Outpatient Surgery Magazine

Salary Survey - January 2020 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Page 85 of 110

the colon or even artificial intelligence during screenings, but technol- ogy will never replace technique. Physicians must be competent, con- fident and consistent at detecting and removing polyps. What do all gastroenterologists with above average ADR rates have in common? "They come into every procedure with a very detailed understanding of what precancerous lesions look like in the colon," says gastroen- terologist Douglas K. Rex, MD, a professor at Indiana University- Purdue University in Indianapolis. "They understand what serrated and adenomatous polyps look like," adds Dr. Rex. And the physicians who don't? They're likely missing critical methods for adenoma detec- tion. These are the GI docs who don't expose all of the mucosa when they're passing the scope through the haustral fold, who don't realize the fold has hidden some mucosa from view and don't work at going back in and poking the tip of the scope in between those folds and exposing that mucosa, says Dr. Rex. To prevent missed adenomas: Adhere to a minimum withdrawal time of 6 minutes. That metric comes from the ASGE/ACG Taskforce. "This is a process measure of the amount of time you spent looking for polyps during a colonoscopy," says Rajesh N. Keswani, MD, medical director of quality at Northwestern Medicine Digestive Health Center in Chicago, Ill., a facility that does approximately 18,000 colonoscopies each year. "It's a surrogate measure of how careful you are during screenings looking for polyps, it highly correlates with the risk of devel- oping cancer after colonoscopy and it's relatively easy to populate in your unit," adds Dr. Keswani. Another proven way to boost your ADR rates is to compare your physicians' performances and focus on the outliers for improvement. At Northwestern, this is accomplished through semi-annual ADR report cards. "Every colonoscopist in our unit gets a report card with their 6- month ADR rate that's benchmarked to their peers who have a similar 8 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J A N U A R Y 2 0 2 0

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