Today, I had one of my upteen ESI's. This was my first one since 2006/7, so I was pretty much prepared going in from what I assumed it to be... WRONG
- No food/water 12 hours before procedure
- Procedure performed in an operating like environment
- Slightly sedated
- Constant monitoring of vital signs
- Needle assisted by fluoroscope, entire procedure 30 minutes
- Brought out to a recovery room
- Waited about 30 minutes before leaving
- Required a driver
- No diet restrictions
- Procedure performed in doctors office (more than just a table)
- Area numbed, no sedation
- No monitoring of vital signs
- Needle assisted by fluoroscope, entire procedure 10 minutes (much less time)
- Off the table out the door (still no driving, but why?)
I spoke to this doctor in depth about all of these changes. He told me, that basically, it was insurance policies and rules that made all these changes.
- Insurance will not cover patient sedation. If this is required, an anesthetist needs to come in and the patient will be required to pay for those charges.
- EOB (Doctor charges) apprx average $108 today, $1,200 several years ago.
- Lack of sedation means many patients experience more discomfort and pain the first 24 hours.
- One good thing, Insurance companies are also beginning to disallow doctors from performing procedure without fluoroscope assistance.
Ok, so the bottom line....
In his estimation have these changes had any impact on the over all success of ESI;s??
(Luckily, this is another doctor I've know for almost 10 years, so, I know I am getting no run-around)
No , not really, I am still seeing more success with lower lumber ESI's then other spinal areas. Plus, with the insurance changes, there has been some backing off the 3 ESIs per year. Now, they can be done more often, which many times can result in better results.
Wow, this was an eye opener for me... I gotta start catching up on some newer technique and procedures
Ron DiLauro Spine-Health System Administrator I am not a medical professional. I comment on personal experiences