Annual fecal occult blood tests are relatively easy and inexpensive. Flexible sigmoidoscopy is difficult for the primary care physician due to the amount of time required to explain the procedure and obtain informed consent, set up the procedure, perform the test and then battle with the insurer so the physician can be grossly underpaid. To simply say we need to do better is not going to bring about a solution. It's obvious that non-primary care physicians, insurers and patients do not understand the daily routine and business environment in which we practice. Screening for colorectal cancer may be cost-effective for the insurer, but it is a financial disaster for the primary care physician.
More money directed toward primary care for colorectal cancer screening is what is badly needed.
Also, I would think that a gastroenterologist is better able to perform a sigmoidoscopy for screening than most primary care physicians, and yet I don't see any of their billboards offering this service. G. Laura, MD Evansville, Ind. Back to top.