Colonoscopy

Colonoscopy screenings are very important but it is crucial to be informed about the colonoscopy procedure, know how you can prepare for a colonoscopy examination, and understand that you should be aware of what medications are used during your procedure.

Being an informed patient in advance means that you’ll know what questions to ask your physician about colonoscopy preparation, and become more aware of what it is actually like to have a colon exam.

HospitalSoup.com Has a series of videos as well as articles that will take you through details of everything that is involved with regards to colon cancer screening based upon an actual patient’s experience. Knowing what a real patient went through with regards to going through a colonoscopy and being screened for colon polyps will help you understand all about colonoscopies.

Learning more about colon polyps, and colon cancer and how important early detection is with regards to being able to save your own life is valuable for you and all members of your family. Being more prepared will help you learn how to choose a gasteroenterologist for your colonoscopy examination.

You may want to bookmark this page as we will have additional articles and videos added with additional information on all kinds of tips and helpful hints for you regarding what is a colonoscopy. Many other useful informational segments about colon polyps and recovering from a colonoscopy exam will also be provided to you.

All You Need to Know About Colonoscopies:

1. Colon Cancer Screening
2. Colon Cancer Symptoms
3. Important Information About Medications Used in Colon Cancer Exams or Colonoscopies
4. Alternative Medications You Must Know About: Before You Schedule Your Colonoscopy
5. What You Should Learn About Informed Consent: How to Find out What Medications Will Be Used During Your Procedure
   And Why You Must Have This Information Prior to Actually Showing Up for your Outpatient Surgical Procedure
6. Preparing for a Colonoscopy
7. Understanding Virtual Colonoscopy

   Early detection of colon cancer and colon polyps saves lives. Make sure you are aware of the benefits of colon cancer screening and then find a well skilled and qualified gastroenterologist who can perform your exam. Don’t be afraid to ask questions of your doctor and health care team in advance of your procedure so that you know what to expect and what your choices are with regards to the colon examination procedure. If you have a friend or family member who has been putting off getting an exam because they didn’t know what to expect, please encourage them to learn more about colon cancer screening because knowledge is power and the life that you save could be your own or that of a loved one if proper colon cancer screening occurs.

Mexican Snack That’s Less Than 120 Calories: Tastes Great Too!

In today’s HospitalSoup.com healthy eating tip let’s talk about another one of my favorite snacks that are fast, easy to make, and most importantly, keep me feeling full for hours.

Take one of the smaller versions of the Low Carb Whole Wheat La Tortilla Factory Tortillas (50 calories) and then add a Sargento Reduced Fat Sharp Cheddar Cheese Stick (60 calories)  inside and roll it up.  Place the tortilla with the cheese inside in your microwave and heat for a few seconds. Just until the cheese melts. Add a teaspoon of salsa if you wish, or some lettuce and salsa and you have a quick, easy, and filling snack.

Who says you can’t enjoy carbs and cheese while losing weight? With the whole wheat and fiber in the tortillas and the calcium and in the cheese along with the protein in this snack it will help give your body the fuel it needs to get through the day without starving. These tortillas are low carb as well, so you can eat them without feeling guilty.

Drink at least an 8 ounce glass of water about 15-20 minutes before your snack and you’ll be hydrating your body which is important for weight loss as well as helping you to feel full faster. 

Leave a comment if you try these and let me know what you think. Enjoy your snack!

Losing Weight While Feeling Full

Healthy Tips for Eating So that You’re not Starving Series

The holidays are rapidly approaching and this year instead of vowing to lose those 10-20 pounds after the holidays wouldn’t it be nice if we wouldn’t gain any weight and better yet, lose some pounds and inches before the holidays arrive? Who doesn’t want to look better in their clothes, or have more energy, or be a more healthy person?  HospitalSoup.com will be sharing some tips and techniques with all of you so that we can all not only survive the holiday season, but approach it with enthusiasm about how we feel, what we are eating, and finally, feeling full without dieting!

In today’s HospitalSoup.com’s healthy eating tip of the day, I’d like to share with you one of my favorite finds. I just enjoyed a delicious lunch using Whole Wheat Smart and Delicious Tortillas from La Tortilla Factory. What I love about this product is that it allows me to have some carbohydrates without negatively affecting my waistline. And the Low Carb high Fiber versions that I enjoy also contain fiber which helps keep me feeling satisfied for longer. There are two sizes that I use. One is the approximately 9 inch size which is wonderful if you’re using them as a wrap with some healthy fajita fixings included, or the approximately 7 inch size if you’re using them for a snack. The larger version has 80 calories and 6g of net carbs, 8g of protein,  along with 12g of fiber while the smaller version has 50 calories, 3g of net carbs, 5g of protein and 7g of fiber.

