That's funny.
Posted on 12/15/2006 10:45:26 PM PST by neverdem
For years, patients and many doctors assumed that a colonoscopy was a colonoscopy. Patients who had one seldom questioned how well it was done. The expectation was that the doctor conducting the exam would find and cut out any polyps, which are the source of most colon cancer.
But a new study, published today in The New England Journal of Medicine, provides a graphic illustration of how wrong that assumption can be, gastroenterologists say. The study, of 12 highly experienced board-certified gastroenterologists in private practice, found some were 10 times better than others at finding adenomas, the polyps that can turn into cancer.
One factor distinguishing the physicians who found many adenomas from those who found few was the amount of time spent examining the colon, according to the study, in which the gastroenterologists kept track of the time for each exam and how many polyps they found.
They discovered that those who slowed down and took their time found more polyps.
“We were all experienced colonoscopists,” said Dr. Robert L. Barclay, a member of the group that participated in the study, Rockford Gastroenterology Associates in Rockford, Ill. “We had each done 3,000 or more colonoscopies before the study.”
Yet, Dr. Barclay added, “if our group is representative of an average group, you will see people who take 2 or 3 minutes and people who take 20 minutes” to examine a colon. Insurers pay doctors the same no matter how much time they spend. Gastroenterologists say colonoscopies can help prevent colon cancer, but warn that there is a pressing need for better quality control.
Still, the experts say, the onus remains on patients to ask for data on how proficient their doctors are.
“Patients assume that one colonoscopist is as good as another,” said Dr. Douglas K. Rex, a gastroenterologist...
(Excerpt) Read more at nytimes.com ...
Just enjoy the hell out of your next 30 or 35 years! Your time will come.
That's funny.
Um, I am a gastroenterologist.
Any endoscopy nurse can tell you who consistently gives a good exam and who doesn't. One guy will line up 15 patients and be done in about 3 hours. He can't find squat but he lives in a very nice house. Another fellow routinely "dry-labs": says he's looked at the entire colon when he hasn't. Again, it's a cash issue.
My advise: if you can, ask an endoscopy nurse for your colonoscopy referal, not your doctor. Caveat derriere.
I was watching it REAL TIME -- as it was being performed, for both procedures. It a show one shouldn't miss.
I had heard all the horror stories of guys after their procedures -- swearing they would never do it again.. But after having experienced it myself - they had to have been real sissies or had an extremely low tolerance for pain. They too had the anesthesia - and still claimed pain.
Personally, I believe they worried themselves into pain by the expectation of pain. Focus on what's going on and learn from the experience..
That being said -- even MORE interesting but involving more anxiety - was watching my own angioplasty while the Doctor was searching for the cause of my heart attack and the damage it did to my heart. That is a a procedure where they insert the camera probe into an artery in your groin -- and then you have to turn, twist, raise arms, lean from side to side to assist the doctor in getting the camera where he wants it.. That damned procedure took more than an hour and I was exhausted at the conclusion -- but alive. At least I learned that my problem would not require a stent, surgery, pace maker or anything more that a change of life style, diet and more exercise.
The spookiest part was when the Doctor asked me to sign a release stating that I was informed that 1% of patients DIE from the damned procedure.. I asked him how he was doing with the odds and he just smiled -- that was reassuring. He also said a much larger percentage die after they refuse to sign the release authorizing the procedure... THAT was the selling point.
Semper Fi
Punk Doctors and Insults....
Yep, they do step in it from time to time....
Until they get to know you, and learn why your body looks such a mess.
The Doctor I have now is quite young - I WANT young doctors, and according to my wife -- he's a "heart breaking gorgeous" young Scotsman. Uh, She changed Doctors and transferred to mine... I need to keep an eye on that situation.
Semper Fi
Make up your mind :-)
... I had one recently, at age 57. The doctor told me afterwards that he had removed one polyp, and that I should have another exam in 10 years.
Then, I got a card in the mail with various categories checked off, indicating that this polyp was "pre-cancerous" and that I should have an exam in FIVE years. So, did a biopsy reveal something the doctor didn't know? or what? I tried calling back, but I hit an automated answering barrier, so I figured I have five years to think about it. I tried to impress the five-year date in my mind, but I forget it already. ... OK sixty two! "... if man is still alive ..."
L
Perhaps the Doctor spoke to you before receiving the lab analysis of the polyp.. Also, "pre-cancer" is not the RED flag.....just YELLOW the way it was explained to me.
My test went "clear" -- yet they told me to return in 5 years..
I suspect the good Doctor likes to replace his Mercedes on a 5 year plan -- no longer the 10 year plan.
Semper Fi
Heh. Heh. "Onus". He said "onus". Heh, Heh.
Oh, wait...
If you had a polyp removed with some pathologically confirmed dysplastic tissue, consider yourself fortunate; if it were me I'd consider a visit in three years. Remember that you are just a patient number in their system, a statistic as it were, and since you have this risk (as I probably do as well, genetically) it's up to you to be proactive.
Sorry for the lecture, I just remember how my granfather went, with the disease in his liver and stomach because they didn't do these back then.
Since you mention your occupation, is corruption really that rampant in the medical fields? I'm an avid reader of medical literature (esp. oncology and oncogenesis) and most seem very "into" their work. Perhaps that's because the doctors writing these papers/giving these seminars are more involved on the research side...?
I would not wait five years.
LOL
The last time I had one, the drugs administered were valium (to relax you) and demerol (to amuse you). They say that demerol is a "pain killer." To this day, I'm convinced that it doesn't stop you from feeling the pain. However, when you've had the demerol, you just don't give a damn! It seems that the drugs given are to done that way to keep you semi-concious, so you are able to help them by moving when they need you to move or shift positions.
Mark
My Dad, who is 80, always prefaces physical exams with a stipulation that his prostate is swollen...
Well this is going to depress Dad!
He used to get me to drop him off and pick him up after one of these "procedures"...
For him to retain and maintain his flight status...NASA made him get these once a year...
Somebody must be rolling around now that the joke is out...;-)
At least she's smiling...She must like it...
Ohhhh, I am sooooo going to get lectured on this one...
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