Frequently Asked Questions

A good clinician can make a difference in expenses. He may need less number of tests to arrive at the correct diagnosis to help a patient. An experienced physician knows the context in which certain expensive drugs and tests are promoted. He can avoid the ones which are of questionable value for patients' care. An informed physician can help his patients clear the confusion. He can direct the patient to avoid very expensive alternatives for the same care. For example, a colonoscopy at many hospitals and some ambulatory surgery centers may incur $6,000 facility charge. This is exorbitant and way out of line of national averages. For the same service an out patient surgery center charge could be less than $1,500. 

Both places may differ in the glitter and outward appearances. But they may be using the same brand of instruments for the procedure. Many times the same doctors may be performing same procedures at high cost and low cost facilities. So there is no difference in the core service a patient need in spite of the difference in charges.

High cost facilities do not guarantee higher quality care. There is always a possibility that the high overhead is at the cost of patient safety and quality and the low overhead facility does not have to make those compromises.

What can you do if you are referred to a GI by your PCP for a colonoscopy or an EGD? Your PCP referring you to a GI specialist may not know the above. He is not the one who pays for your facility charges. You are. So be an informed patient.  Ask ahead to see the facility charges of a colonoscopy where the GI specialist, to whom you are referred, performs procedures. Make sure that your insurance is accepted for the procedure. For most patients, it is better to arrange for a ride and travel to a high quality low overhead and low cost participating facility than to blindly see a GI who only performs procedures at hospitals or at high cost facilities. You can give feedback to your PCP, point out the cost differential and get referred to the right GI specialist.   

Click this link to see a real life patient's experience in our video.

No. The marketing can easily confuse a lay person. But listen and read carefully.

After the cancer has already developed, DNA and FIT tests on stool are reasonably good . 

But in detecting presence of advanced polyps which are closer to becoming cancer they are less than 50% accurate. Who wants to wait until cancer has already developed?

When it can be performed safely, colonoscopy is about 95% accurate in detecting advanced polyps and it allows doctor to take out polyps before they become cancer .

Not in all cases. Many of the new medicines have their role in the treatment of IBS, but a great majority of patients can get better without spending money on them. A correct understanding of the problem is fundamental. For example: Most patients with constipation do not need to take the newer expensive medicines even though most cost is covered by insurance (Insurance companied do not get them for free. Common sense tells us that one or the other way, the consumer will have to pay for the high cost). 

A true GI specialist will take time to your specific problem, understand the underlying issue and give you the right advice which usually has a better chance of getting you better. 

For example: Many patients complain of chronic diarrhea and seek GI specialist help. The path of least resistance for the specialist could be prescribing an expensive new medicine which can give you hope of getting better, but you do not. 

A true GI specialist who spends time with patients may discover that you have hard stool that is hard to eliminate and after a few days you have massive diarrhea. Your underlying is quite the opposite of your complaint: Constipation. He can then explain to you what might be happening with your bowel and what is the right treatment for you which can actually get you better rather than just give you hope.

The age of 75 is not a cut off for screening for colorectal cancer. If a patient is in good medical condition, the surveillance for cancer can be continued even up to the age of 85.

A relevant question: Does colorectal cancer incidence decrease after the age of 75?

The answer is: No. It increases.

Why should one stop when the risk of colorectal cancer increases after the age of 75?

High risk of complications due to advancing age and serious is the main justifiable reason.