Boston Endoscopy Center

The stuff was fantastic. From the reception through the walk through of the process, the different nurses who took the time to explain and check on me up to Dr. Kaplan whom preformed the procedure. The location is great with very easy access in/out. Overall from the moment I left my home till I was back it was a smooth 2 hours and 15 min. I wish to thanks the wonderful and very dedicated team there thst operates flawlessly.

I applaud the dedication, engagement, and professionalism of Dr Douglas Horst & team at Boston Endoscopy Center in Wellesley Hills, MA—likely one of the few practices in Massachusetts exceptionally well-prepared to perform sedation-free colonoscopies. Though only about 1% of U.S. patients request the procedure sedation-free, the practice is standard in Finland, routine in Italy, common in Japan, and likely also common in the UK. My logic for not going under? Granted, the health risks of sedation are negligible for those without sleep apnea, obesity, heart, lung, or kidney disease. But even if you’re healthy, why take an unneeded risk? And I figure foregoing sedation is good practice, in case I later develop one of the above conditions. In that scenario, forgoing sedation during a colonoscopy (and perhaps during other procedures, when plausible) could avoid further health risks. The winning formula for my sedation-free colonoscopy was Dr. Horst’s preparation: a. Ensure the patient is prepared for at least mild discomfort (though I experienced virtually none). b. Establish an intravenous contingency plan in case sedation is needed. c. Station a nurse beside the patient to monitor patient-reported pain levels. d. Ensure the nurse is highly engaged by conversing with the patient, to monitor pain even in a tight-lipped stoic, and potentially get the patient’s mind off such an invasive procedure. This process worked well for me. Though I was supposed to describe to the nurse any pain on a scale of one to ten, that professional also became my de facto sedative, proactively engaging me in discussion. Since we both happened to be bookish, we had plenty to talk about, a welcome diversion. Another tip: Avoid the live video screen depicting your own colonoscopy. Not watching a camera snaking its way through your intestine has a remarkable way of removing any remaining discomfort. If many more colonoscopy patients skipped sedation, we’d all benefit through: -Billions of dollars of annual savings to the healthcare system (by some estimates, sedation costs ~$300–$1,000+ per procedure, so we’re talking billions of dollars in savings). -Potentially reduced out-of-pocket patient costs (depending on your insurance). -Reduced unpaid caregiver driver support: Driving a patient to and from the medical office before and after sedation takes ~3–5 hours per patient. If most people chose sedation-free colonoscopies, we’d generate an estimated annual “unpaid caregiver” time savings of ~30–60 million hours. Most of us don’t have to be stoics to skip sedation for a colonoscopy. We just need to find endoscopy practices well-versed in quality, sedation-free patient care. By making it easy to forgo unnecessary medical procedures, Dr. Horst and his team at Boston Endoscopy Center are serving as a model to help redress a problem that has bedeviled policymakers and economists for decades: our nation’s exorbitant healthcare costs. --Tim D. Stone