Boston Globe Examines Impact of Increased Patient Demand for Colonoscopies
The Boston Globe on Sunday examined a recent "rush" in patient demand for colonoscopies that has "strained the health care system, producing long waits and prompting some hospitals to bring patients in on weekends." The problem highlights a "broader phenomenon in medicine" -- hospitals in some cases cannot serve the "onslaught" of patients who arrive after medical experts recommend certain tests or treatments, according to the Globe. In 2003, the number of colonoscopies covered under Medicare more than doubled from 2002 to 381,364. However, CDC estimates that only 45% of men and 41% of women ages 50 and older have received a colonoscopy or sigmoidoscopy, an indication that "millions more Americans should have screening tests," the Globe reports.
The long waits for colonoscopies at some hospitals are "evidence of a strained system," Robert Hanscom, director of loss prevention for the Risk Management Foundation, said. Dr. William Brugge, director of endoscopy at Massachusetts General Hospital said, "The demand is endless and limitless and beyond anyone's expectations." Robert Burakoff, chief of gastroenterology at Brigham and Women's Hospital said, "It's one thing to have ... all of us espousing the importance of having colonoscopies. The other question is whether the capacity and person power is there." Daniel Podolsky, chief of gastroenterology at Massachusetts General, said, "Right now, the problem is too few people getting colonoscopies rather than too many."
Recommendations on colonoscopies and other tests for colon cancer "have been a moving target," according to the Globe. In 2000, the American Cancer Society recommended that adults ages 50 and older should receive one of five tests for colon cancer and that those with a family history of the disease should receive tests earlier. The American College of Gastroenterology in 2000 recommended that older adults should receive colonoscopies every 10 years. However, the U.S. Preventive Services Task Force in 2002 advised that "it was unclear whether the accuracy of the colonoscopy offsets its additional cost, inconvenience and complications," the Globe reports.
According to the Globe, the long waits for colonoscopies at some hospitals and "overwhelmed doctors have drawn the attention of malpractice insurers and lawyers." Some patients with advanced colon cancer have filed medical malpractice lawsuits against their physicians for alleged failure to recommend colonoscopies, which can detect the disease in a curable stage. Hanscom said that the long waits for colonoscopies could contribute to more malpractice lawsuits because patients have a longer opportunity to cancel the tests and physicians could lose track of them (Kowalczyk, Boston Globe, 8/1).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.