Territorial scoping

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Ouch_Ouch_Ouch
Ouch_Ouch_Ouch Member Posts: 508 Member
in Anal Cancer #1

I had a discussion with you all a little while back: colo-rectal surgeon vs gastroenterologist. I wanted to stick with the board certified colo-rectal surgeon who had diagnosed me.

So, I called for an appointment to have my follow-up scoping done as a colonoscopy since I've never had one before. The doctor's surgical nurse told me that although he used to perform colonoscopies after he arrived in the area, he no longer could as the local medical centerette has decided that only gastros can do them. So, grrr! hospital, for deciding for me!

I saw the gastro today. He is happy to do it, but told me that he really doesn't work below the colon level and that I would have to see the colo-rectal doctor ALSO!

I'm back to requiring TWO procedures because of local hospital politics. That means inefficient use of time and resources, double the fees, double the supplies used and trash created, double the anesthesiology services, double the risk to the patient (moi, in this case), and more needles!!!

Apparently, the local gastros have protected themselves from incursion by a person who is as qualified as they are to do colonoscopies.

I'm hissed off!

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  • mp327
    mp327 Member Posts: 4,440 Member
    #2
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    Ouch

    OMG, I find this so ridiculous!  You are absolutely right--what a waste of time, resources, etc.  It's so political and the patient--YOU!--is caught in the middle.  I would be "hissed" off too!

  • sandysp
    sandysp Member Posts: 868 Member
    #3
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    The way it is

    I see a gastro for a colonoscopy and the anal rectal scopes are done by my Colorectal surgeon. 

    I don't have to be put to sleep for the exam given by the colo rectal surgeon and there are no needles but it is uncomfortable for a short moment or two.

    I am all for the ones who love what they do (isn't that amazing in this region) and do it regularly doing work on me. You are reminding me that I am due for a colonoscopy and have not even scheduled one yet. 

    Thanks,

    Sandy

  • jcruz
    jcruz Member Posts: 379 Member
    #4
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    can they coordinate?

    Is it possible that the two doctors could coordinate on the two procedures?  Before I started treatment I needed two surgeries (which I know is different than two exams) and the two doctors did the surgeries together.  One date, one anesthesiologist, etc.  I'd be hissed off too if I couldn't get past this ridiculous scenario.

  • Ouch_Ouch_Ouch
    Ouch_Ouch_Ouch Member Posts: 508 Member
    #5
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    jcruz said:

    can they coordinate?

    Is it possible that the two doctors could coordinate on the two procedures?  Before I started treatment I needed two surgeries (which I know is different than two exams) and the two doctors did the surgeries together.  One date, one anesthesiologist, etc.  I'd be hissed off too if I couldn't get past this ridiculous scenario.

    my question, too

    jcruz - I have an appointment to see the colo-rectal guy in a week and a half. I plan to ask him about coordination. Barring that, I will prioritize the sigmoidoscopy to check the cancer I know I had/have and put off colonoscopy until the end of October.

    sandysp - My electrophysiologist (a cardiology sub-specially) wants me to have IV atropine pre-procedure to prevent my pulse from bottoming out with a dopamine drip on stand-by. I have rheumatic heart disease with sick sinus syndrome and hyper vagal tone. When I was scoped originally, my heart rate was 38. The colo-rectal surgeon and the anesthiologist had an arguement in the OR over what to do.

  • sandysp
    sandysp Member Posts: 868 Member
    #6
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    Ouch_Ouch_Ouch said:

    my question, too

    jcruz - I have an appointment to see the colo-rectal guy in a week and a half. I plan to ask him about coordination. Barring that, I will prioritize the sigmoidoscopy to check the cancer I know I had/have and put off colonoscopy until the end of October.

    sandysp - My electrophysiologist (a cardiology sub-specially) wants me to have IV atropine pre-procedure to prevent my pulse from bottoming out with a dopamine drip on stand-by. I have rheumatic heart disease with sick sinus syndrome and hyper vagal tone. When I was scoped originally, my heart rate was 38. The colo-rectal surgeon and the anesthiologist had an arguement in the OR over what to do.

    Good grief

    You need them to accomodate you for sure. The tests should not be high risk procedures.

    All the best to you and many blessings,

    Sandy

  • jcruz
    jcruz Member Posts: 379 Member
    #7
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    Ouch_Ouch_Ouch said:

    my question, too

    jcruz - I have an appointment to see the colo-rectal guy in a week and a half. I plan to ask him about coordination. Barring that, I will prioritize the sigmoidoscopy to check the cancer I know I had/have and put off colonoscopy until the end of October.

    sandysp - My electrophysiologist (a cardiology sub-specially) wants me to have IV atropine pre-procedure to prevent my pulse from bottoming out with a dopamine drip on stand-by. I have rheumatic heart disease with sick sinus syndrome and hyper vagal tone. When I was scoped originally, my heart rate was 38. The colo-rectal surgeon and the anesthiologist had an arguement in the OR over what to do.

    good point

    I agree with you that dealing with the known cancer and wait (but not too long) to do the colonscopy.  Best of luck dealing with the doctors and the scheduling.

  • sephie
    sephie Member Posts: 650 Member
    #8
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    2 procedures

    i was treated at MD Anderson..... after tx was over,  colorectal surgeon always did the proctoscopes without anesthesia of any kind....just used lubricant and went  inside with scope...hurt like Hell until 3 rd year post tx...he would not do the colonoscopy..... gastro enterologist did the  colonoscopy at an entirely different time......  seems like too much but that is how i was set up to do it.......  hope you can coordinate yours to be done on same day with  anesthisia of some sort......sephie  PS  i also get an anoscope done at a separate time..... too scared to go very long without someone looking since mine was misdiagnosed for over a year......

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