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Outpatient surgery offers swift solutions

Tualatin center is one of several that let patients recuperate at home


by: TIMES PHOTO: JAIME VALDEZ - Orthopedic surgeon Richard Edelson performs shoulder arthroscopy to a patient at Oregon Outpatient Surgery Center near Bridgeport Village. The center is one of several dozen ambulatory centers across the stateThe first month that Oregon Outpatient Surgery Center opened near Bridgeport Village a decade ago, its team performed nine surgeries.

This month, the center completed more than 350.

The surgery center is one of about 85 surgery centers statewide that offer smaller, less-complicated procedures and allow residents to rest and recuperate at home. 

A decade ago, nobody had ever heard of outpatient surgery centers, said Jesseye Arrambide, executive director of Oregon Outpatient. But so-called ambulatory surgery centers are popping up around the state and are seen by some as part of the solution to fixing some of healthcare’s biggest obstacles.

“Ambulatory surgery centers are truly the leaders in federal and state healthcare reform,” Arrambide said. “By our very design, we are meeting the goal of federal and state healthcare reform.”

The aim of ambulatory surgery centers is to deliver quality care at a lower cost and with higher patient satisfaction, Arrambide said.

“It’s a win-win all the way around,” Arrambide said. Outpatient centers often charge 55 percent of what a traditional hospital would charge for a procedure, have high satisfaction rates and low rates of post-operation complications and infections. 

Big versus small business

At Oregon Outpatient, surgeons work with orthopedic issues, including sports-related injuries, as well as hernias, foot surgery, dental and plastic surgery. 

Inside the operating room, the center looks no different than any other hospital, but the real difference comes after surgery, Arrambide said. 

After the procedures are finished, patients are allowed to go home, where they can rest and recuperate on their own. 

“We’re not pushing people out, they are just ready to go home,” said Richard Edelson, an orthopedic surgeon at Oregon Outpatient.

Arrambide said hospitals and surgery centers co-exist symbiotically, and several hospitals have purchased or opened surgery centers in the state in the past few years.

That’s because the two types of healthcare providers offer different things, said Jonathan Greenleaf, an orthopedic surgeon and co-owner of Oregon Outpatient

“It’s like running a big business versus a small business,” he said. “We treat every patient like an individual, and our patient satisfaction surveys are honestly better than hospitals.”

Arrambide said after a career working in hospitals, she was drawn to something different.

“We have a mindset that they are going home at the end of the day,” Arrambide said. “They can rest at home as easily as they can here. But the mindset in a hospital is to keep you comfortable, because you’re recuperating.”

Spread the word

It’s estimated that ambulatory surgery centers employ more than 1,700 people fulltime across the state, most in small surgery centers with 30 or fewer employees. Those smaller surgery centers often result in a leaner, more efficient operation, Edelson said.

“It allows us to keep a tight watch on things,” he said. “At a hospital, it’s a bigger process, and there are more people involved. People might get to the recovery room and get a bunch of medication, then they don’t see that patient again. There’s a much closer watch from a smaller number of people. That process is much more efficient.”

Surgery centers pay taxes, unlike most hospitals, and the Oregon Ambulatory Surgery Centers Association estimates that outpatient centers contribute about $600 million to the state’s economy every year in taxes and other expenditures.

Despite this growing footprint in Oregon healthcare, Arrambide said the biggest problem facing outpatient centers is just getting the word out there that they exist. 

“One of our challenges tends to be educating patients of what their choices are and educating lobbyists and legislative people about what we can do,” Arrambide said. “We can save the state $2.6 million now. And if we sent 50 percent more people into surgery centers, we can double that. There is a real cost savings.”




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