Postgraduate Assembly in Anesthesiology

The 62nd annual PGA has come to a close in NYC.  I would love to say it was a fabulous exchange of ideas regarding the profound leaps of progress made in the field of anesthesia.  In my humble opinion it wasn't.  I suppose its a sad commentary on the state of anesthesia research but hey who am I to judge, all I contribute is this piddly blog.

The technical exhibits were also less than stellar this year...a few new high tech ways to get the tube in the right hole, a funky new gel LMA, a LOT less swag than in previous years.  Most of the talk seemed to be about capital preservation, exit strategies and how to stick needles in people safely.  


Not the most productive few days, but hey at least we dodged some bullets.  See yall at the ASA.

Anesthesia and Gastroenterology....parasites, greed and symbiosis.

The GI-propofol debate rages on. This week the GI societies presented yet another study regarding the safety and effectiveness of GI supervised-RN-administered-propofol sedation. Summarized nicely here.

This is truly one of the uglier sides of business of medicine. Anesthesia as a whole is in the business of safety under sedation. Not sure anyone can argue that we are the best at it because that is ALL we do...unless you are the CRNA in the previous posting....I digress. If the money involved weren't so enormous there would be no issue. When (and not if) the reimbursements dry up for elective endoscopies the debate will be over.

Couple factoids I've come across about the debate I find disturbing:

• The additional costs of an anesthesia provider to elective endoscopy is estimated to be in the billions every year.
• GI endoscopists nationwide have begun creating corporations which employ anesthesia providers at a low hourly rate and keep the collected reimbursement for themselves...uh conflict of interest anyone?
• Providers who specialize in only propfol sedation for endoscopy are the highest earning anesthesia providers.

Once the biomedical engineers perfect the pill-cam this whole debate will be moot anyway. Or is it the radiologists that'll end it....either way we'll be out of the picture in the not-too-distant future.