Just fyi, the sedation is usually not medically necessary. I have had it (as well as a colonoscopy) done without, just got a spray to numb the throat for a short while. It’s not pleasant, but I found it bearable and it’s much nicer to just walk out and drive home on your own. If necessary I could still have told/signaled that I want sedation after all during the procedure. Propofol works within less than a minute. In that case they would have called someone to pick me up.

That said, I do live in Germany, so money does not play as big a role as in the US when it comes to healthcare. And the doctors and their staff were exceedingly nice and caring.

Maybe, if you believe you can bear it, and if acid reflux does not make it painful, ask to do it without sedation next time.

I’m lucky to have “inherited” my parents’ doctor. She is extremely compassionate and gets deeply involved in you and your concerns on every visit. So much so that she is infamous for being behind schedule, to the point where we fully expect to wait for an hour to see her after the scheduled appointment time. She makes up for it by talking with you for as long as you want.

She also hasn’t accepted new patients for like 4 years… so yeah, I guess all the good ones are taken.

My doctors have been incredible, at least those I've had for the past 4 years or so. Including my gastro.

They take the time to talk to me, they remember who I am, and my gastro is even a direct recommendation from my primary doctor (my gastro is his gastro).

I've been going to gastroenterologists for literally decades, the one I got a couple years ago is the first to finally find the issue, and I've been reflux free. I doubt he'd do a transnasal either - its more limited in scope (hah!), you're only getting part of what an endoscopy can do. That's why its not transnasal endoscopy, its transnasal esophagoscopy.

And that's probably why. Why they wouldn't just say that, I don't know. There are lots of places that will do transnasal esophagoscopy throughout the US, so it isn't a procedure that is just "not done here" or anything, its not as popular in general because its just not as thorough of a procedure.

I hope you find a doctor in the future that takes the time to explain things though.

Edit: Forgot to mention, the hospital system by me is a non profit. Only differentiator I am aware of, and its a great hospital system.

Judging from my own doctors experience, they are way overbooked. Can’t get a personal experience when they gotta see a couple dozen more people the same day.

Afaik it has to do with licensing regulations and litigations...

A doctor is licensed to practice by the state, and must carry insurance on a state-by-state basis to acquire a license to practice.

The problem is that if you get sued 3 times you get blackballed by the insurance industry in your state and the insurance companies won't insure you.

You see a lot of doctors moving states often, its often because they became un-licensable in their former areas.

I have limited industry experience and have talked to quite a few doctors who were indeed a bit distant and hands-off in their practice for this reason alone.