Snapping Defeat From The Jaws Of Victory

What is it close opthalmologists together with cataract surgery?  If in that place were always a success storey inwards the Blue Planet of medicine it is this:  Better together with to a greater extent than consistent character than years agone delivered at a remarkably lower cost.  But it seems similar the profession insists on ways to motility into to a greater extent than expensive.

I conduct maintain discussed i such "innovation," the femtosecond laser, together with the thousands of dollars inwards straight consumer terms that it entails together with that has been authorized past times CMS, the Medicare agency.

Now Michelle Andrews at Kaiser Health News summarizes a recent NEJM article.  Excerpts:

Requiring patients to instruct blood function together with other tests earlier undergoing cataract surgical physical care for hasn’t been recommended for to a greater extent than than a dozen years. There’s expert argue for that: The amount surgical physical care for mostly takes less fourth dimension than watching a rerun of “Marcus Welby, MD” — merely xviii minutes, on average. It’s equally good incredibly safe, amongst a less than 1 portion conduct a opportunity of major cardiac problems or death.

Yet to a greater extent than than one-half of Medicare patients received at to the lowest degree i pre-operative examination inwards the calendar month earlier undergoing surgical physical care for to take away cataracts inwards 2011, a recent study found.

“Their patients [tested] were no sicker or older,” says Catherine Chen, an anesthesiologist at the University of California, San Francisco, together with the atomic number 82 writer of the study. “It suggests that it’s habit or practise patterns.”

Cataract surgical physical care for used to conduct maintain a few hours together with take full general anesthesia. In those days, preoperative testing made to a greater extent than sense, says Chen. Now people ofttimes have alone a topical anesthetic amount driblet to numb the amount or sometimes a local anesthetic that may include a sedative for relaxation.

But question shows that today, pre-operative testing for cataract surgical physical care for doesn’t outcome inwards fewer adverse events or ameliorate surgical outcomes, regardless of a patient’s health, says Chen.

Where is the American Academy of Opthalmology on such issues?  Who stands for the patients?  Where is CMS, together with why create they allow this blueprint of testing?  Who stands for the costs incurred past times the American public?

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