The proliferation of such physician-owned clinics in California has been dramatic in the last 20 years as physicians have sought to control the lucrative elective and non-emergency surgery cases, leaving hospitals with the more expensive (and less reimbursed) emergency and trauma surgery cases. Unlike hospitals with staffing and equipment requirements for all surgeries that occur in a hospital setting regardless of the type of surgery, many physician-owned clinics are not much more than extensions of their offices where most out-patient same-day surgeries are performed without the same staffing or equipment requirements as hospitals. -Dr. Bruce G. Fagel