Training in Laser Bronchoscopy and Proposals for Credentialling: Problems Encountered During and ArrER Laser Bronchoscopy Courses (Part 3)

The data in Table 1 suggest that most laser bronchoscopy course attendees practice in hospitals that already own or plan to acquire YAG lasers soon after the physician attends such a course. On some occasions, the decision to purchase a laser comes at the behest of a hospital administrator who is interested in maintaining an advantage for high-tech visibility in a competitive marketplace (personal communications from several laser bronchoscopy course attendees). Many times, of course, it is one or a few enthusiastic physicians who persuade their hospital leaders for similar reasons.
The data from Table 1 also suggest that most physicians seek formalized training before attempting a new procedural skill, and that many physicians decide against (or are prevented from) performing laser bronchoscopy even after attending a formal training course. The information available does not permit analysis of how decisions are made to acquire lasers, and whether a system for sharing expensive laser equipment was developed, etc. Also not apparent from the data are whether other wavelengths (C02, argon-pumped tuneable dye) were developed along with YAG laser bronchoscopy.
The third recommendation from the guidelines proposed by the American Society for Laser Medicine and Surgery is that course attendees “ . . . should initially do simple cases.” This creates a real dilemma as one begins laser bronchoscopy, because most patients who present with a need for this service have recurrent bronchogenic carcinoma. buy antibiotics online