While colonoscopies would always be the "gold standard", flexible sigmoidoscopies would detect cancers and other problems early, reduce costs for patients and the health system, and reduce the pressure on the waiting list for colonoscopies, he said.
"I could do a test which picks up 60% of the diseases picked up by a colonoscopy for about 15% of the cost."
He understood colonoscopies cost about $1500 through a private specialist, and said he would do a sigmoidoscopy for about $250.
Dr Wegener routinely performed the procedure during his 10 years with a family practice in the state of Indiana.
After emigrating to New Zealand five years ago, he decided to try to do the same here.
Two years ago, he applied for Ministry of Health rural innovation funding to import sigmoidoscopy equipment.
His application was turned down.
Now, he is considering buying the machinery himself, at a cost of possibly $150,000.
In the US, sigmoidoscopies were used as a screening tool, he said, with all patients over the age of 50 advised to be examined at least every five years.
Patients with abnormal results were referred to specialists for colonoscopies, a system Dr Wegener believed would work well here, too.
"Ultimately, we could have GPs throughout the country routinely screening patients for early signs of colon and bowel cancer, just like we have mammographies screening for breast cancer and smear tests for cervical cancer . . . If you catch cancer early there is more chance of treating and curing it.
"It is disheartening that a simple, cost-effective test like a sigmoidoscopy is not routinely done here."
Having patients turned down for colonoscopies through the public health system had played a part in his desire to begin offering sigmoidoscopies, Dr Wegener said.
In his second month in New Zealand, he had a patient denied a test.
The patient had since died of cancer.
"I was surprised the patient was turned down. It changed my referral pattern. Now I always suggest patients have a colonoscopy done privately."
While that was financially possible for some, it was not for others, he said.
Otago District Health Board chief medical officer Richard Bunton said last night flexible sigmoidoscopies were not the solution to the board's problem.
"The problem is, we can't do enough colonoscopies for the people who need them. It comes down to resourcing and priorities, which is a problem across the whole of the health sector."
There was nothing to stop Dr Wegener performing the procedure if he believed there was a need, Mr Bunton said.
However, he said sigmoidoscopies were not a substitute for colonoscopies.
