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Quality metrics of screening colonoscopies performed by PAs
M Phillip Fejleh1, Ching-Chieh Shen, Jacqueline Chen
1M. Phillip Fejleh is a gastroenterology fellow at the University of California at Los Angeles. At Washington University in St. Louis, Mo., Ching-Chieh Shen is an internal medicine resident and Jacqueline Chen is a gastroenterology fellow. Joseph A. Bushong is a PA endoscopist at the St. Louis (Mo.) Veterans Affairs Medical Center. Brian K. Dieckgraefe is an associate professor of medicine at Washington University and practices at St. Louis Veterans Affairs Medical Center. Gregory S. Sayuk is an associate professor of medicine and psychiatry at Washington University and practices at St. Louis Veterans Affairs Medical Center. The authors have disclosed no potential conflicts of interest, financial or otherwise.
Background:
Many communities face a shortage of qualified endoscopists. Training physician assistants (PAs) to perform colonoscopies can expand the availability of colorectal cancer screening. This study examined screening colonoscopy metrics and quality indicators among gastroenterologists, supervised PAs, and gastroenterology fellows.
Methods:
Consecutive patients undergoing average-risk screening colonoscopy were stratified into one of three groups by endoscopist type. Procedure and pathology reports were reviewed for the technical performance and quality metrics of the providers.
Results:
PAs performed comparably to gastroenterologists in technical performance and quality metrics, and demonstrated higher cecal intubation rates than their gastroenterologist colleagues. Comparisons of attending physicians and PAs grouped by years of experience also did not show notable differences in performance.
Conclusions:
In a supervised practice, PAs performed on par with their gastroenterology colleagues on established colonoscopy quality indicators. Following proper training, PAs can be employed in the provision of screening colonoscopy.
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