In-Office Transnasal Esophagoscopy Appears Safe, Cost-Effective

Dr. Cole said that the decision making as to which patient gets the procedure differs among the doctors in the group, and that the indications for performing the procedure have been declining. One doctor will be a little more amenable to scoping than another, while another doctor may want to try another course of treatment before moving to scoping, he said.

Exactly where the procedure would fit into the private practice setting was unclear, Dr. Cole admitted. The literature is all over the place on this. In our office dysphagia or odynophagia is a clear indication to do this. I think, and our numbers indicate this, that we are reducing the scoping when we are able to identify pure cases of laryngopharyngeal or gastroesophageal reflux disease.

Merritt Seshul, MD, another member of the Carolina center in Hickory, said, We began to pare back our use as we refined out indications as to when we do it.

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