Who Should Do It?

Background: One common investigative tool for the gastrointestinal tract diseases is endoscopy, and gastroenterologists provide this service. However, in recent years some internists provide this service, which hasraised concerns in gastroenterologist society.Purpose: To assess the viewpoints of Iranian physicians on whether internist can do endoscopic procedures Methods: The study performed in Tehran and Isfahan with a convenience sampling of practitioners whoparticipated in CME courses. The sample consisted of different groups of general practitioners, internists, internal medicine residents and gastroenterologists. A self-administered questionnaire with Likert type answers was used to determine the attitudes of the practitioners toward this item.Results: For elective diagnostic endoscopy the median of what expressed by internists and residents was complete agreement (+2) whereas for gastroenterologists it was agreement (1) and for gastroenterology fellowships, it was disagreement(-1); the difference was significant (p<0.001).Adding the lack of gastroenterologists’ services to the question, the median opinion expressed by gastroenterologists and fellows changed to complete agreement (2) with inclusion of the item in the task list ofgeneral internist (p<0.05). This difference was not seen for more complex therapeutic procedures (sclerotherapy, ERCP) in fellows’ and gastroenterologists’ choices, but internists and residents still agreed thatan internist should be allowed to perform these tasks.Conclusion: Reaching an agreement on borders of neighboring specialties or disciplines may be very difficult due to methodological pitfalls that face the planners, as well as professional sensitivities common in specialist societies.