Abstract
Background
Flexible endoscopy is a vital component of gastrointestinal surgery. It has and will replace many of the surgical procedures now commonly performed. Flexible endoscopy, unfortunately, is not an integral part of surgical residency training based on resident operative experience as reported by the Residency Review Committee. Moreover, general surgeons have deferred the practice of flexible endoscopy to the gastroenterologists because of concerns over turf battles and referral patterns. The purpose of this study was to assess the overall case load and the economic impact of flexible endoscopy on the practice of general surgery in a community hospital setting.
Methods
This retrospective review was performed over a 6-month period. The total cases and the total billings of inpatient and outpatient procedures for a group practice of five general surgeons in a community hospital were evaluated. The billings were the actual charges based on current procedural terminology (CPT) codes for these procedures using the Medicare fee schedule.
Results
Of the 2,159 procedures performed, 1,154 involved flexible endoscopy cases accounting for 54% of all cases (1,154 of 2,159) performed from February 1, 2003 to July 31, 2003. Flexible endocopy accounted for 43% of the total charges. A. total of 46 surgical procedures and 216 future endoscopies were generated from the flexible endoscopic procedures. Future endoscopic cases were for surveillance of colonic neoplasia and Barrett’s esophagus.
Conclusions
Flexible endoscopy contributed to a major portion of the caseload and revenue generated by the general surgery group studied. The overall impact of flexible endoscopy is even greater than reported because of the future endoscopic surveillance cases or surgical interventions generated on the basis of endoscopic findings.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Residency Review Committee for Surgery Resident statistics summary, reporting period 2002–2003 Retrieved at the ACGME website: http://www.acgme.org
MA Liberman (2003) ArticleTitleColonoscopy: why general surgeons are excluded Surg Endosc 17 1971–1973 Occurrence Handle14569450
JM Marks (2001) ArticleTitleEvaluation of endoscopic and laparoscopic training practices in surgical residency programs Surg Endosc 15 1011–1015 Occurrence Handle1:STN:280:DC%2BD3MrlvVCnuw%3D%3D Occurrence Handle11443445
JM Marks (2003) ArticleTitleWhy surgeons need to do flexible endoscopy Semin Laparoscopic Surg 10 1–2
J Ponsky (2002) ArticleTitleThe economic impact of flexible endoscopy in a large academic surgical department Surg Endosc 16 1456–1458 Occurrence Handle12063577
J Ponsky (2003) ArticleTitleFuture trends in flexible endoscopy Semin Laparosc Surg 10 49–54 Occurrence Handle12695810
TA Stellato (1996) ArticleTitleFlexible endoscopy as an adjunct to laparoscopic surgery Surg Clin North Am 76 595–602 Occurrence Handle1:STN:280:BymB283is10%3D Occurrence Handle8669018
WP Ritchie (1999) ArticleTitleWork loads and practice patterns of general surgeons in the United States Ann Surg 230 533–543 Occurrence Handle10522723
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Nimeri, A.A., Hussein, S.A., Panzeter, E. et al. The economic impact of incorporating flexible endoscopy into a community general surgery practice. Surg Endosc 19, 702–704 (2005). https://doi.org/10.1007/s00464-004-8952-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-004-8952-4