Colonoscopy: Whose Colon Is This Anyway
For years I declined the colonoscopy my doctor recommended, but I never explained why because it would detract from the purpose of my current appointment. My choice for colorectal cancer screening was an annual fecal occult blood test. What annoyed me was that I had to request this test every year even though it was a viable and accredited means of screening.
One day a letter arrived from my MD’s practice touting the benefits of a colonoscopy and I decided it was time to fully explain why I continued to decline and end this harangue.
His reply was startling and disappointing because all of this time I thought he was concerned about my ultimate welfare and genuinely believed a colonoscopy was superior to my chosen screening.
Here is what he had to say that shed a new light of our relationship:
“My own chart notes have stated for several years that you do not want a colonoscopy. The letter (you are referring to) was sent out by our head office to all patients that, on computer analysis, did not have a colonoscopy. The computer is unable to detect that you decline to have one.
“Insurance companies and Medicare are auditing us on the percentage of patients having colonoscopies or sigmoidoscopies. If we fall below a certain percentage we may be penalized. Your refusal will not put me below that line!
What might he or his head office have done, I wondered, if my declining were to put him below that line? And what kind of computer records fail to display case notes completely?
He said nothing about the eight reasons I had provided for declining a colonoscopy.