We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Comment & Response |

The Efficacy of Screening Colonoscopy

Anil K. Rustgi, MD1,2; Ronald J. Vender, MD3; Kenneth K. Wang, MD4
[+] Author Affiliations
1Division of Gastroenterology, University of Pennsylvania Perelman School of Medicine, Philadelphia
2President, American Gastroenterological Association Institute, Bethesda, Maryland
3Division of Digestive Diseases, Yale University School of Medicine, New Haven, Connecticut
4Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
JAMA Intern Med. 2014;174(3):483. doi:10.1001/jamainternmed.2013.13741.
Text Size: A A A
Published online


To the EditorJAMA Internal Medicine published an article noting that Medicare reimbursement rates per hour for procedures (specifically screening colonoscopy and cataract extraction) are higher than reimbursement rates for cognitive care by primary care providers (evaluation and management [E&M] codes).1

We suggest a better way to frame the discussion as follows: there is a gap between cognitive and procedural services. We believe that the valuable cognitive services of primary care providers may well be underpaid, accounting for the gap. At a rate of $220, screening colonoscopy is certainly not overpaid; it requires special education, expertise, and training; carries greater risk; and provides great value.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





March 1, 2014
Christine A. Sinsky, MD; David C. Dugdale, MD
1Department of Internal Medicine, Medical Associates Clinic PC, Dubuque, Iowa
2Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle
JAMA Intern Med. 2014;174(3):483-484. doi:10.1001/jamainternmed.2013.13737.
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...