On WBUR Boston’s Healthcare $avvy: The Health Care Consumer Experience website, Martha Bebinger is determined to be more informed before she goes in for her second colonoscopy (the other one was 10 or so years ago). So she’s posted a list of questions she wants answered and she’s asking for suggestions for amendments to the list. Here it is so far:
1) About the prep – what will give me the best cleaning out with the least discomfort? There’s no point in going through all this if the doc can’t see what s/he is doing.
2) What’s the doctor’s detection rate? One medical society (the American Society for Gastrointestinal Endoscopy) says a doctor should find a polyp in 25% of men and 15% of women (why the difference?), but I know that some physician groups around Boston say the average is 40-50% among docs who really look for polyps.
3) How much time does the doctor spend, on average, on the test? I think more is better, is that right?
4) Does the doctor always get to the end of the colon? OK, I may not be able to ask this. One website says I should ask the doctor to take a picture so that I know they got to the end – but this is too gross and how would I know what to look for anyway?
5) How many colonoscopies does the doc do each year? The avg., according to the ASGE, is 750. Again, more is better.
6) What’s the doc’s error or complication rate per 1,000 patients. I do not want to see blood afterward, although if the doc finds and snips a polyp, I suppose I will.
7) One site says I should ask about the procedures for disinfecting equipment. Really? Isn’t flawless disinfection standard procedure?
8) And finally, I’ll ask how much each doc charges. I’m supposed to be looking for the best test at the best price.
Of course, a more basic shared decision-making question is: why colonoscopy instead of one of the other methods of colon cancer screening?
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