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At 16:03 08/12/1996 +0000, Steve wrote: >I am waiting for our 3/4 year FH budget figures, but I suspect that our >budget has taken a pounding. Largely because several patients have had >several Lithotripsy procedures. The frustration is that they all seem to >be then having formal procedures. One has had 6 goes at stones in CBD, >now is going to have an open cholecystectomy. I don't understand why he >didn't have this in the first place. Any ideas where I can find some >sensible cost quality work. > >It seems to me that lithotripsy is an expensive multiple procedure. Each >procedure seems to have knocked each patient about, 2 of them have >refused further procedures. What are the risks of this new procedure cf >old fashioned single operative techniques. It seems that alternatives to >lithotripsy have been available to all of these patients. > >Am I behind times, or is it reasonable to question this. > Certainly not. This is a *quality* question. Ask the unit for the results of their clinical audit of the service;-) If they haven't ( ;-) ), then set your own quality standards for the contract such as one redo only then they have to pay for the open cholecystectomy, etc. Good luck. Or just stop referring for it as it doesn't work, in "your" unit. -------------------------- Dr David J Plews email: [log in to unmask] %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%