I was an academic pediatric neurosurgeon at large medical centers in the United States for many years before moving to Kenya 2 years ago to do and teach pediatric neurosurgery. It seems that in those 2 years a sea change in medical care has occurred in the United States.
Six months after we moved to Kenya, my wife, a pediatric nurse practitioner, developed biliary colic and underwent an uneventful endoscopic cholecystectomy in our Kenyan hospital. In the year following the cholecystectomy, she had several bouts of pain like the biliary colic and a diagnosis of sphincter of Oddi spasms was considered. We decided to return to a medical center in the United States with a gastroenterologist who had special expertise treating people with sphincter of Oddi problems.
Albright L. The Nonattending Physician. JAMA Surg. 2013;148(8):702. doi:10.1001/jamasurg.2013.369