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The Unwilling ASC Patient

I would never have a cataract operation in a surgery center!" my patient declared, poking her finger on the arm of the chair for emphasis. Regular readers know that I work in a rather quirky state, and live each day as if on a soap opera. That's what makes it so fun to work here. I couldn't wait to see where this one was going, so I took the bait. "Why not?"

"I have a bad heart, a pacemaker and an implanted ventricular defibrillator," she said. I assured her that our surgery center had all the necessary equipment to handle any foreseeable complication. That didn't seem to make a difference.

"You don't have the right equipment, your hospital does," she scoffed, "and besides, doctors who work in surgery centers are evil." Ah, this is going to be good. I pulled up my chair. I couldn't let her stop now. "What do you mean?"

"Hospitals buy the very best equipment for their doctors, and they have the very best nurses. There is absolutely no better place to go when you're sick. Then surgery centers come along and the doctors leave the hospital. Then the surgery centers hire the best nurses from the hospital so that the hospital loses not only part of its business but a lot of its staff, too. It makes me sick."

I interrupted – a big mistake. "Actually it's not like that at all. Surgery centers tend to purchase the latest specialized equipment. And I can assure you that the staffs, systems and protocols found in most surgery centers are all first-rate. That's why doctors like to use them."

The Real Objection

She practically jumped out of her seat. "I'm a retired nurse. I know these things. What happens is they hire away nurses from the hospital and then those nurses quit the union and our membership goes down. I used to be the nurses' union steward and it ticks me off to see our members leave the hospital to work somewhere else."

And then, the grand finale: "I would never have surgery in a non-union shop!"

That was a new one on me. I like to believe that my patients selected me because of my qualifications. This patient's priority was whether my nurses were organized. She didn't care about my experience; she'd take any commodity doctor as long as he worked in the right place. How's that for a cold douse of water and a stiff kick?