When patients have no ride home: Addressing transportation barriers that exacerbate disparities in access to timely diagnostic colonoscopies

Martz and Hwang argue that mandatory personal escort policies for moderate sedation during colonoscopy unnecessarily block patients without a ride home, worsening disparities in timely follow-up after positive stool-based cancer screening. They recommend case-by-case discharge planning guided by clinical judgment, earlier transportation planning through patient navigators, and partnerships with rideshare services to support safe same-day discharges. The authors note that no evidence links escort requirements to lower complication rates, and they encourage gastroenterologists to use shared decision-making to obtain informed consent for discharging home without an escort.