What’s a “Good” Colonoscopy?
No bad jokes. I’m serious.
I’ve reached the wonderful age at which I’m supposed to have this test as part of my general health care. I had one 10 or so years ago, so I know what I’m in for. The best thing to be said is that the drugs gave me a deeply restful nap.
The first time, I went wherever my doctor told me to go. This time, I have a couple of references from my doctor, but I’m going to ask some more questions before I decide whom will perform the delicate procedure.
I’ve talked to a few docs and looked at some websites. Here’s my list of questions. Is there anything I should add?
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.
Shopping for a colonoscopy could take weeks, not including the procrastination factor.
Martha Bebinger covers health care and other general assignments for WBUR. She also created and frequently contributes to HealthCareSavvy, WBUR’s community of patients starting to shop for health care. She was a Nieman Fellow at Harvard University, class of 2010.