The Cost of Variation: Why Poor-Quality Colonoscopy is the Most Expensive Colonoscopy
The whole meeting's frame, planted in its highest-volume territory. Quality variation is expensive because its failures — interval cancers, repeats, missed lesions — land downstream where they cost the most.
Running order (indicative)
- Head
- Dr John Andersonanchors the studio throughout
- Talk 1
- Prof Ernst KuipersView From the Minister's Chair: Value, Outcomes and What Healthcare Owes Its Payers
- Talk 2
- Prof Michael BretthauerWhy the Cheap Colonoscopy Is the Expensive One
- Live case
- Dr Lobke DesomerProf Gianluca EspositoColonoscopy with known small polyps / surveillance — withdrawal & inspection quality
- Discussion
- Allremaining session time
The session, as written
Opening keynote — View from the Minister's chair. (Ernst Kuipers). The big picture, deliberately: value in healthcare is measured in outcomes per unit of resource, not procedures per list — and nobody has yet examined the cost–value equation closely. From the CEO's chair, the Minister's chair and the ICHOM board: professionals will increasingly be held responsible for value for money. He focuses down to colonoscopy and screening only at the end — the segue built for the next speaker.
Lecture 2 — Why the cheap colonoscopy is the expensive one. (Bretthauer). Missed lesions, interval cancers and repeat procedures — the economic case for doing the examination properly the first time. Preparation enters here as the forgotten quality indicator: a Boston score on every report, early repeat when inadequate, because the cheapest failure to prevent is the examination that has to be done twice.
Live case — quality narrated in real time. A surveillance colonoscopy with the withdrawal, fold examination and inspection technique spoken aloud — prep scored on camera — and the audience scoring the examination as it happens.
