I made an appointment for an executive physical (a nice benefit as a member of the staff health plan) with my new doctor. The executive physical includes a flexible sigmoidoscopy. At the time, I figured if I were going to get the “works,” I might as well get a colonoscopy instead. I asked my new doctor if this was all right, even though I knew it wasn’t indicated according to the preventive health guidelines. My doctor (my friend and colleague) said this was fine.

My satisfaction level was going up.

I proceeded to have a colonoscopy last July. Much to my dismay and shock, I learned that I had asymptomatic but advanced colorectal cancer at the age of 43. I am not sure what my patient satisfaction was at that time, but I certainly was not happy.

Approximately a week later, I was in preoperative holding at the Cleveland Clinic waiting for my colon resection. One of the nurses asked me where I would like to go after the surgery: the “VIP floor” (known as the Founders Suites) or the colorectal floor. As a physician and a member of the professional staff at my hospital for over 15 years, I knew I would get greater expertise with the colorectal nurses and staff on the colorectal floor. I was able to make an informed choice to accept the double room on the colorectal floor (with all the associated smells), compared with the private and lavishly appointed “VIP” suite. Although I knew I made the right choice, my satisfaction level went down. I seriously doubt that a patient without medical training and perhaps inside knowledge would have made the same choice that I did.

Sure enough, the nurses on the colorectal floor (and my wife) were diligent in making sure I was getting out of bed, walking, and doing all the things necessary to get my injured colon to work properly again. This included a minimization of my pain medications. Yes, I was a grumpy patient. I hurt, and moving around just hurt more. I didn’t want to get up regularly. I didn’t want my deep vein thrombosis prophylaxis shots; those really hurt, too. At the time, my patient satisfaction

level was low. In retrospect, it was exactly what I needed to get the best outcome.

I am happy to report that I am back to my good health – but what about my patient satisfaction through this ordeal? I would have been “happier” if I’d gone to the VIP floor. If I’d told the nurses on that floor to “come back later” for my necessary walk, they would have acquiesced. The VIP nurses would likely have given me all the pain medication I wanted – regardless of the potential effect on my colon motility.