Procedures in the Office Setting

Foreword
Obstetric and Gynecologic
P r o c e d u r e s i n t h e O ff i c e

William F. Rayburn, MD, MBA

Consulting Editor

This issue of Obstetrics and Gynecology Clinics of North America, edited by Dr Tony
Ogburn and Dr Betsy Taylor, identifies the best topics for discussion about procedures
to be performed in the ambulatory or office setting. I believe that the material presented
here by qualified authors will be of great interest to you in your office gynecology
practice. Noninvasive procedures are being offered more as alternatives to surgery,
as medical treatment becomes more dominant in today’s clinical practice. In addition,
indications for minimal-invasive surgery continue to expand.
Many procedures routinely performed by the obstetrician-gynecologist can be now
performed efficiently in a less costly manner at a free-standing or hospital-based
ambulatory surgical facility or office that offers more patient satisfaction. The office
setting is one type of an ambulatory surgical facility. Examples of procedures that
can often be performed safely in ambulatory settings include endometrial sampling,
endometrial ablation, loop electrosurgical excision procedure, hysteroscopy for diag-
nostic or therapeutic reasons, follicular aspiration, long-term contraceptive insertions,
surgical abortion, cystoscopy, and a variety of vulvar procedures.
In planning this edition, the guest editors recognized that management philosophies
vary widely. An effort is made throughout the issue to consider practice styles and al-
gorithms that highlight key management strategies. As mentioned in each section of
the issue, office-based procedures should be limited to those that can be performed
safely; are consistent with staff expertise and equipment; and are in accordance
with the intrinsic risk of the procedure, the patient’s condition, and satisfactory pain re-
lief. Procedures performed in the office should be those for which there is a reasonable
expectation of discharge within a short period with recovery occurring easily at home.
A report on optimizing reimbursement with appropriate coding for office-based proce-
dures has particular relevance.

Obstet Gynecol Clin N Am 40 (2013) ix–x

http://dx.doi.org/10.1016/j.ogc.2013.09.005 obgyn.theclinics.com
0889-8545/13/$ – see front matter Ó 2013 Elsevier Inc. All rights reserved.
x Foreword

We should anticipate the number of office-based practices to grow in the ensuing

decade with fewer hospitalizations being necessary beyond treatment of certain can-
cer or pelvic support disorders. I appreciate this contemporary overview about patient
selection, resources needed, and helpful tips described by the authors. We look
forward to a timely update in the next 10 years.

William F. Rayburn, MD, MBA

Chair, Department of Obstetrics and Gynecology
Associate Dean, Continuing Medical Education
University of New Mexico School of Medicine
MSC10 5580, 1 University of New Mexico
Albuquerque, NM 87131-0001, USA
E-mail address:
wrayburn@salud.unm.edu