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How to select to whom to refer colonoscopies?

– A group?
– An individual? Does it matter? Should it matter? What is the variability of polyp detection? (see NEJM 2006 article)

How can you ensure quality colonoscopy for your patients?
-Know the ADR of the Colonoscopist you refer to.
-Consider doing colonoscopy yourself! (see Physician Training Program)


Most patients depend on a referral from their personal physicians (PCP). Unfortunately, it is often to a group. If all members of the group are experienced board-certified gastroenterologists, doesn’t that guarantee a good test? Unfortunately, No!

According to the American College of Gastroenterology (ACG), there is a single measure that reflects the quality of a colonoscopy: the ADR (for further details about the ADR, go to

Does it matter? Unfortunately, if the doctor’s ADR is below the industry standard minimum the colonoscopy is nearly worthless. What a shame to go through the rigors of a colonoscopy only to find out you got scant protection from subsequent colon cancer.

You have a choice. A choice that can mean life or death. If you do not confirm the ADR of your doctor is above 25, you may have wasted an opportunity to prevent colon cancer. The medical literature states you only get one-tenth the benefit. Be sure you get the full benefit; verify the ADR.

The ACG affirms that every doctor should measure their ADR. You are the advocate for your patients. They rely on your expertise for getting them the very best protection against colon cancer. If the gastroenterologist will not publish their ADR, you must ask the question, “What are they hiding?” We are not sure how many are below the minimum ADR of 25, but studies suggest that nearly half of colonoscopies are performed by doctors with substandard ADRs. THE ACG clearly asserts that gastroenterologists should make their ADRs available. You have the responsibility to do the footwork for your patients. We welcome you to check out our Meet Our Doctors page. We publish their ADRs.

Better yet, come to Carolina Colonoscopy Center for a visit. Meet our staff. Perform a simulator colonoscopy. Ask tough questions. We look forward to hearing from you. The closer you look, the better we look.

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