For today’s lunch we enjoyed some onions, green and red peppers, and some mushrooms mixed with some skinless chicken breast and combined them together in a pan with just a touch of high quality olive oil.  Once your vegetables and meat has cooked,  heat up your tortilla on the stove in a non-stick pan until both sides are lightly browned. Take off the heat and add your chicken and vegetables, then pile on some fresh lettuce or spinach, I use lots of these low calorie fillers to make a huge fajita, along with a tablespoon of salsa, some fresh tomatoes, and basically  you have a lunch that will keep you feeling full for hours. There are lots of variations you can try for fillings so that you don’t get bored, but basically, this is a product you will want to have around for regular eating or those snack attacks where you know you want something filling but don’t know exactly what to eat.

These Low Carbohydrate, tortillas are also great to use for dinner as well. If you’re in a hurry and what to order them now here’s a link to the Large Low Calorie, High Fiber Tortilla, or the smaller size you can order for a snack sized version. I hope you enjoy these as much as I have. If you try them out, leave me a comment to let me know how you liked them. Or if you have a great idea for a filling please share your culinary creations with us! 

Colonoscopy Sedation Without Versed

Did you know what medication alternatives are available for colonoscopy sedation?

Part II: of the Medications for Colonoscopy Issue

Most of the time when having any types of procedures performed by our physicians we as patients don’t ask enough questions. We just ‘assume’ that our doctors would do the right thing or the best thing automatically for our well being.  The trouble is that many times physicians and/or staff follow standard procedures that are simply the
procedures that they are used to following and may not always be the best procedures for us as an individual patient. And you must also keep in mind that many times things are done that make it ‘easier or quicker’ for the physician and/or staff, but may not make our recovery ‘easier’ for us. The trouble is, that there are many things in
medicine that just ‘depend’. Depend upon the patient, depend upon the situation and ‘depend’ upon the procedure. So your goal when getting any type of procedure performed is to ask the right kinds of questions so that you are well informed and know your options. And so that you can then make an educated decision about what types of medications would be best for your own personal situation, and not simply best for the convenience of the doctor or hospital.  Here’s an article regarding understanding medication options that you may find helpful.

Ok, let’s make this easier by giving you some examples. Particularly in the case of sedation options for having a colonoscopy. We’ve written some previous articles about 1) Preparation for a colonoscopy,  2) Medications for colonoscopy: in part one of our article we talked about one of the most common combinations for colonoscopy sedation, and why you should learn more about how these drugs act both when they are given to you and what possibly could happen when they wear off. And 3) In this article that you are now reading, we’ll  discuss some alternative sedation combinations that can be used during a colonoscopy procedure. Some of these options, keep in mind, may not ever be brought up by your physician unless you ASK QUESTIONS. So find out in advance (not on the day of your procedure), what medications are available, and ask your doctor about options if you don’t feel
comfortable with the ’standard’ medications that are ‘normally given to  ‘everyone’.  You’re not everyone, you’re you, and an individual,  and what’s best for everyone may not be in your best interest.

So in our earlier article about sedation options for colonoscopy we talked about how in most cases doctors will give a combination of Fentanyl and Versed for colonoscopy sedation. What most patients do not know or are not told is that there are other options for sedation during the colonoscopy procedure. While it may be true that for most patients Fentanyl and Versed may work perfectly fine, there is a growing number of adverse patient experiences  that I am beginning to hear about both from nurses in the field and from patients that is concerning regarding the use of Fentanyl and Versed. Interestingly enough, Fentanyl  and Versed may be the ‘favorites’ among staff and physicians, (to use on their patients) but in a growing number of patient reviews and patient reports, when things go wrong with this combination, it has been a traumatizing experience for patients.  Incidentally, I am hearing from some of the health care providers that actually perform these procedures that when they themselves have colonoscopies, many of the health care providers that I am hearing from are choosing NOT to use the Versed and Fentanyl combination. Wonder why? Some engineers have reported that they have lost memories that involve their ability to perform their jobs after being given Versed.  Perhaps that’s why some physicians won’t take Versed themselves. Just understand that proponents of these medications will tell you they give them to thousands of patients and it is normally a “well tolerated procedure” etc. Again,the question is not whether you would “tolerate” this medication or drug combo well, but shouldn’t you be informed about the possible drawbacks to using it?

So let’s re-emphasize that point as I’m sure I’ll have lots of emails from those who want to keep the issues with Versed low profile.  The purpose of this article is not to debate whether you or your physician should use Fentanyl and Versed, or even one of the other alternatives, but to make you, as the patient, aware that there are options in most
cases for medical procedures in terms of what medications are used, and unless you are being wheeled into an emergency room already unconscious, it is my belief that you should know about these options, and you should be aware of what medication options you have with any type of medical procedure that you may be having performed. So this knowledge you will gain can also be applied to other procedures you may have in the future, not just a colonoscopy.

