Colonoscopies ? can a NP or PA perform them?

core0 · Aug 11, 2009

Hi,
I am considering going back for my NP or PA. I am curious if NP or PA's can do colonoscopies. Thanks
love hugs and prayers
Carol

The short answer is yes. The long answer is yes with caveats. There are probably 60-100 PAs doing colonoscopies in the US. I don't know the number of NPs but they are probably similar. Most PAs practice in HMOs and VA. There are a few PAs doing colonoscopy in private practice mostly in underserved areas.

The issue is liability and competetion. If you own a endoscopy center colonoscopies can be very lucrative. Even in other situations they will pay better than office visits for example. This has led primary care to attempt to enter the market. In response GI doctors have raised the privileging numbers to those necessary to graduate from a GI fellowship. For example a GI fellow will have a minimum of 130 colonoscopies with 30 polypectomies. This would be the standard that you could be held to in credentialling. More importantly this is the standard that you will be held to in court. If you have a problem in the first 200 or so colonoscopies it would be almost impossible to defend in court. To the GI's defense the claims data for non GIs doing colonoscopies backs this up.

There is an interesting model used in LA. The NPs and PAs do colonoscopies supervised by a gastroenterologist in a control room watching four monitors at once. If they see a polyp then the gastroenterologist comes into the room and removes it. This puts the riskiest part of the procedure in the hands of the person who has the most experience. The PAs and NPs in this practice make a lot of money (as do the gastroenterologists).

Like many areas of medicine GI procedures are done by non-physician providers but rarely and in special circumstances.

David Carpenter, PA-C

Carolbknits · Aug 11, 2009

hmmm guess that answers...but I guess I don't know if it answers my questions on whether to try to enter that field hahaha! Thanks

love hugs and prayers

Carol