Primary care physicians and physician extenders have been encouraged to perform sigmoidoscopy to improve compliance with screening and address the potential shortage of colonoscopists. A survey of primary care teaching programs reveals that sigmoidoscopy training is inconsistent and lacks minimum standards of competency. It would be helpful to know how many primary caregivers offer sigmoidoscopy in their practice and if they are deterred by insufficient resources and falling reimbursement. Colonoscopy is a more complete and efficient examination than sigmoidoscopy. Primary care physicians could be encouraged to promote colonoscopy if scheduling and patient instructions were easily available. It behooves colonoscopists to provide such assistance.