When is my next colonoscopy due? Patient's ask me this all the time. While this inquiry would seem to lead to a straightforward response, it often doesn’t. Why is this the case? Isn’t there a simple chart instructing gastroenterologists when the next exam is due? Yes, there are published guidelines, which were recently revised in 2019, but not everyone follows them. Some physicians advise the same colonoscopy intervals that they have been recommending for many years. Others rely upon their own judgement rather than consulting with professional guidelines. More often than you might think, patients are the driving force such as when they request a colonoscopy sooner than is medically necessary. I have heard many times patients relating vignettes such as ‘ my friend was just diagnosed with colon cancer. I know I’m not due until next year but can we schedule it now?’ And keep in mind that when any new medical guid...
The week before writing this I saw a couple of patients for 2 nd opinions. This can be very tricky terrain and I do my best to navigate skillfully. A casual remark on my part could damage the relationship between the patient and the doctor of record. Here are examples of remarks that I believe are best left unsaid. “Your doctor did what ???” “We don’t recommend that surgery anymore.” “Sounds like you need a new doctor!” “Have you considered hiring an attorney?” “I agree with you that the doctor’s office was unprofessional.” You get the idea. Other physicians who offer patients second opinions may have a different view on this. They may believe it is their role to make highly detailed medical recommendations as best they can which may represent an acute therapeutic course change. They may even offer to take on the patient formally, a suggestion that would be expected to be welcomed by the dissatisfied patient. Trapped in a Medical Labyrinth...