Hard agree. The almost completely prone position with an unsecured airway and the endoscope transiting frequently is a recipe for disaster. Yet, more and more proceduralists opine that they "will be quick" and "is intubation really necessary?"
One of the great stressors of being an anesthesiologist is being the last line of defense against catastrophic events, planning was to prevent doom and getting flack in response.
Sometimes its hard for me to tell how bad things were when its outside my specialty... I often ask myself "is this just a reasonable difference in practice patterns or insanely egregious?" Sounds like it leans towards insanely egregious.
This honestly sounds to me like ordering a cardiac cath for someone who presented to the ED with heart burn. Or ordering a small bowel resection for indigestion. ALT of 33 and dead on a table, smh.
Yet another downstream consequence of valuing procedures above anything else in medicine.
Quality of care in this country would skyrocket if procedures compensate less than consults. More doctors would only do procedures when not doing them will result in morbidity and mortality.
Instead we've offloaded nearly every cerebral aspect of medicine to APPs so that we can do procedures.
Reason why I intubate most ERCPs
Hard agree. The almost completely prone position with an unsecured airway and the endoscope transiting frequently is a recipe for disaster. Yet, more and more proceduralists opine that they "will be quick" and "is intubation really necessary?"
One of the great stressors of being an anesthesiologist is being the last line of defense against catastrophic events, planning was to prevent doom and getting flack in response.
I think criminal charges were reasonable here
Death from Ercp for chronic abdominal pain and normal LFTs is murder in my book.
Sometimes its hard for me to tell how bad things were when its outside my specialty... I often ask myself "is this just a reasonable difference in practice patterns or insanely egregious?" Sounds like it leans towards insanely egregious.
This honestly sounds to me like ordering a cardiac cath for someone who presented to the ED with heart burn. Or ordering a small bowel resection for indigestion. ALT of 33 and dead on a table, smh.
This is frank murder (Dr. Death kind of stuff).
Shoot me a DM for all things GI. Happy to help you.
Yet another downstream consequence of valuing procedures above anything else in medicine.
Quality of care in this country would skyrocket if procedures compensate less than consults. More doctors would only do procedures when not doing them will result in morbidity and mortality.
Instead we've offloaded nearly every cerebral aspect of medicine to APPs so that we can do procedures.
If the ERCP was not indicated, then the GI should be tried in criminal court for manslaughter. Their medical license should be revoked.