BY JIM HALL
Virginia residents who want their colonoscopies done by CT scan in a doctor's office will have to travel elsewhere for it or wait for the state to change its mind about the idea.
Dr. Karen Remley, state health commissioner, has rejected plans for three such integrated virtual colonoscopy centers, including one in Fredericksburg.
Remley described the projects as costly, ineffective and unneeded. She rejected proposals from physician groups in Manassas and Loudoun County, in addition to the one in Fredericksburg.
Dr. Frank DeTrane had proposed a $924,000 expansion of his Gastroenterology Associates of Fredericksburg practice.
"It was just not meant to be at this time," DeTrane said last week, in reaction to Remley's decision. "Maybe in the future things will change."
The state requires that developers who propose major health care projects get a permit. In this case, an analysis done for Remley by Douglas Harris, adjudication officer, concedes that CT colonoscopy done in a gastroenterologist's office would be convenient for patients.
"But comfort and convenience comes at a price," Harris wrote.
His report also says:
It makes no sense to buy additional CT scanners when all three localities already have machines with unused capacity that could do the job.
DeTrane's claim that his proposal would result
Virtual colonoscopy is no more sensitive than traditional colonoscopy at detecting suspicious polyps.
"Less costly and more reasonable alternatives to the projects exist," Harris concluded.
DeTrane proposed a partnership with Dr. Mark Baumel, who owns a similar integrated virtual colonoscopy center in Delaware. Their idea was to buy a CT scanner and remodel DeTrane's office near Mary Washington Hospital in Fredericksburg to add a virtual option to the traditional colonoscopies that he does there.
Patients would be offered both types. If the patient chose a virtual colonoscopy, and it identified a polyp, the patient would have to have a traditional colonoscopy in the same location on the same day.
About 20 percent of patients would fall in this category, according to the state's findings.
The two types of colonoscopies are comparable at identifying cancers or pre-cancerous polyps on the walls of the colon. Both techniques also require a day-before cleansing of the bowel.
The CT version exposes patients to radiation and is done every five years, rather than 10 years for traditional colonoscopy. It does not involve a sedative or an internal exam.
Officials of Mary Washington Hospital opposed DeTrane's plan, saying it was a violation of the non-compete agreement he signed when he bought the land for his office.
Local radiologists also opposed him, saying that they already offer a similar service.
Baumel, DeTrane's partner, said last week that he remains convinced that an integrated service combining both types of screening in one location is a good idea.
He said, "We hope that Virginia comes to realize that saving lives is more important than blocking another CT scanner from entering the state."
Jim Hall: 540/374-5433
Email: jhall@freelancestar.com