In case you missed it on Healthcare Savvy, WBUR’s Martha Bebinger is on a mission worth watching: She’s trying to figure out how to decide where to get her next colonoscopy. And that’s no easy task, if you don’t want to passively accept your primary care doctor’s recommendation.
The trouble is not just the general lack of transparency in health care. It’s that as would-be smart patients, our toolboxes tend to lack even the most basic information: When we try to shop around, what should we be shopping for? What if we want more than basic patient satisfaction surveys? What if we want actual data about the performance of a particular practice or doctor?
Martha has made a substantial start on what may be a model for the rest of us as we become better health care consumers. Thus far, she has gathered a list of questions, and is asking for suggestions for more. They include:
• 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.
• How much time does the doctor spend, on average, on the test? I think more is better, is that right?
• How many colonoscopies does the doc do each year? The average, according to the ASGE, is 750. Again, more is better.
• 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.
Read the full post here, and if you know colonoscopies, please help Martha — and the rest of us — out.
By Mary Mulkerin Donius
“Got a match? Yeah, your face and my, um, backside.”
That old insult comes to mind every time someone takes me aside to tell me they finally got a long-overdue colonoscopy or just scheduled one for a loved one. It happens all the time.
Ever since I was diagnosed and successfully completed eleven months of treatment for colorectal cancer at Massachusetts General Hospital, I feel like I’ve become a walking, talking reminder about the importance what The New York Times recently termed cancer’s “most unloved screening test.”
My face reminds friends, family members, colleagues and acquaintances to think about protecting their bottoms; it’s a role I’ve come to relish.
Just last month, a study in the New England Journal of Medicine proved what doctors have long suspected; that mortality is reduced by a whopping 53 percent in those who undergo colonoscopies and have pre-cancerous growths removed. It’s the strongest evidence yet that colonoscopies save lives. Despite the success of early detection and the steadily climbing cure rate of colorectal cancers in the past twenty years, only sixty percent of eligible adults get a colonoscopy, according to the American Cancer Society.
Okay, I’ll say it. That really bums me out.
March is Colorectal Cancer Awareness Month. With all due respect to the folks who work hard on the cause, you’d never know it. There’s no little ribbon or bracelet. It’s a tough disease to build a cute little symbol around, I’ll concede. Continue reading
Yes, exercise has all kinds of positive effects, but perhaps the most compelling reason to work out is to avoid the negative. To exercise because you just don’t dare not to. The myriad illnesses that exercise helps stave off are just too frightening.
Case in point: Colon cancer. I know two people who died of it in middle age, deaths that included much physical pain and left behind young children. The National Cancer Institute has a colon-cancer risk assessment tool that lets you calculate your personal risk (That’s mine to the left. Not nearly as low as I’d hoped.) But before you even get there, the introductory page reminds you:
Factors that can lower your risk of colorectal cancer include:
•colorectal cancer screening
•regular use of aspirin and NSAID’s (which stands for non-steroidal anti-inflammatory drug)
•maintaining a healthy weight
•regular, vigorous exercise (all activities that cause sweating and heavy breathing)
•a diet high in vegetables
•hormone replacement therapy use in women
It also includes “inactive lifestyle” among the factors that heighten your risk: Continue reading
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Judge grills Caritas on sale – BostonHerald.com “Caritas Christi Health Care’s underfunded pension liabilities were the focus of yesterday’s Supreme Judicial Court hearing on the proposed $895 million sale of the Catholic hospital chain to Cerberus Capital Management.” (Boston Herald)
Low-dose aspirin may cut colon cancer cases, study says – The Boston Globe “A low dose of aspirin may reduce colon cancer cases by a quarter and deaths by a third, a new study found.” (Boston Globe)
Dollars For Docs: Drug Co. Flattery Wins Docs, Influences Prescriptions : NPR “Drug companies train representatives to approach a narrow set of doctors in a very specific way, using language that deliberately fosters this idea that the doctors who speak are educators, and not just educators, but the smartest of the smart.” (npr.org)
Tennessee Governor Phil Bredesen Attacks Health Care Reform … And Gets It Wrong | The New Republic “The gist of Bredesen’s argument is pretty simple: Some firms will find it more attractive to stop offering insurance and let employees get coverage through the new insurance exchanges, where generous subsidies will be available. But the Affordable Care Act, which I’ve long supported, imposes strong penalties on firms that do not offer insurance, as well as sizeable tax credits for smaller firms that encourage them to offer.” (tnr.com)