Researchers claim that older patients are at increased risk of adverse events following outpatient colonoscopy, findings they say could influence cancer-screening recommendations to individuals with limited life expectancies.

A review of 53,220 elderly patients who underwent colonoscopy between July 2001 and October 2005 revealed that the overall risk of adverse events following colonoscopy is low, but that patients between 80 and 84 years of age were at a 75% greater risk of such serious gastrointestinal complications as bleeding and bowel perforation than patients aged 66 to 69 years were.

Additionally, patients having polyps removed were at a higher risk of complications than patients undergoing screening or diagnostic colonoscopy were. Those presenting with history of co-morbidities such as diabetes, stroke, chronic obstructive pulmonary disease, atrial fibrillation or congestive heart failure demonstrated a significantly higher risk of adverse GI events, according to the study.

The researchers believe their findings, which appear in the June 16 issue of the journal Annals of Internal Medicine, support the U.S. Preventative Services Task Force's recent conclusion that the potential benefits of colorectal screening decrease with a patient's advancing age due to competing causes of mortality.

"Our (research) should aid clinicians in making age- and health status-appropriate recommendations to elderly patients for colorectal cancer screening, especially given the availability of Medicare coverage for alternative colorectal cancer screening tests that are less risky than colonoscopy," conclude the authors.

Daniel Cook

When compared to national statistics, bariatric surgeries are "significantly safer than common operations like hip replacement and gallbladder removal," according to researchers.

Studying data on nearly 58,000 obese patients, they found that the weight-loss procedures have a complication rate of only about 11% and a mortality rate of 0.135%, making them as safe as many routine surgeries. The most commonly reported post-discharge complication was post-operative nausea and vomiting.

For the study, presented at the annual meeting of the American Society for Metabolic and Bariatric Surgery last week, Eric J. DeMaria, MD, vice chair of the surgery department at Duke Medical Center in Durham, N.C., and colleagues mined data from the Bariatric Outcomes Longitudinal Database.

The database compiles information from 650 surgeons and 350 surgical facilities participating in the non-profit Surgical Review Corporation's Bariatric Surgery Centers of Excellence program.

Kent Steinriede

Physician compensation did not rise above inflation between 2007 and 2008, says a survey that shows salaries for both primary care docs and specialists rising only slightly more than 2 percent during that time.

When those figures are adjusted to reflect the 3.8% increase in the U.S. Consumer Price Index for 2008, the compensation actually decreased 1.73% for primary care physicians and 1.59% for specialists, according to the Medical Group Management Association's Physician Compensation and Production Survey: 2009 Report Based on 2008 Data. The report, based on data voluntarily submitted by nearly 50,000 providers, breaks down the numbers for several specialists:

Regardless of how much you like your job, there will come a time when you just don't feel like doing it anymore. The pressure of managing a surgical facility, of dealing with surgeons, staff and patients, of dueling with vendors, insurers and regulatory agencies will simply become too much. This week we want to know how long it takes before a surgical facility manager experiences career burnout. After 1 or 2 years, 2 to 4 years or never?

Go to our home page to register your opinion and see real-time results.

Dan O'Connor