Here are the  most commonly used colonoscopy sedation medications:

1.Fentanyl and Versed:  Versed is amnesiac type of drug which means hat in most cases you won’t remember what has been done to you. You ay be in pain but will be unable to do anything about it.  See part I  of our article on colonoscopy sedation medications for more information about this combination.

2.Fentanyl, (a pain medication)  and Demerol (also a pain medication) this combination has been used in cases for pain control but where the patient will remain aware and be able to view the colonoscopy monitor and/or converse with the doctor during the procedure.

I have read that Katie Couric was given Demerol during her very famous televised colonoscopy procedure but I have not confirmed this. If anyone knows what medication Katie Couric was given during her colonoscopy let me know and I’ll update this article!  It would not  do to have a news anchor be asleep during her television  segment, thus she had to be given either some medication or medications that would not totally put her to sleep. Due to some reports of possible issues with seizures when using Demerol, it is not generally a ‘first choice’ among physicians any longer, but used to be used more frequently.

3.Fentanyl and Valium – We will post a video of a patient  soon which shows a patient  who underwent a colonoscopy and whose Doctor agreed to give him a combination of Fentanyl and Valium during the procedure so that you can actually see how the patient could converse with the physician during the exam. This patient who agreed to share his
colonoscopy experience with us wanted to be aware of what was happening during his exam. He absolutely wanted a physician who would respect his wishes that no Versed was used, but the patient had agreed  to receive medication to prevent pain.  The other positive about this patient’s experience with having Fentanyl  and Valium used during his
procedure  is that the patient was able to converse with the doctor after the exam and could remember the conversation.  The patient recovered quickly, was able to leave the hospital much sooner than those given other types of sedation, was also not groggy during the day and even went dancing later that night!  Note: In order to get this combination of medications the patient researched the procedure, researched his provider, the physician who performed the exam, and worked it out with the physician ahead of time i.e.: before exam day that he would not be taking the Versed. So it is not something that just happened by accident, it had to be planned and discussed beforehand. The patient’s requirements were that he would be given medication for pain but wanted to be aware of what was being done to him during the procedure, and he wanted to be able to view the monitor during the procedure. He also didn’t want to lose an entire day of work after the procedure or feel “drugged” up for the rest of the day.

4.Propofol is an  option for those patients who would like to be totally asleep during the procedure. This is an actual anesthesia agent, fast  acting, so you won’t remember the procedure but will wake up quickly, aren’t sedated or nauseated for long periods of time, can be discharged generally within 30 minutes and many patients report
feeling like they’ve had a power nap. Patients report great satisfaction with propofol and it is used generally for the following reasons: 1) It is fast acting, and short acting, which means once you are given the drug it takes affect right away, but when you wake up there are generally no long term affects like with some of the other sedation type drugs. Patients can return to activities requiring clear headedness and being aware unlike some of the other combinations in
which you may be feeling ‘drugged’ for hours.  Patients report less nausea with propofol than with other combinations of medications. After the procedure you will be awake and alert and able to remember your conversation with the gastroenterologist, unlike with some other combinations like Versed where you may have a conversation with your physician but will probably not remember it.  Disadvantage is that propofol requires a CRNA or Anesthesiologist to administer the drug to  ensure your airway and respirations are maintained during the procedure. Propofol is not a good choice if you would like to remain aware and alert and/or watch the procedure on a monitor.

Quick Fact Tip: When President George Bush had a Colonoscopy back in June 2002, the medication that the President received was propofol. It was also reported that the President was expected to have the procedure in the morning and then go running or exercising that afternoon. With some of the other types of medications that would not be possible. One “fun” way I like to question my physicians when investigating a test that has been recommended for me if I am contacting a physician as a patient  is to ask what medications would  the President would be receiving if he were having the same testing as what my doctor is recommending that I have. This way I can generally find out what options there are for medications that are fast acting. I’m personally not interested in taking any medicines which put me out of commission for an entire day or days if I can help it. So asking this question generally gets providers you’re working with to think along the lines of safety, and efficiency in terms of minimal down time for work etc.

