As has happened in many states within the 3-year period between 1999 and 2002, in Tennessee there was a call for stricter regulations of surgical procedures in physicians’ offices by the anesthesiologists and their national organization.
Other dynamics may have been at play in other states where the plastic and reconstructive surgeons called for limitation of procedures done by other specialties, but limiting office-based surgery procedures to only those physicians who are board certified in plastic and reconstructive surgery or other surgical subspecialties is obviously self-serving.
How Regulations Were Proposed in Tennesee
In Tennessee, anesthesiologists proposed a set of guidelines for physicians based upon their perspective of level of sedation and formal screening of patients as candidates for anesthesia. It’s clear this was a national agenda with central leadership in anesthesiology providing the framework for the guidelines.
The need for better regulation of the surgical aspect of office medicine was also recognized by the TN Board of Medical Examiners, which formed a work group to devise rules for office-based surgery in 2000-2001. The Tennessee Medical Association (TMA) organized a task force composed of all specialties to develop constructive guidelines. The Tennessee Dermatology Society made certain that there was a representative on the TMA’s task force who practiced office-based surgery on a daily basis. In fact, the specialty (anesthesiology) that initially proposed its own set of rules had to be very flexible with the direction and wording of the recommendations from the TMA task force as the form of the suggested guidelines was quite different from their initial structure.
A Long, but Necessary, Process
The process of developing office-based surgery rules and the open hearing required by state law to receive input and comments from interested groups took 3 years. The final version of the Tennessee Board of Medical Examiners’ rules for office-based surgery was submitted to the Tennessee State Attorney General’s office in February 2004 and was accepted by the Secretary of State in September 2005.
The rules, which create standards and definitions for surgeries up to a Level III classification, became part of the statutes governing the practice of medicine in Tennessee on Oct. 17, 2005.
This process, including physicians meeting and discussing aspects of office-based surgery, is preferable to direct legislation of medical practice. The rules generated by the Board of Medical Examiners at least are discussed by physicians and formulated by physicians with input at open hearings.
The Importance of Physician Input
Legislation intended to legislate aspects of office-based surgery by non-physicians does not encompass the broad medical perspective and is usually brought forward because of a particular concern of a constituent (or constituent group) to the legislator.
A very important aspect of legislation versus rules generated by the Board of Medical Examiners is that legislation supercedes rules generated by a board within the Department of Health and requires that rules be rewritten to comply with any legislation. Even though not all parties may be happy with every aspect of rules by the Board of Medical Examiners, in general, those rules have more insight than legislation worded by legislators.
As has happened in many states within the 3-year period between 1999 and 2002, in Tennessee there was a call for stricter regulations of surgical procedures in physicians’ offices by the anesthesiologists and their national organization.
Other dynamics may have been at play in other states where the plastic and reconstructive surgeons called for limitation of procedures done by other specialties, but limiting office-based surgery procedures to only those physicians who are board certified in plastic and reconstructive surgery or other surgical subspecialties is obviously self-serving.
How Regulations Were Proposed in Tennesee
In Tennessee, anesthesiologists proposed a set of guidelines for physicians based upon their perspective of level of sedation and formal screening of patients as candidates for anesthesia. It’s clear this was a national agenda with central leadership in anesthesiology providing the framework for the guidelines.
The need for better regulation of the surgical aspect of office medicine was also recognized by the TN Board of Medical Examiners, which formed a work group to devise rules for office-based surgery in 2000-2001. The Tennessee Medical Association (TMA) organized a task force composed of all specialties to develop constructive guidelines. The Tennessee Dermatology Society made certain that there was a representative on the TMA’s task force who practiced office-based surgery on a daily basis. In fact, the specialty (anesthesiology) that initially proposed its own set of rules had to be very flexible with the direction and wording of the recommendations from the TMA task force as the form of the suggested guidelines was quite different from their initial structure.
A Long, but Necessary, Process
The process of developing office-based surgery rules and the open hearing required by state law to receive input and comments from interested groups took 3 years. The final version of the Tennessee Board of Medical Examiners’ rules for office-based surgery was submitted to the Tennessee State Attorney General’s office in February 2004 and was accepted by the Secretary of State in September 2005.
The rules, which create standards and definitions for surgeries up to a Level III classification, became part of the statutes governing the practice of medicine in Tennessee on Oct. 17, 2005.
This process, including physicians meeting and discussing aspects of office-based surgery, is preferable to direct legislation of medical practice. The rules generated by the Board of Medical Examiners at least are discussed by physicians and formulated by physicians with input at open hearings.
The Importance of Physician Input
Legislation intended to legislate aspects of office-based surgery by non-physicians does not encompass the broad medical perspective and is usually brought forward because of a particular concern of a constituent (or constituent group) to the legislator.
A very important aspect of legislation versus rules generated by the Board of Medical Examiners is that legislation supercedes rules generated by a board within the Department of Health and requires that rules be rewritten to comply with any legislation. Even though not all parties may be happy with every aspect of rules by the Board of Medical Examiners, in general, those rules have more insight than legislation worded by legislators.
As has happened in many states within the 3-year period between 1999 and 2002, in Tennessee there was a call for stricter regulations of surgical procedures in physicians’ offices by the anesthesiologists and their national organization.
Other dynamics may have been at play in other states where the plastic and reconstructive surgeons called for limitation of procedures done by other specialties, but limiting office-based surgery procedures to only those physicians who are board certified in plastic and reconstructive surgery or other surgical subspecialties is obviously self-serving.
How Regulations Were Proposed in Tennesee
In Tennessee, anesthesiologists proposed a set of guidelines for physicians based upon their perspective of level of sedation and formal screening of patients as candidates for anesthesia. It’s clear this was a national agenda with central leadership in anesthesiology providing the framework for the guidelines.
The need for better regulation of the surgical aspect of office medicine was also recognized by the TN Board of Medical Examiners, which formed a work group to devise rules for office-based surgery in 2000-2001. The Tennessee Medical Association (TMA) organized a task force composed of all specialties to develop constructive guidelines. The Tennessee Dermatology Society made certain that there was a representative on the TMA’s task force who practiced office-based surgery on a daily basis. In fact, the specialty (anesthesiology) that initially proposed its own set of rules had to be very flexible with the direction and wording of the recommendations from the TMA task force as the form of the suggested guidelines was quite different from their initial structure.
A Long, but Necessary, Process
The process of developing office-based surgery rules and the open hearing required by state law to receive input and comments from interested groups took 3 years. The final version of the Tennessee Board of Medical Examiners’ rules for office-based surgery was submitted to the Tennessee State Attorney General’s office in February 2004 and was accepted by the Secretary of State in September 2005.
The rules, which create standards and definitions for surgeries up to a Level III classification, became part of the statutes governing the practice of medicine in Tennessee on Oct. 17, 2005.
This process, including physicians meeting and discussing aspects of office-based surgery, is preferable to direct legislation of medical practice. The rules generated by the Board of Medical Examiners at least are discussed by physicians and formulated by physicians with input at open hearings.
The Importance of Physician Input
Legislation intended to legislate aspects of office-based surgery by non-physicians does not encompass the broad medical perspective and is usually brought forward because of a particular concern of a constituent (or constituent group) to the legislator.
A very important aspect of legislation versus rules generated by the Board of Medical Examiners is that legislation supercedes rules generated by a board within the Department of Health and requires that rules be rewritten to comply with any legislation. Even though not all parties may be happy with every aspect of rules by the Board of Medical Examiners, in general, those rules have more insight than legislation worded by legislators.
