We hope that this edition of our “Banding Bulletin” finds you well! In this issue, we’ll address a couple of the FAQ’s that we often receive, as well as present some new ways that CRH can help you to both grow your practice and function more efficiently. Now that Thanksgiving has passed, the end-of-the-year-rush is here! Increasing your efficiency will go a long way towards making your patients and your staff happier leading into the Holidays!
A: In our clinics, this happened every 200-300 bandings. At first, we weren’t certain how to respond, so we would ask the patient to come back to the office the next day for an anoscopic exam, in order to see if we needed to place another band on the hemorrhoidal tissue. Virtually 100% of the time, anoscopy revealed a bit of necrotic tissue where the band was placed, indicating that the intended job was accomplished! With this in mind, our recommendation became “come back whenever your next appointment was scheduled”. We’d then move on to the next intended “target”!
Now, I need to stress that we would never have let the patient leave the office if we weren’t convinced that we had an appropriate amount of tissue banded. If, after a banding, there wasn’t enough “stuff” in the band, then we’d place another band on the intended tissue – if you only had a tiny amount of tissue banded, that band would’ve fallen off before it would’ve done any good for you. For this reason, in those cases where we did need to place another band, we would tell the patient that they may well see a band in the toilet (that first one), and not to worry about it.
A: Assuming that you’ve given the patient a bit of time after their last banding, a good anorectal exam should be performed to rule out things like a subtle, mostly healed fissure. An anoscopy should be performed, to get an idea of the anatomy. Our favorite type of anoscope to use is beveled, with a built in light, allowing for a complete 360-degree exam. You could consider banding the most prominent remaining tissue, which typically is not a “re-banding” but rather prominent tissue between the previously banded areas. We always recommend waiting at least 4 weeks after that 3rd (or “last”) banding before doing anything more, as it does take some time for the post-banding scarring and healing process to start to mature.
CRH has developed all sorts of practice support resources, designed to help educate your patients and free up staff time and resources. These documents are available in multiple languages, HERE. We can also “in-service” your staff virtually or in-person to share “best practices” with your clinic.
From a clinical perspective, our Medical Directors are available to set up brief “Zoom” sessions to address specific questions that you may have, share some “tips and tricks” or identify if an in-person “refresher” would be helpful. Of course, we’re always looking to train any interested Partners or APP’s in your practice as well. If you are interested in setting up a time to speak, please just contact ME and we’ll get you on the calendar.
Have you heard about our new service offering, CRH BandLeader?
BandLeader was designed to provide your practice with significant ancillary service revenue using your existing resources. This proven, systematic approach for identifying, screening and scheduling hemorrhoid patients for treatment begins with a thorough analysis of your practice before creating a business plan that quantifies the opportunity and provides a clear road map for success.
We then manage the entire process from patient acquisition and screening, to scheduling and ongoing support. Click HERE to learn more, and see if BandLeader would be a good fit for your practice.
As the nation’s preeminent GI anesthesia provider, CRH Anesthesia currently serves 82 ASCs and in 16 states, servicing approximately 500,000 procedures annually. If you are interested in learning more about our flexible anesthesia partnerships, let ME know and I will get you in contact with our CRH Anesthesia team.
Thanks so much to everyone for your support over the past year. Everyone here at CRH would like to wish you and yours a healthy and happy Holiday Season, and we look forward to seeing everyone soon!