Cost can be an issue with propofol because some insurance companies are not reimbursing for the use of propofol. This can vary depending upon the area of the country you are in, and your insurance carrier. Most patients report being more satisfied with propofol, but it can add to the cost of the exam. Note: some patients have written in and said that they had to pay extra for propofol (I’ve seen ranges from $125 –400 depending upon the provider and regions). Your costs could be different, or your insurance policy could completely cover the use of propofol at 100%, and we received lots of feedback for this article from patients who had to pay extra for propofol but who said it was the “best money they ever spent.”     The important thing isn’t actually that it is ‘too expensive’ as some providers use as an ‘excuse’ not to discuss this option with a patient. The point is that you as the patient should know in advance there are physicians that will perform exams with propofol and even practices where propofol is used as a #1 choice and that if you find a doctor who uses it regularly or who will use it upon request it is your right to know about it and make an informed choice with your doctor to see if it would be a good choice for you.  If you are comfortable with being totally ‘asleep’ during your procedure and don’t wish to converse with the gastroenterologist and/or see your exam on a monitor while it is being performed, then propofol can be a very good choice. If you wish to remain awake and know exactly what is happening to you during your procedure, or if you want to watch the monitor then you’d probably be much more interested in having a physician who would use Fentanyl and Valium, or Demerol or something along those lines. Your personal medical history may also be an issue in terms of which medications can safely be used so do have conversations with your doctor.   Give yourself enough time before your actual exam to find out what your options are with your doctor, (and not on the day of the exam, you must find out about this beforehand),  and then research the medications that will be given so that you understand in advance how they work and the possible disadvantages to each choice. All medicines can cause side effects but part of being an informed health care consumer is that you are involved in your choices when it comes to medications. 

Full disclosure about medications: There are a significant number of patients who have reported very bad experiences using Versed. There should be real informed consent meaning that patients should be told that Versed is given to keep you relaxed and make you forget, not just ‘here’s something to make you comfy’.  And patients should be told about the side effects and/or possible paradoxical reactions to Versed. If you ever are approached by any healthcare professional who comes at you with any medication and says they are “giving you a medicine to make you feel comfy,” then I personally would run as far and as fast away from that healthcare provider as possible. It is your absolute right to refuse the medication if you are not told what it is for and possible side effects and/or alternatives and to ask for and receive complete and full disclosure about what they intend to give you and what other options or other medications may be available.  It is your right to walk out of an office if you are not told complete information about a test. I was once a patient at a prestigious hospital, known as one of the best in the nation, and refused a radiology test because the doctor who ordered it should not have ordered it until after I had a particular type of surgery.  There was a clear medical reason to wait for the scan and not have a scan with contrast until after my surgery was completed. But the physician who ordered the test said it was ‘no problem’ the nurses whom I asked about it said it was ‘no problem’ to have the test and they were ’sure’ that the physician had checked before ordering the test. To the contrary, so I can recall wearing one of those short little hospital gowns, sitting in a cold room and telling the nurse that I was not going to have the test until I spoke to the Radiologist. Luckily, I had my laptop with me, and so, sitting in the holding area for testing, in my hospital gown, I pulled up the medical research that clearly indicated that the test I was getting ready to have was not in any way, shape or form, to be given to someone before my particular surgery.  The Radiologist leaned over the table where my laptop was perched,  took several minutes to peruse  the documentation I provided and said, “’you’re right, you should not have been scheduled for this test before your surgery. I’ll contact your doctor and we will reschedule it.”    It was a moment I will always remember. Shouldn’t they have known this?  I was at one of the best places in the nation and I had questioned my original doctor about the test and was told it was not a problem. Later, armed with the actual research and my laptop I was able to show the Radiologist the opinions from other surgeons and facilities about how having the procedure was contraindicated at that time.  I got dressed, and walked out of the testing area, and knew then that the responsibility for my medical care and decisions from that point onward were going to have to come from a place of knowledge  and not from just trusting what anyone said no matter how many initials they had after their names.  Unless you are going in for some type of emergency treatment in which case decisions sometimes must be made quickly,  you can and should research your options in advance.  Healthcare professionals  should treat patients like adults, not like 2 year olds. We would tell a child we are giving them something to make them ‘comfy’ not a grown adult.

One rarely known or used resource can be the pharmacy staff. Call your local pharmacist or get to know one in your area and ask them about side effects of medications. Get online and research drug side effects and read about how certain medications work so that you are an informed patient.

For healthcare professionals:

Patients who use providers and who are cared for by nursing staff who offer full disclosure and alternatives
to the ‘this is what everyone gets’ generally feel more satisfied with their care or procedure and are more likely to return to the provider and/or recommend that provider to a friend or family member. Even if the ‘alternatives’ take a little longer or are not the norm. Having an informed patient leads to better outcomes, and more referrals, and
happier patients. It is a win-win situation when your patients participate in the process of receiving care.

Healthy Snack That Keeps You Full and Tastes Great

Part of losing weight or even maintaining your weight includes knowing what foods you can grab for a quick, healthy, and great tasting snack. With the holidays just around the corner, there are bound to be some fast paced days in your schedule and times when you need to eat something quick without overindulging in terms of calories.

Today I’m going to share one of my favorite snacks with you. And the beauty of this snack is that it’s portable, can be taken with you to work if you have a refrigerator, or packed in a lunch bag with a cold pack. Possibly the best thing about this snack is that it also has some protein in it, which can help you feel satisfied after eating it and keeps you feeling full for longer.

