In some point in all our lives regardless of career, we have a choice. Do we go through the full more difficult route to achieve something or do we take a short cut. This could've happened as early as when you were raking leaves as a kid and deciding whether to put them all in garbage bags or just spread them around the yard so they aren't as noticeable. In our lives as plastic surgeons in Denver, the choice comes down to where we operate. Recently in the Denver Post, an article was written highlighting that a patient died at a plastic surgeons office during a procedure where anesthesia was given in a "procedure" room.

Our practice operates at our surgery center, which is licensed by the state of Colorado. There are a rigorous set of rules and regulations that are necessary to become licensed as a surgery center in denver Colorado. We also operate in hospitals such as Porter or Presbyterian St Lukes. All in all, having a licensed surgery center is way more expensive and costly than just having a makeshift setup in our office where anesthesia is provided. In a surgery center there are licensed nurses to examine the patient before and after surgery. There are crash carts in case of emergency. There is an oversupply of equipment and "back up supplies" to make sure that in case of a problem, a patient is going to be safe.

When I bring a patient to the operating room where they are going to get anesthesia, I require that a patient gets a preoperative clearance. It makes sure that the patient is safe and there is not an undiagnosed issue with their body such as an arrythmia, bleeding disorder or stroke. This is critical to optimize the patient or reduce the risks of an anesthetic complication during surgery. Sometimes patients complain that going to their doctor is "an extra step" or a "pain" but I try to reiterate that these steps are done for their safety. It is to reduce the risks of a problem occurring. One of the doctors I worked with once told me that "Shortcuts are great, until they are not". I firmly agree. When undergoing a procedure all the necessary steps should be done to optimize patient safety. At surgery centers where proper licensing, anesthesia team or materials are no available, a risk is being taken with patients. Just like blowing through a stop sign in a desolate part of town, most often you are ok but sometimes you are not.