Consensus statement from a group of colorectal surgeons for health equity and justice

We have reviewed the article entitled “Experience of nurse practitioners performing colonoscopy after endoscopic training in more than 1,000 patients” by Riegert et al. First, we would like to commend the authors on their efforts to address the disparities in access to screening colonoscopies due to the deficiency of trained physician endoscopists to meet the growing demand. As the trend toward using “physician extenders” in the form of advanced practice providers in other areas of health care has proven beneficial in decreasing cost and increasing access to care, it is clearly worthy of consideration in this field. However, we have several questions and concerns with the methodology, ethics, and external validity of this study that we would like to bring forth for consideration and discussion.

Publication History

Article published online:
14 March 2022

• References

• 1 National Institutes of Health. Guiding Principles for Ethical Research. Available at (last reviewed on 03/16/2016): https://www.nih.gov/health-information/nih-clinical-research-trials-you/guiding-principles-ethical-research
• 2 Ikenberry SO, Anderson MA, Banerjee S. et al. Endoscopy by nonphysicians. Gastrointest Endosc 2009; 69: 767-770
• 3 Pathmakanthan S, Murray I, Smith K. et al. Nurse endoscopists in United Kingdom health care: a survey of prevalence, skills and attitudes. J Adv Nurs 2001; 36: 705-710
• 4 St Fleur N. A doctor trained nurse practitioners to do colonoscopies. Critics say his research exploited Black patients. STAT; 2021 https://www.statnews.com/2021/05/04/doctor-trained-nurse-practitioners-to-do-colonoscopies-critics-say-research-exploited-black-patients/