Procedural skills in flexible sigmoidoscopy and colonoscopy for the family physician.

Procedural skills in flexible sigmoidoscopy and colonoscopy are widely accepted as diagnostic and therapeutic tools that assist physicians as they attempt to understand the biological and behavioral elements of undifferentiated gastrointestinal illness. Data support the ability of family physicians to perform and teach some of these endoscopic skills. Although one major contribution of these procedures is in the prevention of premature colorectal cancer mortality, other important patient care benefits are emerging for the office-based physician. Breadth of care enhances our most important therapeutic tool--the doctor/patient relationship. Unnecessary referral contributes to fragmentation and depersonalization of the health care system. Family physicians are urged to examine and acquire new procedural skills appropriate for their community. The process of privileges is discussed.