Surgical centers presenting new options in health care

When Eric Hutchcroft of rural Elburn learned he would need a hernia operation, the surgeon asked where he wanted to do it.

The doctor explained that he is on the staff of three facilities and could do the surgery at any of the three. Where would Hutchcroft feel more comfortable and convenient?

At Delnor Hospital, a large secular medical complex in Geneva?

At Provena Saint Joseph, a large Catholic medical complex in Elgin?

Or at the Valley Ambulatory Surgery Center, a one-story, 32,000-square-foot facility that looks more like an insurance office and is tucked almost invisibly into an office park along Randall Road in St. Charles?

“I picked the surgery center,” recalls the 40-year-old software developer. “It seemed closer to home, and it seemed like it might have a more personal aspect. I figured I wouldn’t have to worry about getting lost in a giant operation.”

When Hutchcroft left the center after the operation, he decided the experience had gone more smoothly than the time he had endured a colonoscopy done by another doctor at a large hospital in the suburbs.

“The waiting time was very minimal,” he said. “The people were very friendly. I would definitely recommend using a surgery center.”

Hutchcroft is one of a growing number of people who have found that getting an operation doesn’t necessarily mean going to a hospital. Nationwide, there are now 5,000 independent surgery centers.

In the Fox Valley, the Valley Ambulatory Surgery Center (nicknamed “VASC”) is one of the oldest and largest of these independent, for-profit centers. It opened in 1987 and in 1997 even added a nine-bed Valley Medical Inn, where patients who need to spend a night or two as an in-patient can stay in bed under the supervision of nurses.

VASC contains seven surgery suites and serves 5,500 to 6,000 patients a year — roughly 20 to 25 operations a day. The center is 60 percent owned by some of the doctors who practice there and 40 percent by a corporation named Symbion, which also owns four hospitals and 75 other surgery centers and clinics.

The newest surgery centers in the area are two clinic-style operations in Elgin that offer more than just surgery.

The Elgin SurgiCare opened last August in an 8,000-square-foot office at the corner of North McLean Boulevard and Todd Farm Drive. It’s part of a chain of seven medical centers and nine MRI/CT/X-ray centers across the Chicago area owned by Chicago physician Dr. Naser Rustom.

The 6,900-square-foot Center for Advanced Medicine and Surgery (also known as Centro Medico del Pueblo) has been under construction for a year and a half in the former Hollywood Video Store at 1460 Larkin Ave. but still hasn’t opened. According to its city building permit, the facility will have nine treatment rooms and seven testing rooms, with about 10 employees. Like VASC and Elgin SurgiCare, it will be open Monday through Saturday. Its owner, who reportedly is a Latino physician based in Chicago, could not be reached for this story.

Some centers offer only surgeries in specific specialty areas, such as Elgin’s Endo Center, which does colonoscopies and minimally invasive gastrointestinal operations; and Elgin’s Valley Surgery Center, which does plastic surgery.

Other such facilities in the area include the Tri-Cities Surgery Center, a joint venture of Delnor Hospital and a group of doctors who do mostly gastrointestinal work; the Center for Surgery in Naperville; and the Algonquin Surgery Center.

In almost every case, surgeries are done by doctors who are not full-time employees of the centers but have their own offices somewhere else. In fact, the Joint Commission on Accreditation of Health Care Professionals requires that surgeons using surgery centers also have admitting privileges to at least one regular hospital. Many of the centers are owned or co-owned by doctors or groups of doctors.

Elgin SurgiCare Manager Robin Fina said patients are attracted to these centers by three things: lower prices, a less-intimidating atmosphere and greater safety from contagious infections.

Hernia patient Hutchcroft said he didn’t really consider the comparative cost of using a hospital versus the cost of using a surgery center. “The way my insurance works, it would have been about the same cost to me either way,” he said.

But Dr. Anthony Giamberdino, the medical director at VASC, said more and more people do pay attention, and “based on my interviews, our prices are lower in 98 percent of the incidences. So for a patient with a significant co-pay, we can save them money.”

“For Medicare patients, we are 38 percent less expensive than a hospital,” said VASC Administrator Deborah Lee Cook. “The government recognizes that we are more efficient and tries to steer Medicare patients toward surgery centers.”

Giamberdino said the lower prices are possible because surgery centers and clinics don’t have to pay hundreds of thousands of dollars in salaries to top-office administrators, don’t have to run a cafeteria and don’t need to run an emergency room. “We’re efficient because we can focus on one thing — surgery.”

The surgery center people also claim their facilities are also less prone to spreading infections.

“Our infection rate is lower because we don’t take sick (with an infection) patients” the way a regular hospital must, VASC Marketing Director Diane Lauterer said.

The type of operations that can be done vary considerably among facilities. And if you’re planning on a heart bypass or brain-tumor removal, you will need a full-fledged hospital.

VASC does only surgery but can do many types of that. At VASC, “it’s easier to say what we cannot do surgically than what we can do,” Giamberdino said. “We don’t do childbirths. We don’t do any procedure that involves a long hospital stay or requires an intensive-care ward. We don’t operate inside chests or skulls. But that leaves a lot that we can do. We have pretty much every surgical specialty represented by the surgeons on our staff.”

Typical operations at VASC include hernia repairs such as Hutchcroft’s, knee and hip replacements, plastic surgery, gynecological and gastrointestinal work, tonsillectomies, and kidney stone and gall stone removal.

“We have done spinal fusions, thyroid surgeries, joint replacements, hysterectomies,” Giamberdino said.

Elgin SurgiCare can do fewer varieties of surgery but is more of a full-scale medical clinic. A full-time certified physician assistant, Mario Astacio, is on hand to examine and perhaps write prescriptions or order tests for someone who walks in off the street with some ailment. A chiropractor, Dr. Houston Brown, works on pain management and has a large room full of exercise equipment to do physical therapy. Parkside Imaging, a sister business in the same building that is also owned by Rustom, has a million-dollar MRI machine plus CT scan, X-ray and ultrasound equipment. Elgin Pharmacy will open a branch in the SurgiCare building soon.

“We’re pretty much a one-stop shop for everything from a chest cold to an auto accident,” Fina said.

When it comes to the operating room, however, Elgin SurgiCare’s scope is more limited than VASC’s. It doesn’t do surgeries that involve fully opening a body cavity, such as Hutchcroft’s traditional-style hernia repair. But if a hernia can be fixed via laparoscopic surgery, that can be done at the SurgiCare. Fina said that using laparoscopes, colonoscopy and other minimally-invasive techniques, Elgin SurgiCare doctors work on such things as shoulders, knees, hemorrhoids, skin, the reproductive organs and the gastrointestinal tract. Even a bad uterus now can be removed laparoscopically.

Astacio said Elgin SurgiCare especially targets Elgin’s large Hispanic population. He said he and the daily staff members speak Spanish as well as English.

In a time when the opening, closing and even ownership of medical facilities is heavily regulated by the state in an effort to avoid expensive duplication of resources, each surgery center must convince the Illinois Health Facilities and Services Review Board to grant it a certificate of need. That board voted last month against allowing new hospitals to be built in Huntley and Crystal Lake, but the panel seems easier to convince about the need for small surgery centers and clinics.

Like most surgery centers, he said, VASC is run by medical professionals.

“The best leadership in a health-care organization is people who have done health care,” Giamberdino said. “Our board of directors is made up of physicians. Our administrator is a registered nurse, and our medical director — me — is a physician. We’re not governed by spreadsheets here. The most important thing to us is our patient outcomes, and the people who provide the care are the ones who make the decisions.”