The Anesthesiology News article noted “Routine preanesthetic tests cost more than $60 billion every year, but far fewer than 1% reveal pertinent abnormalities relating to the anesthetic or the surgery, according to a 1989 study published in the Canadian Journal of Anesthesia (1989;36:S13-S19).”
“For that reason, national guidelines recommend minimizing preoperative testing in low-risk, stable patients undergoing non-emergent surgery. The American Society of Anesthesiologists (ASA) released a guideline in 2012 that advised against routine testing, such as labs, chest x-rays and electrocardiograms (EKG). But the ASA suggested a tailored approach for anything with a high risk.”
“An interdisciplinary panel of physicians from around New York City met recently to discuss the appropriate use of pre-op testing at the New York Academy of Medicine. The session, ‘Why Bother! The Comprehensive Pre-Op Panel,’ was organized after the American Board of Internal Medicine (ABIM) Foundation listed preoperative testing in patients undergoing routine surgery as one of five medical services of questionable value.”
“Preoperative testing has been an accepted part of medicine for more than 150 years since the English physician John Snow wrote about the benefit of examining his patient before administering chloroform. In the 1990s, however, doctors began to ask if these tests made any difference in outcome, and the answer was ‘we always did it that way,’ said Elizabeth Frost, MD, clinical professor of anesthesiology at the Icahn School of Medicine at Mount Sinai, in New York City, who appeared on the panel. ‘I’ve heard surgeons say that their administrator orders the tests, that the patient expects to give blood and be tested, that anesthesia will cancel the case if there are no tests, that there’s a legal liability without testing and that they have to support the hospital and labs,’ Dr. Frost said.”
Click here to read the full Anesthesiology News article “NYC panel highlights waste in system” by Paul Bufano.
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Doctor, Did You Wash Your Hands? ™ provides information to consumers on understanding, managing and navigating health care options.
Jonathan M. Metsch, Dr.P.H., is Clinical Professor, Preventive Medicine, Icahn School of Medicine at Mount Sinai; and Adjunct Professor, Baruch College ( C.U.N.Y.), Rutgers School of Public Health, and Rutgers School of Public Affairs and Administration.
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