My vote for today’s best snack is for:

Sargento Reduced Fat Sharp Cheddar Sticks

Requires No Preparation
Great Tasting
Can Grab and Enjoy While at Home or Bring to the Office
Great Snack to Have Before Holiday Shopping
Low Carbs
Has Calcium which is important for healthy bones
Keeps you Feeling Full for Longer
Only 60 Calories!!!

Breast Cancer – Race for the Cure Austin, Texas

In women, breast cancer is the most common cancer detected, and according to the American Cancer Society, accounts for one in four cancers diagnosed.  On Sunday, November 1, 2009 at 7:30 am. in Austin Texas, the Susan G Komen Austin Foundation Affiliate will hold the Komen Race for the Cure at the Domain shopping area in Austin Texas.

If you’d like to participate you can find out the more or Register to participate in the 5k or 3.1 mile race. There is also a one mile walk available and the race will be held rain or shine.

Quick Facts about Breast Cancer:  (from the American Cancer Society)

* One in 8 women will be diagnosed with breast cancer

Risk Factors for Breast Cancer

* Age (risks normally will increase with age)

* Family History

* Early Menarche

* Late Menopause

* Breast Density

* Obesity

* Use of combined estrogen and progestin menopausal hormones

* Alcohol  Consumption

* Physical Inactivity

It is important for women to be well educated about the risks of breast cancer and how early detection saves lives. Please remember however, that statistics are only statistics, and when looking at the numbers regarding reported incidences of breast cancer, that perhaps the most important element in preventing breast cancer starts with you! Meaning, that you listen to your body and if you think there is an abnormality in your breast, even if you are not at high risk for breast cancer, that you get checked by a physician. And if you detect a lump in your breast and your physician will not send you for a mammogram, get another option, or call your insurance company and find out if you can just schedule your own mammogram directly with either a hospital or radiology clinic in your area that offers mammography services. It’s your body, and please make sure that you don’t rely only on statistics if you find a lump or are having symptoms. Get to a doctor to be checked and if the first doctor doesn’t listen to you, find another doctor.

Resources: Find a Texas Hospital, Austin, Texas Hospitals

Meet Your Patients With Their Clothes On

What You Read Here May  Surprise You – Things You Didn’t Learn In Medical School
Best Practices in Healthcare – Part II of the Series, How the Initial Patient Meeting Helps Set the Stage for Trust and Communication Between Doctor and Patient

Part II

The Mayo Clinic in Rochester, Hospital in Minnesota Case Study

In Part I of this series on 1st Impressions when Meeting Your Patient, we discussed how clean, bright, attractive offices play a part when establishing a positive first impression. In this segment, however, we’ll discuss some simple tips for helping your practice be a practice of choice with patients.

Warning: Side Effects of implementing some of these practices may result in you or your organization receiving additional referrals and business from other patients, so don’t read any further unless you could use some easy, practical tips for adding additional patients to your practice.

Here is some information you can use right away:

When you meet your patient for a discussion, give that patient the opportunity to keep their clothes on!

Let me explain. So at the Mayo Clinic in Minnesota, the offices, as I mentioned earlier, have one thing that I haven’t yet shared with you. They have a small curtain in the offices so that the office has a private area for undressing right in the exam room. Now some of you will say this is impractical or that you don’t have enough space in your offices to do this, but the one setup at the Mayo clinic didn’t take up much space, and had hooks for patients to hang their clothes up and again, was standard in every exam room I viewed.

Why, you may ask is this important? We’ll let’s take a look at the dynamics that are created with a typical office visit or facility that is not setup like the Mayo Clinic.  We’ll come back to the waiting room and check in process in another article, but for our purposes today let’s take you (put on your patient hat please) and imagine you are the patient. Ok, so you, as the patient are taken back into an exam room, that’s way too cold for comfort. It may have an overabundance of white walls and floors —who said healthcare offices had to be white and that any pictures on the walls if they are even present look like they were snatched up as a last resort at one of the discount stores close-outs. Now, there’s nothing wrong at purchasing pictures at the local discount store, and you don’t have to spend much at all, to make a pleasing environment, but you do have to put some thought into it in terms of what colors, (not white please) will be most appealing to both you, your staff and patients when entering your exam rooms. If you are design challenged hire a design student or college student to help you, but make the room visually appealing please.

