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This is what I think about
provider endorsement and we learned this very acutely in the ACES study. With the ACES
study, we said “We’re going try to encourage screening flexible sigmoidoscopy or
endoscopic screening - colonoscopy or flex sig, we didn’t care which – to a
population.” In this case, Aliquippa. And we tried to create this sigmoidoscopy service
and get providers on board, but we really didn’t succeed. Partly there were a lot of
political issues with UPMC Aliquippa and the home-ship. You can’t imagine the kinds of
things that we encountered. But “build it and they will come” is not the way it’s
going to work. People do what their doctor tells them to do. If you try to be an external
force, try to get people to do something, it’s very difficult. Altering physician
behavior is very, very difficult and studies have been done. In a lot of them, it looks
like they’ve accomplished something and then six months later the doctors are doing what
they did before. |