Performing Colonoscopies at an ASC | pg. 4
How to Reach Younger Generations | pg. 3
Delivering Diagnoses With Empathy | pg. 6
As you know, March is Colorectal Cancer Awareness Month. Every year, another group of Americans becomes eligible for their first colonoscopy, especially following the reduced minimum screening age of 45 years old.
We wanted to take a moment to once again encourage all physicians to reinforce and stress the importance of receiving a colonoscopy to your patients. While this month is dedicated to reducing rates of colorectal cancer among our population, informing patients of prevention and receiving appropriate screenings should remain a year-round initiative.
Despite now being multiple years removed from the brunt of the COVID-19 pandemic, millions of Americans remain on the patient backlog or have yet to schedule a screening with their physician. Remind patients that colorectal cancer is largely preventable and that taking proper steps to get ahead of any diagnosis greatly increases
one’s chances of survival and a positive outcome, especially if they delayed receiving care throughout the years of the pandemic.
As you inform your patients, direct them to the many valuable resources offered by various organizations, such as Colon Cancer Coalition, Fight Colorectal Cancer, the Colorectal Cancer Alliance, and more. These organizations and their websites offer statistics, resources, and links to support groups to assist patients at any step of their journey.
We’d like to also mention the increasing rates of young-onset colorectal cancer in those under the age of 50. This steady increase has been noted in several studies and should certainly be a topic of discussion among physicians and their patients. With proper education and preparation, patients can be well informed on potential risk factors and causes of colorectal cancer, no matter their age.
Genetic modifications, such as Lynch Syndrome, family history, and even factors such as race can lead to increased risk for groups of patients. It is critical that physicians help patients understand and identify these potential factors so they can be best prepared to take appropriate action when scheduling and receiving their colonoscopy.
Lastly, please remember that the colonoscopy is the “Gold Standard” of colorectal cancer prevention. While alternatives may offer ease of use and save a trip to a physician, they fail to be as comprehensive and detailed as a colonoscopy.
As a physician, you play a major part in the health of your patients. We encourage you to take a moment with each patient you meet this March to discuss colorectal cancer prevention and assist those eligible in scheduling their preventative screening.
Suzette
Sison Editor in Chief ssison@pegisolutions.com Kelly McCormick Digital/Managing Editor kmccormick@pegisolutions.comContributing Writers: Lynn Hetzler, Jake Keator, Robert Kurtz, and Rachael Samonski
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When colonoscopies are performed in ambulatory surgery centers, hospitals can better focus on other procedures and increase patient access. This decision helps provide your patients with better care and non-GI patients by keeping hospital beds free. Learn more ways to improve patient care at pegijournal.com.
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Healthcare is a lifelong endeavor, beginning at a young age, through adolescence, adulthood, and laterlife. A critical component of providing care means reaching out to patients at a young age to schedule proper procedures. With each generation preferring one form of communication to another, finding the most effective method can be difficult, whether it’s letters, phone calls, or emails.
For GI professionals, reaching patients of younger generations can be a challenge, as GI health is often not thought of in their daily lives–even to adults who are now eligible to receive their first colonoscopies. However, steps must be taken to reach them. Below are ways to reach different age groups to provide GI education and schedule procedures.
Younger adults have been the biggest drivers of change in healthcare in regard to patient experience. Across the industry, healthcare providers are moving from physical documentation to digital alternatives.
Ages 18—25
• Create and develop a social media presence (TikTok, Instagram).
• Utilize your social platforms to encourage patients to schedule procedures and provide education.
• Use text message reminders over traditional print mail to schedule appointments.
Ages 26—30
• Print mail, in combination with digital reminders, can increase patient retention and satisfaction.
• Emails are more effective in this age group in comparison to younger audiences.
Ages 30—45
• Maximize email and schedule reminders that can link to popular apps like Google Calendar and Apple Calendar.
• Phone calls are more helpful for this age group.
This younger age group can be most easily reached digitally, mainly through social media. Some healthcare advocates are maximizing social media to spread awareness and educate young patients. While not a healthcare provider, Elizabeth Wachsberg, who has fought cancer multiple times since a young age, uses TikTok to share her story and encourage others to receive colonoscopies, with over 5,550 followers and 84,000 views.
• Send educational materials about colonoscopies and the importance of these procedures through email.
to reach patients when it comes to getting the word out about important healthcare information.
Research shows that younger generations are more proactive regarding their health. Patients in their late 20s have also shown to be more proactive than reactive. This group can still be easily reached via social media but is more inclined to reminders and patient education materials. Those who have a family history of GI diseases, such as colorectal cancer, may be more willing to schedule a procedure or visit through a phone call or text reminder.
