Journal of General Internal Medicine

, Volume 32, Issue 7, pp 813–814

A Preoperative Medical History and Physical Should Not Be a Requirement for All Cataract Patients

Perspective

Abstract

Cataract surgery poses minimal systemic medical risk, yet a preoperative general medical history and physical is required by the Centers for Medicare and Medicaid Services and other regulatory bodies within 1 month of cataract surgery. Based on prior research and practice guidelines, there is professional consensus that preoperative laboratory testing confers no benefit when routinely performed on cataract surgical patients. Such testing remains commonplace. Although not yet tested in a large-scale trial, there is also no evidence that the required history and physical yields a benefit for most cataract surgical patients above and beyond the screening performed by anesthesia staff on the day of surgery. We propose that the minority of patients who might benefit from a preoperative medical history and physical can be identified prospectively. Regulatory agencies should not constrain medical practice in a way that adds enormous cost and patient burden in the absence of value.

KEY WORDS

cataract surgery preoperative evaluation risk assessment 

Copyright information

© Society of General Internal Medicine 2017

Authors and Affiliations

  1. 1.Department of OphthalmologyJohns Hopkins School of MedicineBaltimoreUSA
  2. 2.Armstrong Institute for Patient Safety and QualityJohns Hopkins MedicineBaltimoreUSA
  3. 3.Departments of Anesthesiology & Critical Care Medicine, Surgery, and Health Policy and ManagementJohns Hopkins UniversityBaltimoreUSA

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