Your Good Health: Colonoscopy account should be reported

dr_keith_roach_with_bkg.jpgDear Dr. Roach: I have been having colonoscopies regularly since 1990. I was due for one last year, but it was postponed due to COVID-19. My previous doctor had retired and I found another physician who, I thought, would be excellent.

While on the bed, waiting to be moved to the procedure, the doctor came and sat down on one side of the bed. My other half was sitting on the other side. After the doctor said what he was going to say, he departed. My other half asked the nurse if the doctor was intoxicated. Why, she asked? She was told that he was slurring his words and had somewhat glassy eyes.

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“Oh no, I’m sure he was not intoxicated” she said.

Upon completion of his job, he informed both of us that he went in only a third of the way, afraid he would “poke my diverticula and injure me.” What? My previous doctor, who had completed seven of these since 1990, never had any difficulty getting past my diverticula.

After this doctor finished, he recommended that I go have a CT scan of my abdomen and pelvis, and a repeat colonoscopy based on findings on CT. I find this very suspicious and suspect he was just trying to cover his liability. From this information, what is your opinion, please?

Anon.

This is very disturbing. Your story contains two concerning points. The first is that your wife noticed the doctor slurring his words and not looking right (“glassy eyes”), which could indeed mean he was intoxicated. In hindsight, it would have been wiser to refuse the procedure at this point, as you had reason not to trust the doctor. However, I recognize that is hard to do, especially after going through a preparation.

The second issue is that the doctor is recommending a CT scan. This is not a substitute for a colonoscopy, and unless there is something he saw on the colonoscopy that you haven’t told me, doesn’t make a lot of sense medically.

Although having diverticula does make a colonoscopy somewhat more risky, a careful examiner does not usually have difficulty passing the scope past the area of the colon affected by the diverticula. I’m puzzled by his response.

I think this encounter is worrisome enough that I would report it. You have two choices: One is to report it to the hospital where he practises. Most hospitals have a patient services team that responds to concerns like these. The second is to report to the state medical board. Either choice should be taken very seriously and lead to an investigation.

There are two sides to every interaction, and a medical column allows for only one. Whether or not the doctor provided poor care, he at least communicated poorly and there is enough suspicion that an investigation, which might lead to an intervention, is appropriate. While I am sure you will never see this physician again, you might be helping future patients.

Dr. Roach regrets he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers can email questions to ToYourGoodHealth@med.cornell.edu.

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