Colonoscopies Save Lives and Reduce Healthcare Expenditures

Dr. Elliot A. Heller responds to the New York Times Article – “The $2.7 Trillion Medical Bill: Colonoscopies Explain Why U.S. Leads the World in Health Expenditures”

Dear DDAR Patient

My colleagues and I were extremely disappointed to see the New York Times article unfairly blaming colonoscopies for our nation’s growing healthcare costs. We’re very concerned about the negative impact this article could have on patients getting screened for colon cancer. Studies have shown that death due to colorectal cancer has been reduced by 53% in the United States as a result of screening colonoscopies. The New York Times article failed to note that early detection by colonoscopy results in millions of dollars of cost savings to the nation’s healthcare bottom-line, money that would otherwise be spent on the care and treatment of patients with terminal colon cancer.

We at DDAR go to great lengths to provide cost-effective delivery of high-quality care to our patients. Having your colonoscopy procedure at an office-based surgical (OBS) facility is a real quality value. Nothing is compromised, as all Office Based Surgical (OBS) facilities, like our DDAR endoscopy suite, are accredited and must adhere to the same standards for quality, infection control and patient safety as any Ambulatory Surgical Center (ASC) or Outpatient Hospital Facility.

Lastly, we’d like to note that the federal government, under the Patient Protection and Affordable Care Act, has placed a priority on eliminating all barriers to getting Americans over 50 years of age to have a colorectal cancer screening procedure. Colonoscopies are on the short list of procedures for which insurance carriers cannot impose cost-sharing requirements, such as co-pays, co-insurance and deductibles. This means your carrier should provide you with first dollar coverage for your screening colonoscopy.

The New York Times article was biased in holding colonoscopies responsible for the rising healthcare costs. The only cost we see regarding colonoscopies is that it could cost you your life by NOT being regularly screened.

Read original NYT Article

CDC Recommends One-time HCV Testing for Baby Boomers

In August 2012, the Center for Disease Control and Prevention issued final guidance recommending that all people born from 1945 to 1965 be tested once for Hepatitis C virus (HCV). This recommendation was based upon an analysis of the 1999-2008 National Health and Nutrition Examination Survey (NHANES), which found that one in 30 baby boomers is infected with Hepatitis C. Baby boomers account for 75% of HCV prevalence in the United States. Many were infected prior to any awareness of HCV, and consequently, any understanding of how HCV is transmitted. Most HCV infected individuals are asymptomatic and unaware of their infection until significant complications from chronic HCV occur.

HCV is the most common bloodborne illness in the US with an estimated 2.7 million to 3.9 million people living with the disease. The virus is spread through exposure to contaminated blood. HCV can also be transferred through sharing of personal items such as a razor or toothbrush. Approximately 80% of patients with HCV have no symptoms. Despite delayed onset of symptoms in many patients, HCV- infected patients are at an increased risk of developing many serious complications.

Our goal at DDAR is to diagnose early and initiate treatment to prevent future complications. Our physicians, in collaboration with Deborha Caputo CNP, understand that treatment and management of HCV patients must be customized for each patient. As such, we stay abreast of all updates and progress in HCV treatment and therapy. We are optimistic that the 20+ new HCV treatments in clinical research trials in the U.S. will pave the way for further improvements in DDAR’s HCV patient management.

Please check with your physician about Hepatitis C Virus screening during your next office visit.

Dr Yaron Langman performs the first fecal transplant in Rockland County.

FDA recently relaxed rules allowing an innovative form of therapy for a type of colon infection known as Clostridium difficile (C. difficile).

The colon contains hundreds of distinct strains of bacteria which help maintain healthy digestion (at least 500 have been identified and there are likely hundreds more). One of those, C. difficile, can grow out of control when the others are killed. This most often occurs after the use of antibiotics and can become life threatening. Ironically, C difficile infection has been treated with a range of antibiotics, but the infection often recurs and/or does not respond. New research based on experiments in the 1950's has suggested that returning the colon to its normal balance of microbiome (hundreds of different types of bacteria) can suppress the C. difficile and allow the colon to quickly heal. This has been attempted using probiotic supplements. Unfortunately, that treatment has only a limited effect because not enough new types of bacteria are being reintroduced through supplementation.

A more promising approach is fecal biotherapy. Simply stated, with this treatment, a healthy donor provides a stool sample that is administered to the patient. Data suggest that up to 90% of people respond and can be cured of their C. difficile infection. There are various ways to administer the stool, but the most common is during a colonoscopy. Although mainly performed at large medical research centers, the method has slowly become more widely accepted in other health facilities. Dr. Langman has performed several "stool transplants" with great success. He was the first provider to perform such transplant at Nyack Hospital and has pioneered the current standardized protocol in Rockland County.

Although still in its experimental stage, fecal therapy is available to those patients for whom traditional treatment has failed. It is important to note that fecal biotherapy also shows promise in other diseases such as ulcerative colitis.

Patient Portal

Patient Health PortalDigestive Disease Associates of Rockland is now offering our patients access to their medical information online and viewable anywhere you have Internet access. With the eClinicalWorks portal, you can:
Request appointments.

  • View your lab results that are processed at Quest Diagnostics or Labcorp.
  • Access your current list of medications and request refills.
  • See your personal health records and pertinent information from your recent office visits.
  • Send electronic messages to our office staff that will be forwarded to our physicians for a response.
  • View your billing statement and pay balance due through our secure credit card processing option.

To gain access to our secure patient portal, you must become web-enabled with our electronic medical records. Simply call 845-354-3700 and provide our staff with a personal (non-work) email address. We’ll then email you with your secure username and password to get you started. The first time you log into the portal you’ll need to sign off on a user agreement and set up a security question.

Please note that the portal must not be used for urgent communication with your doctor or office staff.

Download brochure





Early detection is vital, over 90% of all cases of colon cancer can be prevented with recommended screening. Despite its high incidence, colon cancer is one of the most detectable and, if...

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With colorectal cancer being found in an increasing number of younger adults, the pressure is on to screen millions more.  See linK to NYT Article:...