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Virtual medical procedure fails

A plan for a virtual colonoscopy service in Fredericksburg suffered an early setback yesterday

Date published: 7/8/2009

BY JIM HALL

Dr. Frank DeTrane's plan for a virtual colonoscopy service suffered a setback yesterday when a regional health advisory group rejected it.

The board of directors of the Northwestern Virginia Health Systems Agency, meeting in Culpeper, voted 10-8 to recommend to the state health commissioner that she deny his proposal.

"I'm so disappointed," DeTrane said after the meeting. "I don't think I lost today as much as the people of Fredericksburg lost today."

DeTrane, leader of the area's largest gastroenterology practice, has said he's ready to spend nearly $770,000 to buy a CT scanner, install it beside the traditional optical colonoscopy equipment in his office and begin an "integrated" service.

Patients would be screened for colon cancer using one or both technologies. The service would be the first of its kind in Virginia, modeled after similar programs in Maryland, Delaware and Wisconsin.

"It's a novel idea, but it makes so much sense," he told the panel.

Yesterday's hearing was DeTrane's second stop in the state regulatory process.

The Virginia Department of Health requires developers to obtain a "certificate of public need" before starting a major health project. The process includes local and regional hearings before panels of citizen volunteers.

Last month DeTrane won the support of the Rappahannock Health Advisory Council.

Now he and his plan will march to Richmond with one recommendation for and another against.

Dr. Karen Remley, state health commissioner, will make the final decision, possibly this fall.

As he did last month, DeTrane again ran into opposition from MediCorp Health System, parent company of Mary Washington Hospital and Stafford Hospital Center.

Phil Brown, a MediCorp executive and member of both advisory groups, said that DeTrane is bound by a deed restriction he signed in 2005, when he and his partners bought the land for their office from MediCorp.

The office is located on the hill behind Mary Washington Hospital, near Cowan Boulevard.

"Every physician that built on this particular site has this same exact deed restriction," Brown said. "The deed restriction is to protect MediCorp's interest."

Brown added, "We intend to enforce our deed restriction. They will have to find another location for their project."

Other members of the panel noted that the Fredericksburg area already has 11 existing or approved CT scanners, and that those scanners aren't busy enough to justify adding another, according to state standards.

"I can't see how we can possibly vote to approve this," said Louis Hodges.

Several members of the group said that virtual colonoscopy was a good idea, and they asked DeTrane to work with MediCorp to provide the service.

But after the meeting, DeTrane said he was not optimistic about an alliance.

"I have been trying since Day 1 to work with them," he said. "But it's either their way or no way. They want to control the market. They want to be able to have no competition, and they're going to use their influence to make it that way."

Jim Hall: 540/374-5433
Email: jhall@freelancestar.com

Colonoscopy using a CT scanner is said to be quicker, cheaper, less invasive and sedation-free, compared to traditional optical colonoscopy. Studies show that it's also comparable to traditional colonoscopy at identifying polyps. Both techniques require a day-before cleansing of the bowel. One of virtual colonoscopy's selling points--that no probe is inserted in the patient--is also one of its disadvantages. If the CT scan identifies a polyp, the patient must get a traditional colonoscopy to remove the polyp. About 85 percent of patients who get a virtual colonoscopy have no polyps. Patients also are exposed to radiation with the virtual colonoscopy.

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Date published: 7/8/2009

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