Providers mentioned that lack of insurance reimbursement presented a challenge in ensuring patient compliance. They also stated that primary care physicians are often responsible for followup, and they do not have the systems in place for timely followup or do not see it as a priority. Providers also mentioned that it is sometimes difficult to reach patients for followup even when letters are generated automatically. They said that letters get lost or patients move or give false addresses because they are afraid of getting bills they cannot pay. When asked what providers need to improve their ability to provide screening and followup to patients, providers stated that it is primary care physicians who need the most help with this.
Gastroenterologists already know how and when to conduct followup and most have mechanisms in place.
Primary care physicians, however, need more educational material to help them understand the importance of screening and to help them educate their patients about the importance of screening. Providers mentioned that there are so many things competing for the attention of the average primary care physician that they need constant reminders, simple checklists, and a simpler way to follow guidelines. Providers also need simple and direct information to share with their patients, like wall posters for their offices and brochures that are simple and accurate. Providers need help with understanding the screening guidelines so they can implement them and communicate them clearly to patients. One provider said that if primary car physicians do not improve their ability to communicate about screening soon, there will be an increase in legal action against them for not being able to recommend what is considered a standard practice of care.