-

December 30th, 2012

Quality Colonoscopy: How do you let your patients know you meet the mark?

Colonoscopy prevents most colorectal cancers, but only when it is performed as part of a high-quality examination. The quality measures most often discussed include cecal intubation rate, cecal withdrawal time, documentation of bowel prep quality in endoscopy reports, adenoma detection rate  (ADR), and appropriate recommendation of subsequent screening or surveillance intervals after colonoscopy. While third-party payers are increasingly considering using some of the above as pay-for-performance measures, I have also noticed many more patients asking about some of these measures when they are being consented for a colonoscopy. This leads me to ask you the following.

1) Do you routinely inform your patients of your ADR, cecal intubation rate, and/or withdrawal time?

2) Do you follow guidelines regarding repeat colonoscopy intervals (i.e., 10 years for normal-risk patients with a normal exam, 5-10 years for 1-2 small adenomas, etc.)?

3) Do you document bowel prep quality on your reports, and if so, do you use a validated method such as the Boston Bowel prep score?

4) Are these above measures available on your website or posted in your office?

5) For those of you who do not do some or all of the above, why don’t you?

6) Do you think patients care about these facts?

I am looking forward to an interesting conversation.

 

4 Responses to “Quality Colonoscopy: How do you let your patients know you meet the mark?”

  1. K.Venkataraman says:

    I think that these requirements Should be mandatory on practicing GI specialis

  2. F. Marrero says:

    I think we need to find a way to report these data points. Also, I think we should consider disclosing complication rates as well.

  3. Ognian Pomakov says:

    It depends where you practice.
    In an area with well educated patients and referring MD’s, that is a must. I have also seen places where neither patients nor doctors knew what those meant.

    I still believe that practicing high quality endoscopy and letting the world know about it is the best way to distinguish our(trained gastroenterologist’s) work from other individuals providing colonoscopy services.

  4. lola g. says:

    I have had many colon scopings and use gastro/endoscopist. never once did any doctor go over any details before or after about whats in this article. are they afraid to show their expertise level or do they think patients are dumb people?

Leave a Reply

Note: This is a moderated forum. By clicking on the "Submit Comment" button below, you agree to abide by the NEJM Journal Watch Terms of Use.

Gastroenterology Research: Author M. Brian Fennerty, M.D.

M. Brian Fennerty, MD

Editor-in-Chief

NEJM Journal Watch Gastroenterology

Biography | Disclosures | Summaries

Learn more about Gut Check on Gastroenterology.