Is this really not the surgery I'm imagining?
Correct. The in-office banding procedure for hemorrhoids has no incisions, no sedation, no operating room, no general anesthesia, and no recovery time in the way most people picture surgery. The procedure most patients fear — surgical hemorrhoidectomy — is reserved for a small number of advanced cases. Most patients never reach that point.
— Lisa L. Johnson, M.D., U.R.P.S.
Do I really not need anyone to drive me?
You really don't. With no sedation, there is no restriction on driving. Most patients drive themselves to the appointment, drive themselves home, and many drive back to work. This is the single most common point of relief we hear after a first visit.
— Lisa L. Johnson, M.D., U.R.P.S.
Will I be embarrassed?
You might be, briefly — and then you won't be. About half of what Dr. Johnson sees every week is anorectal. There is nothing about your situation we have not encountered, no description you can use that we have not heard, and no question you can ask that we will react to with anything other than professionalism. The first five minutes of your first visit will tell you this is true.
— Lisa L. Johnson, M.D., U.R.P.S.
How do I know whether I have hemorrhoids, a fissure, or something else?
Most patients can't tell — and they shouldn't have to. The distinction usually takes less than a minute of examination. Pain with bowel movements suggests a fissure. Bleeding without pain suggests an internal hemorrhoid. A persistent bump that does not change suggests a skin tag. We sort this out at the first visit.
— Lisa L. Johnson, M.D., U.R.P.S.
What if it's something more serious?
This is the question we hear most quietly. Most anorectal symptoms are caused by benign conditions — hemorrhoids, fissures, skin tags. But persistent rectal bleeding, change in bowel habits, weight loss, or symptoms in a patient overdue for colorectal cancer screening warrant careful evaluation and coordination with appropriate screening. We will tell you honestly which category you are in and what next step we recommend.
— Lisa L. Johnson, M.D., U.R.P.S.
Is this covered by insurance?
For nearly all medical plans, yes. Anorectal conditions are medical, not cosmetic, and the diagnostic visit and treatments are covered as such. Our team verifies your specific plan before your first visit and gives you an estimate of any out-of-pocket cost.
— Lisa L. Johnson, M.D., U.R.P.S.
Why come to PHII rather than a hemorrhoid clinic?
Two reasons. First, you see Dr. Johnson — a fellowship-trained pelvic surgeon — not a rotating roster of providers. Second, anorectal conditions almost always coexist with other pelvic floor issues: constipation patterns, pelvic floor dysfunction, prolapse, sometimes incontinence. A single-service clinic cannot evaluate or treat those. We can. And often, those are the root cause that needs to be addressed for the symptoms to actually go away.
— Lisa L. Johnson, M.D., U.R.P.S.
How long is the visit?
A new-patient consultation is 60 minutes. A banding visit, including check-in and aftercare instructions, is typically 20 to 30 minutes total — and most of that is conversation, not procedure.
— Lisa L. Johnson, M.D., U.R.P.S.
Can I bring someone with me?
Of course. Many patients bring a partner, a friend, or an adult child to the first visit. They can sit with you for the conversational portion if you'd like, and step out for the examination.
— Lisa L. Johnson, M.D., U.R.P.S.
What if I'm too anxious to go through with the procedure on the day?
That is completely fine. The first visit is a consultation and examination. We do not perform any procedure without your full understanding and agreement. Many patients come in, talk with Dr. Johnson, decide they want to think about it, and schedule the banding for a later visit. There is no pressure, and there is no rush.
— Lisa L. Johnson, M.D., U.R.P.S.