Does open access endoscopy close the door to an adequately informed patient?

Background: The use of open access endoscopy is increasing. Its effect on t he adequacy of patient informed consent, procedure acceptance and the impac t on subsequent communication/transfer of procedure results to the patient have not been evaluated. The aim of our study was to compare the extent of preknowledge of procedures and test explanation, patient medical complexity , information transfer and overall patient satisfaction between a patient g roup referred for outpatient open access endoscopy versus a patient group f rom a gastrointestinal (GI) subspecialty clinic. Methods: information was obtained from all patients presenting for outpatie nt upper and lower endoscopy by using a 1-page questionnaire. Patients from the two groups who had an outpatient upper/lower endoscopic procedure were contacted by phone after the procedure to obtain information with a standa rdized questionnaire. Results: The open access patients reported receiving significantly less inf ormation to help them identify the procedure (p < 0.01) and less explanatio n concerning the nature of the procedure than the group of patients referre d from the subspecialty clinic (p < 0.005). There was no difference between the two groups in satisfaction scores for examinations performed under con scious sedation. For flexible sigmoidoscopy without sedation, however, the GI clinic patient group were more satisfied with their procedure. The major ity of patients, regardless of access, were more likely to receive endoscop ic results from a gastroenterologist than the referring physician. Furtherm ore, the patients in the GI clinic group who underwent colonoscopy felt sig nificantly better at follow-up. Conclusions: Patients undergoing open access procedures are less likely to be properly informed about their endoscopic procedure. Our results indicate that with open access endoscopy, a defined mechanism needs to be in place for communication of endoscopic results to the patient.