The prevalence of gastrointestinal procedures has grown at a considerable rate in the last few decades with over 20 million endoscopies performed in the United States each year. Nowadays, it is recommended that all Americans undergo a screening at the age of 50, and repeat the procedure every 10 years.
With the growth rate expected to continue as a more health-conscious public ages in record numbers, the debate over the usage of conscious sedation versus full anesthesia has become a hot-button topic. A recent New York Times feature presented cases of several patients undergoing endoscopic procedures using full anesthesia and being saddled with exorbitant anesthesia bills that they did not expect. The controversy not only focuses on the pricy costs, but also maintains that many of these patients would be perfectly fine undergoing conscious sedation, a far-less expensive option than administering an anesthetic like Propofol.
Robert C. Goldstein, MD, chief medical officer of Somnia Anesthesia, supports the use of Propofol during a colonoscopy. However, he cautions that there is still an unethical practice of anesthesiologists and gastroenterologists paying for referrals, generating high costs for consumers when an anesthesiologist choose to remain out of network.
Dr. Goldstein also says, “Although using a general anesthetic administered by an anesthesiologist or nurse anesthetist may mean an added cost to the patient or insurance company for a colonoscopy, the health and financial benefits far outweigh the costs.
“In multiple studies conducted over the past few years, results have shown that use of a more potent drug, such as Propofol, for inducing anesthesia improves the polyp detection rates and cancer diagnosis rates, sometimes by as much as 43%. These early detections not only save lives, but often spare patients and insurance companies the long and costly process of cancer treatment.”