Monday, May 11, 2015

Tribal warfare

A comment on my post below about unnecessary testing before cataract surgery presents a striking example of one problem in medicine--the inability of specialists from different disciplines to agree on and incorporate best practices in patient care:

In my experience this process (pre-op testing prior to cataract surgery) is completely driven by anesthesiology.

At my institution we have fought to change this process to no avail so recently we started having topical days without any anesthesia staff present. We give the patient a mild oral anti-anxiety medication (if needed) and do the short case under topical conditions. Without anesthesia monitoring the cost is even lower.
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2 comments:

  1. AnonymousMay 11, 2015 8:35 AM

    Interesting....at our institution it is the complete opposite. Anesthesiologists are actually trying to educate surgeons and staff not to get "routine pre-op" bloodwork, EKGs, Chest X-Rays etc. I agree with one of your commenters in the previous post: hard to overcome decades of "this is how I have always done it"

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  2. Thomas PaneMay 11, 2015 11:46 AM

    I agree. There are several good reviews from anesthesia journals challenging the need for routine labs for different types of surgery including cataracts.

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