Mr. Ralston,

I would like to commend you on an excellent article highlighting not only the deficiences in practice (to say the least) at the Endoscopy Center of Southern Nevada but the need to continue with screening for colorectal cancer. As a practicing Gastroenterologist myself in a large Midwest city I observe on an almost weekly basis the devastating physical and emotional effects left on patients diagnosed with this largely preventable disease.

In my mind three tragic events, all of which are intimately intertwined with one another, have occured. The first is a blatant lack of respect for the value of human life and for a patient's safety. Once upon a time in medical school you are asked, not ordered, but asked to take the Hippocratic Oath. The first rule of medicine is to "do no harm". Clearly, a refresher is needed for the physicians in question if not more aggressive action.

Secondly, an unknown number of patients have been infected with a largely chronic form of infectious hepatitis. The numbers of people infected will grow more than likely, but will pale in comparison to each individual who each day must live with the fact that they have a disease that they contracted while trying to "improve" their health and overall life situation.

Thirdly, and closely related to the Hepatitis C outbreak, is the fact that perhaps thousands of patients will go unscreened from a colorectal cancer standpoint because of lack of trust in a given physician. This is a particular tragedy as in a best case scenario without outbreaks and outlaw physicians we only screen apprroximately 30-40% of the screenable population in the best of circumstances. The "fear of screening" will continue to plague Las Vegas and likely Nevada in general for years to come and comes on the heels of a health system in Nevada still recovering from high insurance premiums and a mass exodus of quality physicians in the 1990's. What is needed clearly is action. Perhaps a public service announcement is needed. (Where are you Katie Couric?) Perhaps better regulatory control in the health department is needed? Clearly recent events regarding personal and business relationships make the waters very murky. Perhaps an outside "arbitor" is needed to clean the situation up? Many questions remain and many more will be asked but what is certain is that colorectal cancer will continue to contribute unnecessarily to morbidity and mortality in our country, now more than ever. Sincerely,
A physician with a personal interest in Las Vegas times three.