More family physicians doing colonoscopies

A recent study says they can be done safely. Hospitals, however, are slow to credential generalists, and specialists say they do the screening test better.

By Victoria Stagg Elliott, AMNews staff. Oct. 4, 2004.

Jeffrey Edwards, MD, a family physician at St. Mary's Hospital and Clinics in Cottonwood, Idaho, has performed hundreds of colonoscopies. These patients usually come to see him because they don't want to travel great distances to see the nearest specialist, wait months for an appointment or deal with a physician they don't know. He refers those who are at high risk for complications. But he cares for those at low risk on-site.

"Some of our folks come as far as two and three hours away, and they'd have to go another hour farther to a major medical facility," he said. "Being able to provide these services here has been really valuable."

He's one of a growing number of family physicians, particularly in rural areas, who are adding colonoscopy to the services they provide. A paper, authored by Dr. Edwards and published in the September-October issue of the Journal of the American Board of Family Physicians, suggests they may be doing the right thing. The study found family physicians trained in the procedure can provide safe and effective colonoscopy and achieve results similar to that of other specialties.

Those family physicians who do the procedure say it is a natural addition to the cancer screening they already carry out and is not much more complicated than the flexible sigmoidoscopy that many perform routinely. Advocates also say making this procedure a regular part of primary care could dramatically increase access to it, and not just for rural residents. For example, anecdotal evidence suggests that demand for colonoscopy has outstripped supply in some urban areas, resulting in long waits.