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  1. G Neale
  1. Clinical Skills Centre, University College, Rockefeller Building, 21 University St, London WC1E 6JJ, UK; g.neale@ucl.ac.uk

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In 1984, Sir Christopher Booth (President British Society of Gastroenterology (BSG) 1979) gave a lecture in Berlin on the effect of technology on clinical practice. He lauded the rapidly expanding benefits of diagnostic and interventional gastrointestinal endoscopy but was led to ask “Will the gastroenterologist simply become a technician who carries out a series of complex but personally satisfying techniques?”1

Most gastroenterologists remain general physicians but in talking with specialist registrars I have been surprised by their overwhelming interest in honing endoscopic skills. If this leads to a simplistic approach to the investigation of possible gastrointestinal pathology, it has its dangers. Analysis of two cases in the past month reminded me of this.

Case No 1

An elderly man was …

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