In my career, I’ve seen amazing changes in the practice of surgery. In the old days, the removal of cataracts was considered major surgery. Patients were in bed for days, flat on their back with sandbags around their head to keep them immobile.

Now, one-day cataract surgery is the rule. You enter the hospital, or more likely the Day Surgery Center, have the surgery and go home. A hernia used to mean five to seven days in the hospital. Not any more.

What’s happening? How come these surgical procedures take less time? Well, they may not but the patient gets to spend less time in the hospital. Same day surgery has arrived!

As technology and medical advancement swept through the 20th century, perceptions of hospitalization failed to keep pace. Twenty years ago, when it became obvious that escalating health care costs were bankrupting America, hospitals were still being viewed as a place to dally, a place to get some much-needed rest.

Eventually, it became clear to everyone, including the U.S. government, surgeons, and insurance companies that ways had to be found to lower hospital costs to the consumer; one solution was to shorten the length of hospital stays.

The government restricted the amount it would pay for Medicare patients. Insurance companies introduced preferred provider arrangements and health maintenance organizations and through advance approval of elective hospitalization. The medical community contributed by coming up with new techniques and treatments to speed up stays.

Day Surgery Units allow the patient to check in, have surgery, and go home.

However, there are some negative aspects to same-day surgery. There is little time to get settled in or for the staff to get to know you. 

The increasing impersonal nature of hospitals can be a problem for some. But it’s a trade-off that results in lower costs for all.

You do have rights. If your doctor suggests an operation and does not mention day surgery, you should inquire. Many operations can be done on a one-day basis but some still require the traditional stay.

If your hospital does not offer day surgery, perhaps another hospital or a free-standing day surgery clinic is more suitable to your needs. Also, if your doctor advises a traditional stay, it’s best to follow the advice, though you should always feel free to seek a second opinion.

In general, it’s good practice to spend as little time as possible in the hospital. But ultimately, be sure to make your decision based on the most important consideration of the need to ensure the best quality care. 

You deserve it.

Dr. Michael M. Warren is Ashbel Smith professor of surgery at University of Texas Medical Branch Division of Urology. Write him at

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