digitel wrote: The real hot air concerning CRH, in my opinion, is the value of full anesthesia for colonoscopy. The problem is that people that have never had a colonoscopy before don't really know if they need it or not. When asked what are they to say? Patients should be better informed, in my opinion. Most nurses and gasteroenterologists, according to the survey below, believe it isn't worth the price.
On the side, Cologuard increased its expected market share with the latest financials based upon customer response. More people are choosing Cologuard.
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Is it worth it? Since patients who have never undergone the procedure can’t know the answer beforehand, researchers asked the experts what they would choose for themselves.
Dr. James Scheiman of the University of Michigan in Ann Arbor, who wasn’t involved in the research, told Reuters Health, “This is an incredibly controversial issue and (the authors) have tackled it in an interesting and bold way and I applaud them for it.”
Dr. Don Rockey, chairman of the department of medicine at the Medical University of South Carolina in Charleston, and Dr. Deepak Agrawal, from the division of digestive and liver diseases at University of Texas Southwestern Medical Center in Dallas, approached this question by asking those most familiar with colonoscopy and sedation medications - gastroenterologists and endoscopy nurses - three questions.
First, if you were having screening colonoscopy, what sedation would you prefer? Choices were no sedation, midazolam-fentanyl (moderate sedation) or propofol (deep sedation).
Second, if you prefer propofol, how much extra would you be willing to pay out of pocket for it? Possible answers ranged from nothing to more than $500 or “doesn’t matter.”
Finally, they asked, if you prefer propofol, why? Choices were: I don’t want to feel anything; my recovery time will be faster; or, I want to be taken care of by the anesthesiologist/certified RN anesthesiologist. Respondents could check all that apply.
Rockey and Agrawal received responses from 451 gastroenterologists and 460 nurses. Most responders in both groups said they preferred deep sedation with propofol, mainly because they didn’t want to feel anything and the recovery time would be faster.
Yet, among those that did prefer propofol, most were unwilling to pay more than $200 for it, far less than is currently charged to patients, the authors point out in the journal JAMA Internal Medicine.
So why are gastroenterologists performing so many colonoscopies with propofol when they value it at less than current cost? The answer is “undoubtedly complex,” Rockey and Agrawal write.
https://www.reuters.com/article/us-anesthesia-colonoscopy/is-expensive-anesthesia-for-colonoscopy-worth-it-idUSBRE96O0RW20130725