June 9th, 2009
Can We Justify Performing Upper and Lower Endoscopies on Consecutive Days?
I recently saw a patient who was referred after upper and lower endoscopies had not revealed the cause of his abdominal discomfort. What struck me was that the patient had these two exams on consecutive days. That meant two days lost from work, two days with altered diet, two trips to the endoscopy center, two days with a driver commitment, two anesthetic administrations, etc. I am not naïve to the fact that most insurers discount heavily for endoscopy procedures performed on the same day. But how do we justify the additional risk, costs, inconvenience, and impact on a patient’s quality of life by not performing needed procedures at the same time?
Perhaps I am missing something here, so I would really like to better understand the rationale for this practice. Please weigh in on the practice of same-day versus consecutive-day endoscopies.