Doctor Who: Doctor Who The Colony Of Lies

The scope bends, so the doctor can move it around the curves of your colon. You may be asked to change position occasionally to help the doctor move the scope. The scope also blows air into your colon, which expands the colon and helps the doctor see more clearly.

The doctor uses a tool called an endoscope to do an upper endoscopy. An endoscope is a thin, flexible tube with a light and a tiny camera on the end. The doctor inserts it into the mouth, down the throat, and into the esophagus. The doctor views the images on a screen to look for tumors or other health problems.

Most often, a gastroenterologist will do an upper endoscopy in a doctor's office, GI clinic, or hospital. A gastroenterologist is a doctor who specializes in the GI tract. Many other specialists can perform an upper endoscopy as well.

A doctor or nurse may spray your throat with a local anesthetic to numb it. Or you may receive a liquid anesthetic to gargle. This helps prevent gagging. The doctor may also insert a mouthpiece to hold your mouth open during the procedure.

You will lie on your left side or your back on an exam table. As the doctor slowly inserts the endoscope, you will feel pressure through your esophagus. The endoscope inflates your stomach by blowing air into it. This gives the doctor a better view of the stomach lining.

Open biopsy. After a general anesthetic is given, the doctor makes an incision in the skin on the chest and surgically removes a piece of lung tissue. Depending on the results of the biopsy, more extensive surgery, such as the removal of a lung lobe may be performed during the procedure. An open biopsy is a surgical procedure and requires a hospital stay.

You will be asked to sign a consent form that gives your permission to do the biopsy. Read the form carefully and ask questions if something is not clear. If you are to have a thoracoscopic or open lung biopsy, your doctor may discuss with you the possibility of more extensive surgery being performed during the procedure depending on the results of the biopsy.

In addition to a complete medical history, your doctor may perform a physical examination to ensure you are in good health before undergoing the procedure. You may undergo blood or other diagnostic tests.

You will be asked to fast for eight hours before the procedure, generally after midnight. If local anesthesia is to be used for the procedure, you may be permitted clear liquids in the morning of the procedure. Your doctor will give you specific instructions.

Notify your doctor if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medications, aspirin, or other medications that affect blood clotting. It may be necessary for you to stop these medications prior to the procedure.

Numbing medication will be sprayed into the back of your throat to prevent gagging as the bronchoscope is passed down your trachea into the bronchi. The spray may have a bitter taste to it. Holding your breath while the doctor sprays your throat may decrease the taste.

The biopsy site may be tender or sore for several days after a needlebiopsy. Take a pain reliever for soreness as recommended by your doctor.Aspirin or certain other pain medications may increase the chance ofbleeding. Be sure to take only recommended medications.

Any doctor who earns enough points qualifies to be included on the list. The company first sends doctors a flattering letter congratulating them on their \\\"impressive achievements,\\\" and invites them to be included as one of America's Top Physicians. Doctors are then encouraged by a second company, \\\"State License Documentation\\\"- or SLD- to buy plaques and trophies that cost anywhere from $99 to $530.

ABC News' investigation looked at over 150 doctors with disciplinary records from 7 states- California, Connecticut, Delaware, Florida, New Jersey, New York, and Texas. And ABC News found that the Consumers' Research Council of America listed nearly one-third of those doctors with disciplinary records as \\\"Top Doctors.\\\"

After numerous phone calls and emails to SLD, ABC News received yet another email from an anonymous representative -- this time from SLD -- stating: \\\"I understand that you are doing a story on Top Doctors. Listed below is a partial list of companies that do Best Doctor lists. Each company has a different way of determining what qualifies someone as a top doctor. It ranges from some companies using high education such as board certifications to some companies allowing you to just purchase your way on to the list. Here are some links that you may want to check out.\\\"

Castle Connolly has partnered with more than 40 magazine, newspaper, and websites for top doctor feature issues including regional magazines like Boston Magazine and Indianapolis Monthly and national magazines like US News and World Report.

Yet ABC News found a few doctors on the Castle Connolly top doctors list who have been disciplined by their state medical boards in the last few months, including a radiation oncologist in Connecticut who was charged with a civil penalty of $5000 for treating the wrong side of a cancer patient's mouth with 29 separate radiation treatment sessions in 2006.

But within 24 hours of being notified of ABC News' findings, Castle Connolly sent an email to ABC News notifying us that doctors with disciplinary records identified by ABC News \\\"have been removed\\\" from the Castle Connolly \\\"Top Doctor\\\" lists.

Dr. Kent Sepkowitz, Vice Chairman of Clinical Affairs in the Department of Medicine at Memorial Sloan-Kettering Cancer Center, said although Castle Connolly does \\\"winnow out the lousy doctors for the most part,\\\" Castle Connolly is \\\"absolutely a popularity contest.\\\"

And so hospitals spend a great deal of effort to get as many of their doctors on some \\\"Top Doctor\\\" lists, earning bragging rights for the hospitals, especially in competitive city markets with multiple hospital systems.

A hospital employee from a large urban hospital who wishes to remain anonymous told ABC News that a senior hospital administrator sent an email offering a $300 American Express gift card to the first 100 doctors who nominated their peers for a top doctor award on the Castle Connolly website, spending a staggering $30,000 on gift cards to try to increase the number of top doctors chosen from their hospital. John Connolly told ABC News \\\"I've never heard of anybody offering or receiving money. If you've heard of it, you ought to expose them.\\\"

Castle Connolly insists doctors \\\"cannot and do not pay to be listed,\\\" but Castle Connolly does admit they do get money from American Registry, the plaque company that sells actual plaques to doctors.

And full access to profiles of top doctors on the Castle Connolly website is free to the public only for doctors whose hospitals have paid a minimum of $11,000 to become part of Castle Connolly's 'Partnership for Excellence Hospital' program.

The website \\\"TopDocs.com\\\" is not affiliated with Castle Connolly or Consumers' Research Council of America and does not claim to rank doctors in any way. But a spot on TopDocs.com is available to any physician who pays for membership, regardless of true top doctor status.

But when asked if his website's name could be misleading patients into thinking they are viewing profiles of actual top doctors, Dougherty said he \\\"has never had anybody say they are confused about it.\\\"

The dubious nature of some of these awards have led experts to question the rating systems altogether. Sepkowitz said, \\\"the beauty of the doctor-patient relationship is that it is not quantifiable, and the magic that takes place when it does work is the last sort of thing that these sorts of ratings could measure.\\\" 59ce067264

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