IM or Surgery?

[Taurus]

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I seriously doubt many GI docs are going to be interested in NOTES. My understanding is the reimbursement on a Lap Chole, and a Colonoscopy is roughly $300 (is that about right Dr. Cox?). In the time it would take to yank a gallbladder through someones stomache or anus they could preform 5 or 6 colonoscopies.

Virtual colonoscopy is here and radiologists are best positioned to read them. GI docs need to find something to fill the void.

 

[Winged Scapula]

It's not being chicken so much as being passive-aggressive, IMHO.

True. There are a lot of us who fit that description (me included).😳

 

[Blade28]

True. There are a lot of us who fit that description (me included).😳

Really? That's surprising, given your outspoken personality here on SDN! 🙂

 

[Winged Scapula]

I seriously doubt many GI docs are going to be interested in NOTES. My understanding is the reimbursement on a Lap Chole, and a Colonoscopy is roughly $300 (is that about right Dr. Cox?). In the time it would take to yank a gallbladder through someones stomache or anus they could preform 5 or 6 colonoscopies.

Yeah...its $300-$400 or so depending on location, Medicare vs insurance, etc. but that is the Medicare rate. If you snare some polyps, coagulate, etc. you can charge a little more.

I agree for all the technology required for NOTES, training, etc. it is doubtful that GI docs are going to be doing it for money...if they can get an institution to purchase the equipment for them and they want to do it for "fun", sure. But I'd imagine their medmal insurance going up and it might not be worth the trouble for the average GI joe.

 

[Winged Scapula]

Really? That's surprising, given your outspoken personality here on SDN! 🙂

Ahh...the presumed cloak of anonymity. Its much easier to tell someone something on-line, in a letter, etc. rather than tell them to their face. You know that.

IRL I have to be really upset before I say something to you and instead will probably give you the silent treatment. So I would characterize it as passive aggressive although in reality its really because I hate confrontation and tend to have long fuse, short explosion type....then everything is ok.

I've given very few bad evaluations in my day...usually because I WILL eventually say something if I've dropped enough hints and the student/resident doesn't get it. Those that ended up with bad evals just didn't care enough or want to be better to meet expectations. (Tip: don't roll your eyes at me when I'm going through the list of cases for the day.)

 

[Blade28]

But I'd imagine their medmal insurance going up and it might not be worth the trouble for the average GI joe.

"GI Joe," I like that! Never heard them called that before. 🙂

Ahh...the presumed cloak of anonymity. Its much easier to tell someone something on-line, in a letter, etc. rather than tell them to their face. You know that.

IRL I have to be really upset before I say something to you and instead will probably give you the silent treatment. So I would characterize it as passive aggressive although in reality its really because I hate confrontation and tend to have long fuse, short explosion type....then everything is ok.

Yeah, that's true. I've been on the Internet long enough (since 1994) to know that users' online personnas are often vastly different from their true characters...people tend to be more outspoken, more bold, more outrageous.

And yes, that's a good description of passive-aggressive behavior. 🙂

 

[Winged Scapula]

"GI Joe," I like that! Never heard them called that before. 🙂

Thanks...not sure where I got it from but I started saying it during residency to a GI fellow name, not suprisingly, "Joe."

"Sure thing I'll see that consult, GI Joe!" It was fun saying that. Small things amuse residents.

Yeah, that's true. I've been on the Internet long enough (since 1994) to know that users' online personnas are often vastly different from their true characters...people tend to be more outspoken, more bold, more outrageous.

And yes, that's a good description of passive-aggressive behavior. 🙂

I'd say I'm still pretty outspoken in real life...friends like to call me for advice because I'll tell them what I think rather than say, "well whatever you think." Of course, my ex once said he liked that about me as well...for some reason he didn't like it as much at the end of the relationship as he did at the beginning!