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Re: Ultrasound as part of the normal exam From: Efrain Ramirez (eramirezt@coqui.net) Sun Mar 13 09:18:36 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: DoctorJoe@aol.com: "Re: Interesting case." Previous message: R. Daniel Braun: "Re: Interesting D&E lawsuit Two more cents, and I'll raise you 2 more..." In reply to: Don Miller: "Re: Ultrasound as part of the normal exam" Next in thread: Don Miller: "Re: Ultrasound as part of the normal exam" Reply: Don Miller: "Re: Ultrasound as part of the normal exam" Reply: art fougner, md: "Re: Ultrasound as part of the normal exam" IMHO there should be some kind of reasoning for performing a procedure – is it “mandatory” to perform an U/S to 19 y/o – 120 pounds, slender – came in for a routine Pap - adequate bimanual – no symptoms - ?? Ah! And -- in just 15 seconds – that’s fast – must have an extraterrestrial machine/printer of the third kind.. I understand that in a chubby or uncooperative patient or a patient with anovulatory cycles – pain – *whatever* !! --- doing an U/S you can get additional information that might help you in the diagnosis/management of the patient – fine!! > At Sun, 13 Mar 2005, Don Miller wrote: > >At Sat, 12 Mar 2005, Garry E. Siegel, M.D. wrote: >> >>I seem to remember a thought a while ago that doing a vaginal scan >>during a routine pelvic exam should be commonplace. > >It's more than a thought. Steven Goldstein at NYU has been advocating >and doing it for over a decade or two (heard him last year at ACOG). It >takes about 15 secs to survey the pelvis and current machines are about >the size of a laptop and portable. And you know in 15 secs what's going >on. > >IMHO, as someone who personally performed 1,000 ultrasounds a year, >vaginal and abdominal, vaginal ultrasound, as an extension, or the >primary component of a GYN visit should be the standard of care today. >The only reason it isn't (and probably won't be for a decade or so) is >because folks don't like to change their routines (and it's NOT the >money). Many are apparently satisfied thinking that they're actually >accomplishing something when they do a bimanual exam on a 300 pound >woman. > >There are of course the hazards and precautions whenever you talk about >routine screening. Any kind of routine testing will have false >positives and maybe unnecessary interventions in the hands of those who >are unaware of those kind of things (e.g. how many thousands of women >had emergency C-sections for variable decelerations when FHR monitoring >was introduced?). US has been advocated for ovarian cancer screening in >menopausal and not generally recommended in all populations because of >public health and cost reasons - not for delivery of best care reasons. > >-- >Donald W. Miller, Jr., MD, FACOG >eNATAL, LLC >http://www.eNATAL.com > -- I think I will do nothing for a long time but listen, And accrue what I hear into myself...and let sounds contribute toward me. ~walt whitman~ Next message: DoctorJoe@aol.com: "Re: Interesting case." Previous message: R. Daniel Braun: "Re: Interesting D&E lawsuit Two more cents, and I'll raise you 2 more..." In reply to: Don Miller: "Re: Ultrasound as part of the normal exam" Next in thread: Don Miller: "Re: Ultrasound as part of the normal exam" Reply: Don Miller: "Re: Ultrasound as part of the normal exam" Reply: art fougner, md: "Re: Ultrasound as part of the normal exam"

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