03 · Answer the questions For clinic use only
The question battlecard.
The 14 questions callers ask most, with suggested wording for each. Use it close to word for word or adapt it to your own voice, as long as it stays honest, plain, and inside what can be claimed. One answer still waits on a fact the clinical lead needs to confirm, and it is marked.
Use this on every call · the close
"Would you like me to get you on the schedule for a consult? There's no obligation, and it's the best way to get answers specific to you."
Then capture name, best phone number, and best time to reach them. The consult is always the goal. Answers exist to remove what's holding someone back, then return to this line.
Reading the chips
A confirm chip marks wording still awaiting clinical sign-off (see page 01). Say only the approved part and book the consult for the rest.
Question 01
What exactly is this procedure?
Best answer
"It's an outpatient procedure for hemorrhoids, performed by a surgeon. You come in first for a consult, and if it's right for you the procedure is a separate visit that takes about 15 minutes. It has published clinical results behind it. The best next step is that short consult."
Question 02
How does it work?
Best answer
"Under light sedation, the surgeon performs an incisionless procedure by applying gentle thermal energy to the tissue just above the hemorrhoid. The tissue contracts and is drawn back in, alleviating symptoms." confirm: mechanism wordingCorrected against the published paper. The earlier version described closing off a blood-supply artery, which is a different procedure.
Question 03
How is it different from banding?
Best answer
"Rubber band ligation often has to be repeated over several visits. This is a single outpatient procedure. In the published study, most patients were still symptom-free five years later."
Question 04
How is it different from surgery?
Best answer
"A surgical hemorrhoidectomy is effective, but it usually means general anesthesia and a longer, harder recovery. This is an outpatient option performed by a surgeon, which is why people ask about it as the middle path between repeat banding and surgery."
Question 05 · most common
Does it hurt?
Best answer
"That's the question we hear most. In the published series every patient had light sedation rather than general anesthesia, with a local anesthetic added if it was needed confirm: anesthesia, and the surgeon will walk you through exactly what to expect. I won't promise a specific experience because it varies person to person, but I can tell you what most patients report."Coaching: never say painless. Honest and warm wins.
Question 06
What is recovery like?
Best answer
"Because it's light sedation rather than general anesthesia, there's no downtime from being put under. Everyone in the published study went home within 30 to 60 minutes, and most went back to work the same or the next day. The surgeon will give you specifics for your case at the consult."
Question 07
Will my hemorrhoids come back?
Best answer
"No procedure can guarantee they never return. What I can share is the published evidence: in a study that followed patients for five years, the large majority stayed symptom-free."
Question 08
Who performs the procedure?
Best answer
"A surgeon performs it, not a technician or an assistant."
Question 09
Is it FDA approved? Is it safe?
Best answer
"It's performed by a surgeon, and it has a peer-reviewed published study with five-year results behind it, with hundreds of patients treated to date. Safety and your specific situation are exactly what the surgeon will go over at the consult." confirm: regulatory wordingCoaching: never say "FDA approved" or "FDA cleared", and never paraphrase FDA status. If a caller presses on FDA specifically, that answer belongs to the surgeon at the consult.
Question 10
How much does it cost?
Best answer
"We accept commercial insurance plans, and we also offer self-pay. The consult is where we confirm your coverage and any out-of-pocket cost, with no obligation."
Question 11
Do you take insurance or Medicare?
Best answer
"We accept commercial insurance plans, and we also offer self-pay. We aren't able to bill Medicare or Medicaid."Coaching: Medicare or Medicaid-only callers are a polite pass. See page 02.
Question 12
Am I a candidate?
Best answer
"The procedure helps a wide range of people with hemorrhoids. The best way to know if it's right for you is a short consult, where the surgeon will review your history and answer everything."
Question 13
Do I have to travel to Seattle?
Best answer
"Yes, the clinic is in Seattle. Patients travel to us from well beyond the city, so it's really a question of whether the trip works for you."
Question 14
Can I see proof it works?
Best answer
"There's a peer-reviewed study published on the procedure. I can send you a plain-language summary, and the surgeon will walk through the evidence with you at your consult."The summary is the one-page handout on page 05.
+ Three tone rules that hold the whole card together Expand
- Honesty beats hype. Patients with this condition have often been let down before. A measured, truthful answer earns more trust than a big claim, and it keeps us compliant.
- Answer, then book. An answer's job is to remove the one thing holding the person back, then return to the consult offer. Avoid long lectures.
- When unsure, defer to the surgeon. "That's a great question, and the surgeon will go through it with you at your consult" is always a safe, credible answer, never a failure.
Figures from the published paperFor clinic use only
Sias F, Milone L (2025), Journal of Surgery. Do not hand these figures to patients; they are here so the team answers from the paper rather than from memory.
- Anesthesia
- Every patient received light IV sedation with midazolam 2 mg. Propofol 30 to 40 mg was added in 35 patients, and local lidocaine (2%, 10 ml) in 72, for anoscope insertion discomfort. Not "local anesthesia for most patients"; the paper does not support that.
- Procedure time
- Average 10 minutes, range 5 to 15 minutes.
- Discharge
- All patients discharged within 30 to 60 minutes of surgery.
- Pain
- 92% reported no pain in the first five post-op days; 8% reported some, with a maximum VAS of 4 out of 10. Only 25 patients needed analgesics for more than two days.
- Return to work
- Most patients resumed work the same or the next day.
- Complications
- 38 (15.3%) minor bleeding, no intervention. 5 (2%) rehospitalised for bleeding requiring transfusion, days 1 to 8. 10 (4%) hemorrhoidal thrombosis. No urinary retention.
- Five-year outcome
- 216 of 248 (87%) completely asymptomatic. 32 (12.9%) minor residual prolapse or proctorrhagia, retreated locally.
- Pre-op guidance
- Eat whole foods, increase fiber, avoid white bread and processed food, avoid constipation and straining. Patients are asked to fast beforehand for anesthesia purposes. From Meribel's clinicians, not from the paper. The paper protocol overrides it.
"For a total of 248 patients (ages 22–78), 220 male and 128 female, with second-, 12%, and third-degree, 88%, hemorrhoids were treated using this technique. All the patients received Midazolam (2 mg); 35 received supplemental Propofol (30-40mg); 72 received local anesthesia with Lidocaine (2%, 10 ml). The average operative time was 10 minutes (5-15 minutes) and all patients discharged within 30-60 minutes from the surgery."
Two arithmetic inconsistencies sit in the source itself: 220 male plus 128 female totals 348, not 248, and the introduction describes a series of 232 patients while the results report 248. Worth raising with the clinician review before any of this is quoted externally.
Answer the worry, then come back to "let's get you a consult time."