Northern Virginia's first one-day surgery clinic is under construction and is scheduled to open in October at 10730 Main St., Fairfax City.
Dr. William J. Gazale, orthopedic surgeon and founder of the new Fairfax Surgery Center, said the "in by dawn, out by dusk" procedures will be provided "in a safe, surgical environment for the patient whose operative needs are too demanding for the doctor's office, but do not require overnight hospitalization.
Procedures performed at the center will include biopsiers, internal examinations using instruments with special lenses called "scopes," (bronchoscopies for lungs, cystoscopies for bladder, arthroscopies for joints), vasectomies for men, tubal ligations for women, manipulation and reduction of fractures, facelifts and tonsillectomies.
Abortions will not be performed. Chilbrith, in the Northern Virginia area remains an in-hospital procedure, Gazale said.
"Any surgeon or dentist having privileges at an accredited hospital in Northern Virginia automatically will be permitted to operate at Fairfax Surgery Center," he said.
Gazale said the most obvious advantage of the one-day surgical center is less expensive care. He cited reports that the cost of one day in a Washington-area hospital rose 10 1/2 percent between 1977 and 1978.
At the one-day clinic, a single present fee will be charged so that the patient and the surgeon, as well as the patient's insurer, if any, will know in advance what the charges will be. The fee includes all services and materials used in the operating and recovery rooms, as well as X-rays, electrocardiograms, dressings, casts, drugs and special equipment.
The fee will average $268 for operations requiring the use of general anesthesia; procedures involving the use of local anesthesia will average $134, he said.
Other charges, such as the physician's fee and that for services provided by the anesthesiologist in the operating room, will be extra and will be handled routinely under the patient's health insurance contract. Laboratory work, such as blood and urine analyses, also will be extra. All of these fees have been scaled down, Gazale said, so that they are significantly less than those charged by hospitals.
Follow-up will be by the doctor, in the doctor's office, Gazale noted. He added that "the patient does not contact the center, but sees his or her own doctor. It is the doctor who determines whether each case is amenable to the center's facilities."
In addition to two adult recovery areas, a separate pediatric unit is being constructed where mothers may join their children as soon as they awaken from anesthesia.
"One-day surgery substantially reduces the psychological trauma associated where mothers may join their children as soon as they awaken from anesthesia.
"One-day surgery substantially reduces the psychological trauma associated with medical treatment, particularly in children," Gazale said.
The country's first one-day surgery clinic was established in Phoenix, Ariz., about 10 years ago. Since then more than 50 similar facilities have been built nationwide.
The Center For Ambulatory Surgery, a private institution, is located in the District In Norfolk, the Ambulatory Surgery Center is affiliated with the city's Lee Memorial Hospital.
Among patients and doctors, the centers have almost universal appeal, said Gazale. In a poll of 150 area surgeons, Gazale said he received 125 positive responses to his idea for establishing an ambulatory surgery center.
Peggy Pond, spokeswoman for the Fiarfax Hospital Association, which operates Fiarfax, Commonwealth and Mt. Vernon hospitals, said about one-third of the surgery done at the three hospitals is performed on an out-patient basis.
"We feel the backup of a full-service hospital provides patients with an element of security a free-standing facility cannot offer," Pond said.
Among health insurance carriers, acceptance has been slow. Each company treats the one-day clinic differently when scheduling payment.
A spokesman for the American Foreign Service Protective Association in Washington, said, for example, "Our criterion is that the one-day procedure must be something that could not be done in a doctor's office in a few minutes. We have to be satisfied that an actual surgical procedure was necessary."
A Washington Blue Cross-Blue Shield official said, "Payment for outpatient surgery depends on the type of policy held by the patient."
Arguments against the outpatient surgery concept include fears that such facilities may encourage unnecessary operations and that lower charges for surgical outpatients would be offset by higher charges for everyone else.