In Dr. Robert L. Barbieri ’ s December editorial, “ Massive obstetric hemorrhage: High-and low-tech tools , ” he posed the following question: “ Should all obstetric services have access to the high-technology interventional radiology procedures? ” My answer: definitely not; it is too expensive.
Why are health-care costs spiraling? Because of the frequent introduction of new, high-tech (and therefore expensive) techniques. Is there any proof that the balloon, compression sutures, and artery ligation are inferior to embolization? Until there is, I avoid recommending radiological techniques.
Here ’ s another important question: Do we really want experienced radiologists ready to embolize in every community hospital? The result will be that our hysterectomies disappear into their intervention rooms, and I am strictly against that.
On a lighter note, thank you for taking such great care of OBG Management You succeed in selecting truly relevant topics, which are then presented just right! I also appreciate the “ Fast Track ” ; it is so nice to go straight to the important places.
Matthias Muenzer, MD
Medford, Mass
Dr. Barbieri responds:
We thank Dr. Muenzer for his kind words concerning the “ Fast Track ” feature in OBG Management . The editorial staff recognizes that our readers have exceptional pressures on their time and need to have clinically important information presented as concisely as possible. The “ Fast Track ” was specifically designed with this in mind.
Regarding the December editorial, I agree that 2 factors that should dampen our enthusiasm for introducing interventional radiology services in every hospital that provides obstetrical services are the multimillion-dollar cost associated with interventional radiology and the potential impact of its widespread use on the high-acuity case volume of obstetricians.