You don't believe that GI specialists should be aware of current trends in their specialty among their colleagues in other parts of the world? First of all, do you only read technical articles in your area of work/research that have been written by U. S. residents? I'm going to guess that you search out and read articles from all over the world, in order to stay on top of developments in your area of expertise. Right? By the same token, I would expect nothing less of any physician who claims to be an expert (as designated by her or his status as a medical specialist). Therefore, either the problem here is a failure to stay up with recent developments in their field (and 40 years is hardly recent :roll ), or a lack of desire to use the best methods available in the rest of the world. The excuse of shifting the blame to the FDA and/or the pharmaceutical industry certainly has some merit, and they could indeed stonewall such efforts, but the bottom line is that motivated people (or motivated groups of people) can certainly bring about changes, if they have a desire to do so, and physicians are certainly not devoid of influence.
Yes, the FDA, and first and foremost, the pharmaceutical industry, have to shoulder most of the blame. But I think it's pretty clear that if gastroenterologists kept up with technology in their area of expertise on a global basis, they would have to be well aware of what GI specialists in other parts of the world are doing. The FDA cannot approve any drug, unless it is at least proposed to them, and the drug companies are not going to waste any money proposing the registration of a product that has limited profit potential (which surely applies to cleanout solutions for colonoscopy exams. Therefore, it is incumbent upon the GI specialty to advocate for such products used in their own practice, or they will never be adopted, and that defines precisely what has happened — they haven't bothered to even attempt to promote the adoption of such products, because they don't consider it important. Why don't they consider it important? Because they are not particularly concerned about patient comfort or convenience.
We see posts way too often on this board, that clearly illustrate that point. For example, consider this recent one:
http://www.perskyfarms.com/phpBB2/viewtopic.php?t=17642
I realize they're busy. Most people are. But as a group, it's pretty clear that way too often, they don't demonstrate that they are particularly concerned about their patients' comfort and convenience. This may be a phenomenon that applies only to MC, and many of them probably put off consulting with MC patients because they are so uncomfortable about trying to treat an issue that they know so little about, and seem to have limited success with. But is that a legitimate excuse to postpone trying to help a patient? And since MC is the main focus of this board, and MC is a debilitating disease, that makes this is an important issue to us.
You have to remember that you may be getting expedited care, because you also have an aggressive form of Crohn's disease, and GI docs consider Crohn's to be a "serious" disease (and rightfully so). Therefore, YMMV. By contrast, most of the rest of us are treated as if we have a nuisance disease, which gives us a second class rating, right off the bat.
You say we should just find a good GI doc, and stick with her or him. That sounds good in theory, but it's not so simple in many parts of the country. Luck plays a big part in that, and an unlucky streak can make us feel devastated and hopeless. And when we're sick as a dog, why should we have to search all over the country to try to find a GI doc who gets it? That in itself says a lot about many aspects of the GI specialty, including attitude.
Yes, there are a substantial number of good ones out there (and some of them are on our list), but without the benefit of that list, they can be very difficult to locate, unless we just happen to be lucky. By contrast, I believe it's safe to assume that virtually all GI docs know how to treat Crohn's disease, or UC, with at least some degree of success. Therefore, when it comes to treating Crohn's and UC, I'm sure that most GI docs enjoy a relatively good rating by their patients. With MC, however, that rating tends to fly out the window in the majority of cases, and for good reason, IMO. The gratifying part is that whether due to patient complaints or their own initiative, more and more GI specialists are beginning to learn enough about this disease to at least understand it better, and that has to be a good thing.
Tex
When you got back home after work every day, do you think that your wife would be likely to ask, "How was work today, honey?" I'm guessing that she would learn pretty quickly not to ask that question.