Advanced Practitioners and Anorectal Care
We have seen a dramatic rise in practices’ desire to involve their Advanced Practitioners in the care of anorectal patients. We have found that many NPs and PAs enjoy the ability to provide this care, as to date, more than 150 such caregivers have successfully integrated banding into their practice!
This has allowed the physicians in those practices to free up more time for the endo suite and has increased their practices’ capacity to treat patients in need of care! We’ve worked with many more APs to increase their comfort level with evaluating and initiating care in patients with anorectal complaints, whether they begin banding patients or not.
If you are interested in learning more about our training program for NPs and PAs, please contact ME and we’ll get you more information!
Improving Practice Efficiency, Patient Satisfaction and your Training Session
One of the issues we frequently encounter during training sessions is that up to a third of the patients scheduled cannot be banded because they are very uncomfortable during their digital or anoscopic examination. The vast majority of these patients have an anal fissure and banding them while they are so tender increases their likelihood of post-banding pain. Because of this, we start to “cool down” the fissure with diet and topicals for a couple of weeks, and then begin banding them at that later date.
In GI practices, so many of these patients were just in your endo center for their colonoscopy, so that is the perfect time to get a “sneak peek” at the situation. If your patient has ANY anorectal symptoms, perform a quick anorectal examination BEFORE sedation is administered to help identify some of the non-hemorrhoidal issues that so many hemorrhoid patients suffer from. For practical purposes, if the patient has any tenderness in the midline (posterior or anterior), and if they don’t have an abscess or a fistula, the most common issue is an anal fissure. Treat these patients with fiber, topical medications (my favorite is 0.125% nitroglycerin ointment) and topical lidocaine if the patient is very tender. In a couple of weeks when they come back for their hemorrhoid treatment, there is a much greater likelihood the patient can be treated. If not, you’ll be able to do a more comprehensive anorectal exam in order to clarify exactly what is going on.
CRH Anesthesia Continues Expansion
On May 1st, CRH proudly announced our latest transaction, partnering with Western Ohio Sedation Associates. This is CRH’s first venture in Ohio, bringing the total ASCs served to 39, now participating in 272,000 cases annually! A relationship with CRH will allow those with a current anesthesia service to monetize some of the equity built up in that part of their practice, and help those interested in developing an anesthesia program. CRH’s expertise in coding/billing/contracting/collecting and operations can also bring additional value to this part of your practice.
DDW Right Around the Corner
CRH will be in full force at DDW in Washington, DC next month! Dr. Andy Gorchynsky and I will be there to offer clinical support, and we will have members from our Anesthesia Team, as well as our Business and Account Management Teams in attendance. Some events and highlights:
Please let me know if there is anything that we can do in order to support your group. The months following DDW are some of the busiest on our training calendar, so if you have any partners or Advanced Practitioners who would like to be trained, or even if we can come back to your practice to share our latest treatment protocols and technical improvements, please let us know and we can get you on our schedule before things fill up!