Patients in this age bracket are now eligible (or soon to be) to receive their first colonoscopy. This group should be reminded regularly of the importance of receiving a colonoscopy and its place as the “gold standard” of colorectal cancer prevention.
In this group, social media is a less effective tool to make contact, though it should still be utilized. Unlike the above groups, email becomes a more prominent tool for communication between physicians and patients in the middle adult age range.
Physicians meet with patients of all ages and while reaching younger generations can be difficult, proper planning can help every patient continue to be informed and educated on their health.
TikTok has quickly become a favorite of this group. With the proven efficiency of videos for dispersing information, social media has become an important tool for doctors
For more patient best practices, the latest GI industry news, and more, check out our blog at pegijournal.com.
When it comes to where GI doctors schedule and perform colonoscopies, they have options. But for most of these procedures, the optimal site will be an ambulatory surgery center (ASC)
Annie Sariego and Tracy Belsan, market presidents for PE GI Solutions, discuss the numerous benefits associated with performing colonoscopies at surgery centers.
High quality. ASCs have a reputation for providing high-quality care. It’s a reputation that’s been earned and validated over many years, Sariego says. “To be a licensed and accredited ASC, you must abide by strict quality standards. These standards help ensure the highest quality of care is delivered consistently, thus keeping patients safe and reducing the risk of infections.”
Low cost. Surgery centers are also justifiably recognized as low-cost settings, says Belsan. “Everything
we do at the ASC is patient-centric and focused on the patient experience. That not only concerns the quality of care but also the cost for our patients. We also keep the cost for the facility, its physicians, and the healthcare system as a whole top of mind when we’re thinking about the services we provide and their price points.”
Convenience. By design, ASCs provide greater convenience for patients than larger facilities. “Although health systems are fantastic partners of ours and provide important services, it’s much easier for patients to go to a freestanding facility than navigate the morass of a health system,” Belsan says. “When you go to an ASC, there’s usually no question of whether you’re at the right location for the service you need or where you need to go to receive the service.”
Convenience extends to scheduling colonoscopies, Sariego says. “ASCs tend to be more controlled environments from a scheduling perspective. Physicians and patients can
More doctors are streamlining patient healthcare by performing colonoscopies at ASCs
find the times that work best for their schedules.”
ASCs also typically have on-time starts because of their consistent throughput and flow, Sariego adds. “This means patients and their families can keep the time they need to take off for colonoscopies to a minimum and allows GI doctors to optimize the time they spend at the ASC.”
While GI doctors should always carefully select the site where they perform colonoscopies, taking into consideration factors such as patient risk and accessibility, the clinical, financial, and operational benefits of performing the procedure at ASCs should make surgery centers the default location. “When colonoscopies are performed in ASCs, it’s great for patients, it’s great for physicians, and it’s great for our healthcare system,” says Annie Sariego, market president for PE GI Solutions.
Specialized staff. Since ASCs have specific specialties and procedures, staff become specialized in those areas. This tends to translate to a better patient experience, Belsan says. “You can focus your training on just those specialties and procedures, which leads to highly trained staff. We see this expertise reflected in high patient experience scores.”
When staff excels in their work, they tend to be more satisfied with their work, Sariego says. “When you combine happy staff with happy patients, you typically get happy physicians.”
Enhanced access. A goal of PE GI Solutions, shared by its ASCs and other surgery centers around the country, is improving access to GI services, including colonoscopies. ASCs that specialize in GI can focus on expanding access. “We know the importance of undergoing routine colonoscopies and work to get as many people in for the service as possible,” Sariego says. “This effort includes outreach to and education of the uninsured and underinsured residents of the various communities we operate in. We won’t turn patients away who should receive this preventive care.”
Collaboration with physician practices. ASCs usually collaborate closely with their associated physician practices since the practices serve as ongoing referral sources. “When you achieve the high levels of collaboration we see between our surgery centers and practices,” Belsan says, “you can hardwire patient access and throughput—the continuity of care—in a much more integrated way than may be possible with health systems.”
This collaboration also helps support more effective colonoscopy recall programs, Sariego adds. “The connection you get from having the same physicians from practice to ASC really lends itself to getting patients back in for their next procedures.”
Ease of growth. When warranted, ASCs can typically take advantage of growth opportunities more easily than larger settings, Belsan says. “There’s more nimbleness
and flexibility if we want to expand, grow, or provide different patient access at a location. Our business model allows for a greater ability to expand a room, add days, add hours, add staff, or undertake other growth initiatives that would not be possible in a health system.”
Quality and performance improvement. The specialization of ASCs also supports greater quality and performance improvement. “In the case of our ASCs, we can focus on quality data specific to GI procedures and only GI procedures since that’s all we do,” Sariego says. “This helps ensure the standards of care we provide exceed national GI benchmarks for quality.”
