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Physicians' Use of Nonphysician Healthcare Providers for CRC Screening

Objectives: This study examined physicians' use of nurse practitioners and physician assistants to provide colorectal cancer (CRC) screening with fecal occult blood testing (FOBT), flexible sigmoidoscopy (FS), and colonoscopy, as well as attitudes toward using these providers to perform FS.

Results: Overall, 24 percent of primary care physicians used nurse practitioners or physician assistants to perform FOBT. However, only 3 percent of all physicians surveyed used nurse practitioners or physician assistants to perform FS, and less than 1 percent of gastroenterologists and general surgeons used nurse practitioners or physician assistants to perform CRC screening with colonoscopy. An estimated 15 percent of general surgeons, 40 percent of primary care physicians, and 60 percent of gastroenterologists who did not use nurse practitioners or physician assistants to perform FS agreed that these providers could effectively perform the procedure.

Conclusions: Use of nonphysician providers for CRC screening with FOBT and FS is a possible means of increasing screening rates. However, current involvement of nurse practitioners and physician assistants in CRC screening is limited, and physician beliefs about their ability to perform FS are a potential barrier to increasing the involvement of nonphysician providers in CRC screening delivery.

Reference: Sansbury LB, Klabunde CN, Mysliwiec P, Brown ML. Physicians' use of nonphysician healthcare providers for colorectal cancer screening. Am J Prev Med 2003;25(3):179-186. [View Abstract]

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Last Modified: 11 Apr 2014