A Colonoscopy Quest That Captures A Central Health Shopping Problem

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.