the story of a woman who was nervous about having reconstructive surgery in a surgery center located "between a deli and a dry cleaner." It was a great piece that unfortunately was pockmarked by stereotypes.

Ranit Mishori, MD, MHS, a family practice resident at Georgetown University/Providence Hospital who wrote the article, perpetuates the stereotype that ASCs are renegade offshoots of mainstream medicine and not altogether safe when compared to hospitals. A few examples:

  • "Just as Midas Muffler broke away from traditional auto mechanics and H&R Block from general accounting practices ... ASCs are transforming health care."
  • "Fears that [ASCs] may compromise patient safety appear unwarranted - as long as patients and procedures are selected carefully."
  • "ASCs tend to draw away just the kinds of patients that financially pressed hospitals need to stay in business."
  • "For all the advantages ASCs offer when things go right, they depend on the good, old-fashioned hospital for backup when a procedure goes amiss."
  • At ASCs, "the staff generally aims to be home in time for dinner."

To be fair to Dr. Mishori, she did her homework and painted a balanced picture, extolling the safety record of ASCs and citing their many patient-friendly amenities ("very little waiting around in half-open gowns") and doctor-friendly features ("do double the cases in half the time"). It's just a shame she leaned so heavily on labels, a crutch we'd all be better off without.