Wednesday, February 22, 2006

Flexible sigmoidoscopy (flex sig) -Is it being phased out?

Flex sig seems to be going the way of the doctor visit when enough time was available to discuss things in depth with the patient. With flex sig, however, time does not seem to be the issue.Money is part of it (low reimbursement may barely cover costs) as it the popularity of colonoscopy for cancer screening.

The February 17, 2006 issue of Medical Economics reports the following all of which speaks to the decline of sigmoidoscopy:

1.About 25 % of internists provided flex sig versus the 1986 figure of 75%.
2.A recent AAFP survey reported that about only 25 % of FPs preform the procedure.
3.Both ACP and AAFP no longer teach the procedure at their annual meetings.
4.Dr.Patrick Alguire,director of education at ACP,is quoted as saying that flex sig is now offered only as a elective in IM residency programs.

Colonoscopy got a big boost when Medicare added screening colonoscopy to its approved procedure list and GI docs had to be pleased with the publicity of Katie Couric's on air colonoscopy.

I used to tell patients if they wanted to have their colon examined for early cancer or polyps they needed to get their entire colon examined and I believed offering them a flex sig in place of a colonoscopy ran the risk of giving them a sense of false security not to mention the malpractice issue.

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