This narrower focus can lead to more effective benchmarking, Belsan says. “Nothing gets in the way of us constantly monitoring and measuring our performance. We can then share these impressive statistics with patients who are increasingly interested in quality data. We can also share the data with physicians, both those already working for us and those we’re looking to recruit. They want to understand the metrics and align themselves with locations that shine on quality.”
Improving access to other services. An important benefit of performing colonoscopies in ASCs rather than in hospitals is that it allows hospital beds to go to patients who need them. “We have hospitals reach out to PE GI Solutions because they want to partner with us,” Belsan says. “They understand that combining their strengths and our strengths means greater patient access and more convenience for patients, both those requiring GI services and those requiring care in other specialties. When colonoscopies are performed in ASCs, hospitals can better focus on those areas and procedures they really need to focus on for their own patient access and bottom-line issues.”
Tracy Belsan is a market president for PE GI Solutions. She can be reached at tbelsan@ pegisolutions.com
Annie Sariego is a market president for PE GI Solutions. She can be reached at asariego@ pegisolutions.com
To learn more about how working with an ASC can benefit your practice, visit pegijournal.com.
No matter if you are a brand-new physician or an experienced practitioner with years under your belt, delivering a colorectal cancer (CRC) diagnosis can be an emotional and stressful process. Managing the emotions of the patient and others present with them involves balancing confidence, empathy, and more.
“This was one of the most difficult things I have ever done,” Erica Cohen, MD, of Capital Digestive Care’s Chevy Chase Endoscopy Center says when describing her first experience delivering a diagnosis. “I knew the patient’s life was about to change forever because of what I was about to say. I felt an uncomfortable heaviness walking into the room. I still feel that heaviness any time I have to deliver difficult news to a patient.”
Upon receiving the news, patients can respond in numerous ways. In her years in practice, Dr. Cohen explains that responses to this life-changing news can vary depending on the individual. Some react immediately with tears; others are more stoic, wanting the next steps; while some simply show no emotion at all.
“I try to invoke confidence and strength and focus on the next few steps of staging and meeting with the appropriate specialists,” she says. “I enlist family and friends for support. I avoid discussing the variety of treatment options before getting all the data, as that can cause more uncertainty and anxiety.”
Dr. Cohen adds, “I know there are always a variety of emotions when you deliver bad news to someone. Some people are very stoic and just take it in stride. Some people want to know as much as they can about what you found and the possible prognosis and risks. Everyone handles bad news differently, and I think that our response to the patient’s reaction is somewhat based on taking the patient’s lead.”
Dr. Cohen believes the most important aspect of delivering the news is “to be present.” She advises other physicians to ensure that the patient knows they have their physician’s full
attention. Examples of showing you are totally present include turning off your phone to ensure there are no distractions, and standing or sitting close to them. Dr. Cohen also likes to ensure the patient is not in the exam room alone.
“If they have a family member with them in the car or in the waiting room, I ask the patient if they would like me to bring them in,” Dr. Cohen says. “I never want the patient to go through this alone. It also has the added benefit of having someone else on hand who may pick up things the patient doesn’t as they process the information.”
These small steps will help put your patient at ease, knowing you are dedicated to answering their questions and helping them plan for the future.
When delivering a new CRC diagnosis, there are several other important factors to consider. These include cultural sensitivity, gender sensitivity, sensitivity for the patient’s support group, and the personality of the patient themselves.
With the reduction in the minimum screening age from age 50 to 45 presented by the United States Preventative Services Task Force, a new generation of patients now have access to vital CRC screenings. However, some patients continue to delay or refuse screenings due to fear or misinformation. Cohen explains how she approaches the subject with newly eligible patients.
“I say, ‘Listen, the guidelines have changed because there’s been an uptick in colon cancer in younger people’,” she says. “Any test is better than nothing, and if you are at average risk, you have no family history of colon cancer, you have no history of polyps, and you have no symptoms, doing a noninvasive test is better than nothing. Sometimes that helps get them in the door, at least to get some screening as opposed to waiting 10 years because they’re too afraid.”
For more patient tips and stories, the latest GI industry news, and more, check out our blog at pegijournal.com.
Erica Cohen, MD, works for Capital Digestive Care at the Chevy Chase Endoscopy Center and the Chevy Chase Clinical Research Center in Chevy Chase, MD. Capital Digestive Care is a strategic partner of PE GI Solutions.
“Everyone handles bad news differently, and I think that our response to the patient’s reaction is somewhat based on taking the patient’s lead.”
Erica Cohen, MD
Delivering a colorectal cancer diagnosis can be difficult for physicians and involves a wide range of emotions and empathy
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