Now back to the attire or clothes issue or lack thereof in most health care practices. So, you as a patient are put in this stark white room that is so cold and bright that it makes your head spin, and are then told to undress and get in this little gown, open in  the front or back depending upon which type of exam you will be getting, and then you are left to sit on the exam table usually, with the crinkly little paper sheets until the healthcare professional finally shows up to grace you with their presence. In the interim, you may or may not have some tag eared magazines to read, or you may simply try to determine how quickly you may be seen by the noise of the doors slamming or closing in every room that is near the one you are in. As the doors and commotion is heard outside the exam room in which you are sitting, you are making assumptions about the practice, the practitioners etc. In some offices, patients may wait for close to an hour or more, in these cold, uncomfortable, and annoying environments,  depending on the practice, and then when the provider comes in beaming and smiling and hurriedly glancing down at the chart saying “Hello Ms. or Mr. Smith, my name is  ________ and how are we doing today?”  Do you wonder as the provider why your patient may not be exactly in the right frame of mind to not only meet you appropriately, but feel good about this encounter?  Meeting, especially as a new patient, a provider in this type of scenario doesn’t exactly put the patient at ease, and actually, isn’t good for the provider either because if you have a patient who is comfortable, you are more apt to be able to get a more complete and accurate history.

Ok, so I think you get the picture. Now, let’s contrast this by how the Mayo Clinic handles their patient appointments.  When your appointment time is called you are escorted back to a nicely decorated exam room, with warm inviting colors that has the comfortable bench and a small area at the back with a rounded curtain (like the ones you sometimes see for rounded showers).  The pictures are the walls actually look like they were “chosen” to be there, and although I’m sure that there are waiting times during emergencies that would make the situation different, but in most cases, patients are seen within minutes of being placed in the exam room. Someone at the Mayo Clinic obviously has put some thought into the temperature of the room, because the feedback I received patients was that it was not too hot, nor too cold in the exam rooms. Obviously, this is somewhat subjective, but I don’t think there’s anything written in stone which says exam rooms have to be freezing! Ok, on with the process at the Mayo clinic. So the patient is in the exam room, but has not been asked to undress yet, and meets their provider fully clothed. Note: seeing the patient fully dressed can actually yield clues about the patient that you would not see if you had them disrobe before meeting them. Now who do you think will be able to get a better history? The practice that has made the patient wait – with minimal clothing, or the Mayo Clinic Practice who has setup an environment to make the patient feel comfortable and has given the patient the chance to meet the healthcare provider on equal footing. Once the patient has met the healthcare provider, the patient is asked to disrobe using the small curtain area right there in the room, while the provider sets has access  to the computer in the room and waits for the few minutes that it takes for the patient to change into the exam gown. Now, I know some of you will say but this can waste time, I need the patient to be ready when I come into the room etc. or others who would say there’s no way to minimize the wait time, there are emergencies etc. And I will say to you that’s true, there are emergencies and patients understand this, so if you’re going to have them wait longer than a certain amount of time, how about communicating this to them and/or rescheduling for another day if you’re way behind. In terms of time wasted, there are ways using the computer in a room where you can actually work on something while the patient changes, and in the visits I was viewing at the Mayo Clinic, it only took a few moments for the patients to disrobe because somehow knowing that the physician was in the room, made the process much quicker. And the patient isn’t worried that someone will open the wrong door and there they will be in all their glory, because they have a curtain giving them privacy while they quickly change.

Somehow, during my visit with more than 7 different healthcare providers at the Mayo Clinic, all of them managed to be on time, and this happened on 2 separate visits.  Just some food for thought. All of you may not be able to incorporate this into your practices but I hope I’ve given you something to consider about how you setup your interactions with patients. The one thing to remember is that when looking at your procedures for waiting room, check in, and exams, is to think like a patient and not like a provider in order to come up with best practices that will work for your office and will therefore as a side effect, bring you increased numbers of patients and more importantly, have more patients who are satisfied with the quality of their care.  It’s no wonder why the Mayo Clinic has waiting lists of patients from all over the world who wait for months to get in to see them. What lessons can be learned and implemented in your practice?

Meeting Your Patient – 1st Impressions are Everything

Best Practices in Healthcare – How the First Impression during the Initial Patient Meeting Helps Set the Stage for Trust and Communication between Doctor and Patient

Part I: Looking at the Mayo Clinic in Rochester, Minnesota 
Stay Tuned for Part II which will show you how your practice can implement some simple things which can make a world of difference in patient care and patient perception

Obviously, there are many things that need changed within our healthcare system. But what about those times when we see organizations doing things not only “right” but setting an example that is “GREAT”.  It’s important to recognize the outstanding practices within certain healthcare organizations that work well, and to emulate those if possible within our own organizations so that we can fix the things that need fixing, and make improvements in the areas that can be enhanced.

So in today’s Best Practices in Healthcare segment, I’d like to discuss how a Minnesota Health Care Organization, The Mayo Clinic in Rochester, Minnesota sets up meetings with new patients. Remember, you never get a chance to make a first impression and there’s a reason why patients travel all across the world to obtain their healthcare at the Mayo Clinic. Let’s look at some possible reasons why.

