I could not have said it any better than you did, but I will add some additional observations.
You are very much alone in an office setting with no back-up personnel and even limited equipment back-up. You must be (1) very self-confident, (2) very experienced, (3) possess strong clinical and interpersonal skills, and (4) very flexible.
You get an office practice by marketing yourself, being able to provide the service and knowing the business of anesthesia. Most of us who have practiced in the office setting have set up a private practice business and have negotiated contracts and have a strong understanding about finances, such as reimbursement models and business finances.
I think office surgery is going to be regulated in the near future and probably a CRNA with less than 5 years experience will not be able to get malpractice insurance
coverage for office practice.
I just heard yesterday of a patient who arrested at the end of a rhinoplasty procedure in an office setting. She is a coma. The anesthesia provider was an MD (big sigh of relief here), but I have reviewed many legal cases where a CRNA was the provider.
One last thing--no coffee breaks, no lunch breaks, no regular hours--yesterday, I put in 12 hours without a break.
I know I sound negative, but this is one practice setting where you have to pay your dues before you start it. There are a lot of positives--no shifts, no call, no OB, good reimbursement and a wonderful opportunity to be a true professional.