Gut Check on Gastroenterology Archive

June 13th, 2011

Foreign-body retrieval from the stomach: how do you do it?

I have observed extreme variation in how my colleagues manage GI foreign-body retrieval from the stomach. Some always use general anesthesia and endotracheal intubation; others (myself included) use conscious sedation. Some use an overtube to withdraw the object into if possible; others simply pull it up to the endoscope and use the endoscope to guide […]

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May 17th, 2011

How good a colonoscopist are you?

I have noticed that we all think we are the best endoscopist around (in my case, that is indeed true!). However, we really never measured colonoscopy skill as a “patient-centered” metric and instead often use speed, efficiency, sedation needs, etc. when judging our colleagues. What is more important than these measures, however, is whether we find and remove […]

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January 23rd, 2009

Ambulatory Endoscopy Centers: No Seniors Allowed!

Ambulatory endoscopy centers (AECs) have proven so successful in providing convenient, efficient, low-cost, high-quality endoscopy services to outpatients that they are now ubiquitous around the country. Given this success, you might assume that payers would steer business their way. However, that’s not the case with the Centers for Medicare & Medicaid Services (CMS). In fact, […]

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December 3rd, 2008

Are We Telling Patients the Truth About Colonoscopy?

Last week I heard one of our really talented GI fellows talking with a patient before her open access colonoscopy, and she told the patient that this test prevents colon cancer. I was somewhat surprised at the definitive implication of that statement and later asked her how much protection from colon cancer does colonoscopy screening provide? What […]

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November 4th, 2008

Whither Gastroenterology?

What does it mean to be a gastroenterologist in 2008? Is our field moving in the right direction? I suspect that most gastroenterologists were and are attracted to the specialty because it offered the opportunity to deal with multiple organs and diseases. My generation of gastroenterologists came of age along with the exciting and emerging ability to diagnose–and […]

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