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Comparing Colonoscopy Screening Quality Indicators between Surgeons and Gastroenterologists in a Rural Healthcare System

Hunaiz A Patel, MD, Asadulla Chaudhary, MD, Theodor Kaufman, MD, Nicholas Hellenthal, MD, Jose Monzon, MD, Stephanie Oceguera, MD, James Bordley IV, MD. Bassett Medical Center

Introduction: There is a significant shortage of physicians providing colonoscopy, especially in rural areas. Rural general surgeons often claim endoscopy as one of the cornerstones of their practice and as a result, there has been discussion regarding the quality of screening by different provider specialties, specifically non-gastroenterologists. The purpose of this study was to compare colonoscopy quality measures between both board-certified gastroenterologists and general surgeons in a rural upstate New York hospital system.

Methods and Procedures: All colonoscopies (5,286) were performed by 23 endoscopists, (14 surgeons and 9 gastroenterologists), within our healthcare network in 2017. Withdrawal times and adenoma detection rates served as the basis for the quality metrics and were compared using chi-squared testing.

Results: 2,677 colonoscopies were performed by surgeons (average of 191 per provider) and 2,761 were performed by gastroenterologists (average of 307 per provider). Adenoma detection rates for surgeons and gastroenterologists were essentially the same at 28.57% and 28.78%, respectively (p=0.328). Withdrawal times were slightly longer for surgeons at 13.2 minutes versus 10.68 minutes for gastroenterologists, though this difference was not statistically significant (p=0.344).

Conclusion: Our results show that surgeons are on-par with gastroenterologists in performing colonoscopy from a quality standpoint of both adenoma detection rates and withdrawal times. With the ongoing shortage of gastroenterologists, appropriately trained general surgeons have been shown to have equal competence in the performance of colonoscopy.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 93463

Program Number: S146

Presentation Session: Flexible Endoscopy II

Presentation Type: Podium

65

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