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Related Experiment Videos

Flexible sigmoidoscopy by paramedical personnel.

P Schoenfeld1

  • 1Division of Gastroenterology, National Naval Medical Center, Bethesda, Maryland 20889, USA. pssmd@aol.com

Journal of Clinical Gastroenterology
|March 17, 1999
PubMed
Summary

Screening flexible sigmoidoscopy (FS) significantly reduces colorectal cancer deaths. This review examines the effectiveness and challenges of using paramedical personnel for FS screening to meet rising demand.

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Area of Science:

  • Gastroenterology
  • Medical Screening
  • Public Health Policy

Background:

  • Colorectal cancer (CRC) mortality can be reduced by 45%-80% with screening sigmoidoscopy.
  • Flexible sigmoidoscopy (FS) screening is underutilized in the US, but its use is increasing, with an estimated 10 million procedures annually by 2000.
  • Increased demand necessitates exploring alternative providers for FS screening.

Purpose of the Study:

  • To review the effectiveness of paramedical personnel performing FS.
  • To examine medico-legal and reimbursement issues related to paramedical endoscopists.
  • To outline a training program for paramedical personnel in FS.

Main Methods:

  • Literature review on the efficacy of non-physician endoscopists.
  • Analysis of current legal and reimbursement policies affecting paramedical personnel performing FS.

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  • Development of a proposed training curriculum for FS procedures.

    • Main Results:

    • Research on the effectiveness of paramedical endoscopists is limited.
    • Physicians are currently the only professionals reimbursed for screening FS.
    • Some state nursing boards prohibit registered nurses from performing FS.

    Conclusions:

    • Paramedical personnel, including physician assistants and nurses, can be trained to perform screening flexible sigmoidoscopy.
    • Addressing legal and reimbursement barriers is crucial for expanding access to FS screening.
    • Standardized training programs are needed to ensure quality and safety when paramedical staff perform FS.