The medical offices for each clinician at the Mayo Clinic that I saw,  are standardized. This helps if you’re looking at purchasing desks or equipment, because if you’re in purchasing, buying items in bulk often makes it easier to obtain a discount on rates. And, if nothing else, having the same setup in terms of your clinician staff rooms makes it easier to standardize in terms of procedures, equipment etc.  Alright, so that’s an oversimplified view of the economics of the office setup for a practitioner. What about the dynamics of the patient’s viewpoint?

As a new patient at the Mayo Clinic, when one enters the office of a practitioner, because they are standardized, what you will find are clean, bright, and comfortable offices. Each desk is connected to a seating area, similar in some respects to a built in that you would see in some kitchens which maximizes space and increases comfort. You won’t find hard, uncomfortable chairs here, but rather, padded built ins.  Making the patient comfortable is the first step in establishing a trusting relationship and giving the patient the opportunity to feel more relaxed and therefore more likely to share more easily the details that could lead to the practitioner being able to get a complete history and therefore more accurate diagnosis.

Navigating around to different areas of the Minnesota  Mayo Clinic is also easy, there are standards in terms of how signs are used, and each elevator clearly shows which part of the building you will be taken to, making it simple for all age patients to get where they need to go, on time and without much stress.  Pictures, plants, and music are strategically placed around the clinic which also helps reducing stress and making the experience more pleasant for the patient and family members who receive care in this Minnesota healthcare organization.

In the next segment of the Best Practices in HealthCare I’ll talk about one of the other practices that the Mayo Clinic uses in their initial meetings with patients and clinicians that leaves a great impression with the patients and is easy to implement, yet is not normally done in most physician offices as a standard practice. Stay tuned and thanks for reading this edition of Great Practices in Healthcare by HospitalSoup.com

Healthcare Costs – What is The Cost of your Procedure?

Buyer Beware in Healthcare – Some tips to Find out the Real Cost of A Medical Test or Health Care Procedure

Part One of our Investigative Report on Getting Pricing information in Austin Texas Hospitals and Outpatient Imaging Centers in Texas

Everyone’s talking about healthcare reform these days, but just what are some of the important healthcare issues, and which ones should you as a consumer, be concerned about right now?

One of the most crucial elements in terms of fixing our healthcare system should be to establish more transparency in terms of pricing among our health care providers.  There are discussions about pricing and discounts and you may think as a consumer that you may be offered a “cash pay” discount if you offer to pay in full or upfront for a particular test or medical procedure. But even those who consumer themselves savvy consumers may find themselves wondering what the “real” price is of a procedure.

We recently sent a reporter on an assignment to try to obtain pricing costs from different providers in the Austin Texas Area, including Texas Hospitals, Texas Outpatient Facilities and Imaging Centers in Texas.

Here’s an overview of how to try to obtain cost information for medical procedures. Note, your mileage may vary, and plan to spend much time on the phone, but here are some tips that may help you in this process.

1. Step One: The first thing you need to determine when you are having a medical test done is if you will be using insurance or not. Some of you will obviously have healthcare insurance while others may not, but there are different costs of a procedure which can vary widely, and one of the things you need to know is that some facilities will be less if you pay up front and in cash, while others may actually charge you more. And this can also vary depending upon the procedure, the facility, and the test. 

2. If you can, ask your doctor for the CPT Code, which stands for Current Procedural Terminology, and is the number that is assigned to a particular procedure or task within the healthcare community. Doctors, hospitals, and other healthcare providers and medical professionals use CPT codes for billing and reimbursement purposes.

Note: If your doctor has not provided you with a CPT code but you are interested in getting a price for a service, sometimes you can call the scheduling office first, for example, of an imaging center, or a hospital facility, and ask them for the CPT code for a particular procedure, then write this number down and use it when you are speaking to the billing department when trying to obtain the price.

2. Step Two: In order to get the cost of a procedure your best bet will be to ask to speak to the billing manager of the facility where you are considering going for your test or procedure.

3. How to Ask for Pricing Information: Tell the billing manager you are interested in finding out the price for a particular service or procedure. You may be asked to provide the CPT code, which if you have done your research in advance you will already have. The initial price you will be given will probably be the “regular price” which is not necessarily the best price.  Here’s where you will need your patience and ability to remain on the line to question further.

If you will not be using insurance, ask the billing manager if they have a cash discount option or what is the best price for a patient who will not be using insurance. You may be surprised to learn that your “cash discount” price may be higher than what your insurance company would be charged, even though you are paying in cash, at the time of service while your insurance company could take weeks or even months to pay.

