Monday, December 18, 2006

Get out your stopwatch

The New York Times reports on a study that shows that, even amongst experienced physicians, the rate of "success" from a colonoscopy can vary enormously:

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.

How much can the time taken vary?:

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.

Oh come on. Shouldn't there be just a wee bit of emphasis on telling gastroenterologists that it is clear that doing the job in 3 minutes means they are not doing it properly?

Having had this procedure myself, I was given a videotape of it afterwards. (Watching the bit of smoke as a polyp is burnt off is kind of fun.) I wonder if the 3 minute wonders in American give out videos too? If so, get out your stopwatch and check.

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