Endoscopes: Easily Managing Costs

By Marc Levinson

Gynecological and urological physicians behave similarly: They both operate within hospital and outpatient facilities/ambulatory surgery centers, as well as managing viable office practices. This dichotomy creates special needs regarding anesthesia issues, types of procedures performed, personnel support needs, surgical space requirements, and medical/surgical equipment acquisition necessary to perform a myriad of diagnostic and operative procedures. These five highlighted decision-making requirements have a major impact on the type of equipment selected and each requirement is further explored below:

o Anesthesia issues related to patient tolerance and facility capability and preparedness

o Invasiveness of the procedure/surgery

o Healthcare personnel support

o Surgical space limitations

o Acquisition cost and maintenance of medical devices balanced against procedure reimbursement

Anesthesia is critical to which procedures can be performed in what healthcare setting. In an office setting, for example, the patient is awake and therefore great care must be taken to ensure patient discomfort is minimized. Therefore, it is critical to only perform procedures in settings (i.e. office practice) where that facility is appropriately equipped (with the necessary safeguards) to manage those procedures in a safe and comfortable environment. As anesthetic new discoveries and applications have evolved, it has allowed more and more minimally invasive procedures to be performed in an office setting where procedural efficiency is enhanced (relative to hospitals and ambulatory surgery centers) and patient acceptance/compliance is now the new norm.

And the necessity and degree of anesthesia required will also dictate how invasive a procedure can be performed in the respective proper setting. It is clear that performing a procedure in an office setting holds many advantages (e.g., less time-consuming, reduced administrative requirements, lower delivery costs, etc.) over inpatient or outpatient healthcare facilities. However, there are many surgeries that still require general anesthesia and therefore must be peformed in an appropriate setting (i.e., hospital or surgery/ambulatory center) to ensure patient safety.

It is also important to understand what healthcare support personnel are needed to perform a procedure. Yes, it is much more convenient to perform many procedures in an office where only one and possibly two support personnel are sufficient to manage the procedure. But there are still numerous invasive procedures where a team of nurses, complementary healthcare personnel, and possibly assistance from other physicians are required in executing a successful surgical procedure.

In a healthcare setting, space is always at a premium. Unfortunately, because of the invasiveness of the procedure, the number of personnel required, and the amount of medical equipment utilized, there is no choice but to perform these procedures in an outpatient or hospital facility. But as new anesthetics and techniques emerge, medical equipment innovates, and surgical protocols change, it will be possible to transfer some procedures to an office setting.

Lastly, medical device equipment as it relates to a particular surgical procedure may require more or less space and personnel depending on equipment needs and surgical procedure. Additionally, the cost of this equipment and maintenance may make it prohibitive to perform a procedure in an office setting. These limitations, for now, provides sensible guidance as to where a procedure will be performed and what equipment to purchase.

This is the EndoVentions booth.

Marc Levinson is CEO of EndoVentions Medical, Inc.