If you have insurance you may have another hoop to jump through. Did you know that the providers of services are not required to disclose the prices to you, the consumer, that you would be charged if you are using your insurance company to pay for a service?  You may get that information depending on the facility and whomever you happen to get on the phone on that particular day and time, but they are not required to disclose this information to you.

According to a leading insurance company representative who wishes to remain anonymous, the providers themselves, own the rights to the actual cost amounts, or contracted amounts that they pay the insurance companies. So, as the consumer, even though most of us have lifetime limits on our insurance company policies, and it is in our best interests to know how much we would be paying on tests that are done, especially if we have the time to “shop around for healthcare”  and are not in an emergency room situation, are not being currently provided with the actual costs for our own healthcare?

This is absurd and absolutely needs to be changed. What other service or product that we would purchase would we have to pay for or have deducted from our “limits” on payments when we don’t know or can’t get the amount that a service costs?  In part two of our series on Healthcare costs we will share with you the actual variances that we received on pricing for the cost of a CAT scan in Austin Texas. Note:  the range was between $250.00 and $1650.00 for the same test. So it does pay to do your research up front, and to understand the real costs of healthcare. 

Note: as I mentioned in the article above, one of the things we discovered was that if using a “negotiated” or contracted rate which would be your insurance company discount, that facilities are not “required” to provide you with that information. Because this is not currently a law that there would be transparency in making pricing information available to consumers, one of the ways that some of our colleagues are dealing with this now is by refusing to use any facility that does not offer at least a range of pricing or attempt to be helpful to a consumer seeking price information. Now, granted, it is impossible for a facility to be “exact” with some amounts of testing, because, let’s say for example, the patient arrives at the testing facility and the radiologist on staff determines that there needs to be more than one view or picture taken of a certain area. Or perhaps the price that was obtained was given “without contrast” which means that the exam was initially supposed to be done without having the patient drink or receive fluids which would illuminate certain areas for testing, but it is later decided that the exam needs to be done with contrast or adjusted in some other manner. Of course, the pricing in these situations would need to be changed, but it is our opinion, that the consumer should be given at least a base price range up front if they ask for it, and there should not be a veil of “secrecy” behind health care pricing which is the way that our current system has existed for years.

What are your thoughts? Have you tried to obtain pricing information for a procedure and could not? Have you found out that certain procedures have huge differences in costs depending upon the facility?

Note: We are not saying that it is wise to make health care decisions based solely on costs. There are some tests and procedures that are highly specialized or in some cases use better equipment or machines where it may make more sense to pay more and obtain the best quality care. But, in certain instances, where the machine and equipment are the same, and you can get good quality radiologists or practitioners reading your exam results (that’s another issue for a future article) where you, as the consumer, should be aware that there are certain tests that you may be charged way over and above what you could have paid, and that information should be available to you, so that you can investigate your choices like you would any other important purchase in your life. 
Do you think we should take the Secrecy out of Healthcare pricing and Procedures? What are your thoughts?

Handwashing – Do you Know How to Wash Your Hands?

Handwashing: most of us think we know how to properly wash our hands. We’ve been doing it for years, and our mothers have been telling us to remember to wash our hands since the first day we can remember.  But many of us don’t wash our hands correctly or  understand that proper handwashing  takes a certain amount of time.  Did you know that washing your hands correctly is one of the most important things you can do to prevent infection? Diseases like e-coli,  salmonella, and other food handwashing techniques will help you and your family protect against illnesses borne illnesses can be prevented in many cases if proper handwashing is done. And, as the flu season approaches this year knowing and practicing good like the cold or the flu. 

Here are 10 Tips for How to Properly Wash Your Hands

1. Gather needed supplies

2. If using a public restroom (where the paper towels require you to touch a knob or button to advance the paper, go ahead and advance the paper before your hands are wet so that you do not have to touch anything  after your hands are washed.)

2. Turn  on warm water

3. Wet your hands

4. Apply liquid soap if available or use a clean bar soap.

5. Wash, scrub all surfaces of your hands including front and back of the hands, in between the fingers, underneath the fingernails and the wrist area.

6. Wash for a full 15-20 seconds

7. Tip:  To help your kids know how long to wash their hands have them sing happy birthday out loud twice to themselves. By the end of the song, the 15-20 seconds has passed

8. Rinse very well, again rinsing all surfaces that you washed

9. Dry your hands using a clean towel or air dryer if in a public bathroom. Don’t use your hands to touch anything after leaving the restroom including door handles or the air dryer. I use my shoulder to turn on the air dryer

10. When leaving the bathroom, use a clean, dry towel to open the door so that your hands are not recontaminated with any germs.

Knowing proper handwashing technique is useful for everyone in your family. Especially with the H1N1 flu outbreak along with the regular colds and flu that circulate during the fall and winter months, NOW is a great time to learn and practice good handwashing hygiene.

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