It may seem that a colonoscopy is a simple procedure and that any qualified gastroenterologist can perform. Most colonoscopies usually take under an hour and millions are performed every year. However, because the procedure also requires the patient to be sedated and usually without the ability to verbally communicate their comfort level, this procedure necessitates a feeling of trust on the part of the patient and excellence on the part of the physician. It is important that you choose a colorectal doctor about whom you feel comfortable and confident.
When you are searching for a new specialist, like a colorectal doctor, there are a number of questions you can ask to help you choose the best fit. The qualifications of your physician are of course important, but so is the interpersonal relationship you have with your physician. Before you choose your colorectal doctor, take a moment and write down what is important to you in a specialist. Consider that if you are diagnosed with a condition or disease, you will be developing a long-term relationship with a provider that you trust has your health and well-being in their best interests.
The following questions are suggested inquiries to help you find a colorectal doctor that you are comfortable and open with and can treat you in precision and excellence.
Your physician’s experience is a testimony of the skill and quality of work that is put into your colonoscopy examination. It is not simply how many colonoscopies your colorectal doctor has done, but how thorough and careful each one has been. One of the more severe complications of a colonoscopy is a perforation, a tear or hole in the lining of the colon. Perforations occur as the colonoscope is inserted into the colon or during the removal of a polyp. A skilled gastroenterologist has a lower rate of rupturing the lining of the colon due to his or her advanced ability to operate the instrument. In asking how much experience your candidate for a colorectal has, you may want to inquire how many polyps are adenomas your doctor has removed and the number of patients who have suffered complications.
If you are diagnosed with a serious gastrointestinal condition, such as colon cancer, you will need to find a well-qualified colorectal surgeon. The highest level of accreditation a doctor can receive is a board certification. To become a board-certified physician, you go above and beyond the training you receive to earn your medical degree and commit to extensive training and testing procedures. What this means to you as a patient is that your physician has not only completed five years of surgical training but also endured strict examinations and an extra year of colon and rectum surgery. A board-certified colorectal surgeon has to take a recertification exam every ten years and other requirements in between this interval. While being board-certified does not necessarily define the excellence of your colorectal doctor, it is a testimony of qualifications. If you have a board-certified doctor, you know that your physician is well-qualified and intent on being up-to-date on cutting edge procedures, treatments, and technologies.
A colonoscopy procedure can last from as little as 15 minutes to an hour or more depending on if your physician finds polyps. Obviously, the chances of detecting polyps or an adenoma increase with the more time that is spent looking for them.
A physician who is devoted to looking long and hard for a polyp will have a higher adenoma detection rate. It is perfectly reasonable for you to ask how long the physician typically takes. A question you may ask is, “How long does it take for you to pass the colonoscope throughout the entire colon, including near appendix at the end of the right colon?’. A diligent physician will be careful, spend more time, and detect more polyps.
The doctor-patient relationship should be a primary concern in your doctor’s practice. Your doctor’s ability to communicate with you and guide you with appropriate counsel allows you to freely achieve health and receive the best in medical care. Further, an open relationship with your doctor helps to put you at ease and also helps your feelings of security that your doctor cares about your opinion about care you receive. Your doctor’s bedside manner is a major indication that you have a competent physician. Knowing that your doctor will honestly tell you about the condition of your health, including any diagnosis of a disease or disorder for which you will need treatment, will give you a sense of control over your treatment and recovery. Patients who feel they are in control of their health have been shown in studies to be able to tolerate pain, recover from illness, and attain normal daily functioning of activities after surgery.
The adenoma detection rate is a measure of the quality of the performance of a gastroenterologist in detecting the precancerous polyps known as adenomas. As a guideline, a colorectal doctor performing a colonoscopy should detect one adenoma or more in 15% of women and 25% of men who are older than the age of 50. This minimum threshold is a measurement of the precision and care a doctor takes during a colonoscopy. Many doctors do not measure their adenoma detection rate.
If your doctor does measure their adenoma detection rate you simply need to ask what their rate is. Any rate higher than 25% usually indicates that your colorectal doctor can detect adenomas in a precise manner and thus prevent colon cancer.
Many patients come up with questions about their health or upcoming procedures when they get home from an appointment. Knowing if your physician has time set aside to consult their patients outside of set appointments is an important piece in the development of a healthy doctor-patient relationship. A doctor who has time set aside to answer phone calls or respond to emails shows that your physician is available to you when any question or concern arises. You may also want to ask if the physician charges for a phone consultation. Many doctor’s offices currently are setting aside times for telehealth appointments where you can virtually visit with your doctor in the comfort of your own home. You may also want to ask if your physician has an online patient portal that connects you virtually with the office, making it easy to ask questions and discuss any issues that come up after an appointment.
Knowing your doctor values your opinion and willingly answers your questions with an open heart and mind is pivotal in finding a good fit in a specialist. This helps to build a comfort level with your physician and frees you to express all concerns and doubts you have during regular exams like colonoscopies and treatments for any conditions with which you are diagnosed. In some cases, a patient may be diagnosed with a life-long chronic illness which necessitates a long-term relationship with a physician. Beyond your comfort level, location, meaning where you have your appointments, also is important. Colorectal appointments can be invasive and knowing you won’t need to make a long commute home, or that there is a restroom nearby to the exam room may be important for your comfort level. In your interview process for a new colorectal doctor you may want to inquire if there are bathrooms near or in the exam room in the case you need one nearby immediately.
Finding a new specialist can be time-consuming, especially if you live in a highly-populated area with many providers to choose from. Before you begin making phone calls and setting up a consultation with your future colorectal doctor, consider calling your insurance provider to make sure that the physician is a preferred provider under your insurance plan. You should also ask which services are covered by your insurance plan during colorectal appointments. Many health plans require that you get a prior authorization before your visit. If you are unsure if you need an authorization, confirm with your insurance plan provider. You may be charged out-of-pocket for services your insurance plan covers if you neglected to get a prior authorization. Also, be sure to confirm that the doctor accepts your coverage before making an appointment. Physicians will often add or drop health insurance providers during the course of their practice.
Fong, H., & Longnecker, N. (2010). Doctor-patient communications: A review. Oschner Journal, 10(1), 38-43. Retrieved from PMC: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096184/
HealthCare.gov Writing Staff. (2019, April 18). 3 questions to ask your doctor. Retrieved from HealthCare.gov: https://www.healthcare.gov/blog/questions-to-ask-your-new-doctor/
Howley, E. K. (2018, October 03). 6 questions to ask when looking for a colorectal surgeon. Retrieved from US News and World Report: https://health.usnews.com/health-care/patient-advice/articles/2018-10-03/6-questions-to-ask-when-looking-for-a-colorectal-surgeon
Keehn, J. (2017, March 30). How to find a good doctor. Retrieved from Consumer Reports: https://www.consumerreports.org/doctors/how-to-find-a-good-doctor/
Schattner, E. (2014, June 09). Does it matter who is the doctor who performs your screening colonoscopy? Retrieved from Forbes: https://www.forbes.com/sites/elaineschattner/2014/06/09/does-it-matter-who-is-the-doctor-who-performs-screening-colonoscopy/?sh=5aae4ad02844
This great interview with Dr. Ken will give you a good primer on what to expect from your first interactions with a colorectal doctor.