Los Angeles-based Cedars-Sinai has quietly become one of the most influential laboratories in modern gastroenterology, a place where ideas born at the bedside are increasingly shaping how digestive diseases are treated around the world.
At the center of that work is Barham Abu Dayyeh, MD, director of interventional gastroenterology and executive director and associate dean for innovation, whose career has focused on translating ambitious clinical ideas into real therapies for patients.
For him, the driving force behind innovation is simple: physicians confronting problems that medicine has yet to solve.
“The best innovation comes from people in the trenches who have their fingers on the pulses of truly unmet patient needs,” Dr. Abu Dayyeh told Becker’s. “But the process currently is quite challenging because it takes a decade and about $100 million to get a solution for a medical problem.”
That long, costly journey from concept to clinical care is precisely the gap Dr. Abu Dayyeh and his colleagues are trying to close.
Their approach centers on identifying large unmet clinical needs, developing new technologies to address them and accelerating the path from invention to patient care through partnerships with industry, clinical trials and regulatory collaboration.
“My goal is less than five years,” he said of the timeline for bringing innovations to patients. “In 2026, medicine should do better for patients by getting solutions and cures quickly to the bedside, rather than having them stuck in chasms.”
Targeting diseases at their roots
Some of the most ambitious efforts in advanced endoscopy are focused on metabolic disease, particularly Type 2 diabetes, which continues to rise worldwide.
“Type 2 diabetes is now affecting every single continent of the world,” Dr. Abu Dayyeh said. “The projection is at least 40% to 100% doubling within the year 2030 across the globe.”
While modern medications have dramatically improved disease management, he argues they largely treat symptoms rather than the underlying drivers of the condition.
“All the therapeutics that we’ve developed so far mostly manage the symptoms of that disease,” he said. “None of them are curative or re-establishing health.”
His team is exploring regenerative endoscopic therapies designed to target the gut, a key organ in metabolic regulation, with the goal of restoring metabolic balance rather than simply controlling blood sugar.
“We’re still managing disease rather than establishing or re-establishing health by allowing the body to heal itself,” he said.
Rethinking GI program growth
As GI programs nationwide look to expand services, Dr. Abu Dayyeh believes health systems must think more strategically about how growth happens.
Borrowing a concept from the business world, he divides expansion into two complementary paths: organic and inorganic growth.
“Most organizations that are successful, about 70% of what they do is working well, and you need to preserve it and keep tweaking it rather than disrupting it,” he said.
But meaningful transformation requires confronting the areas that are not working.
“The other 30% is where healthy programs are willing to say, ‘Am I willing to take that 30% and break it down?’” he said. “Because in the process of breaking it down and pruning it, I know how to grow it to scale.”
That balance, he argues, prevents organizations from either clinging too tightly to the status quo or chasing disruption for its own sake.
Creating space for physician innovation
Even with the right strategy, innovation rarely flourishes without the right environment. For Dr. Abu Dayyeh, the biggest obstacle is often the everyday pressures of clinical practice.
“Frustrated people cannot innovate,” he said.
Physicians who are constantly navigating administrative burdens and operational challenges have little room to think creatively, he said. Health systems hoping to drive innovation must intentionally carve out space for physicians to pursue ideas.
“We need to protect physician leaders and create wide spaces away from the high demands and frustrations of practice,” he said.
Equally important, he added, is helping clinicians understand the economics and operational realities of healthcare.
“Physicians need to understand the business of medicine, because we do not live outside of that business,” he said. “Understanding the business means that you get cures to patients faster, and you run an efficient enterprise.”
The next era of endoscopy
Looking ahead, Dr. Abu Dayyeh believes gastroenterology is entering a new technological phase, what he calls “endoscopy 3.0.”
The first era of endoscopy focused on diagnosis, allowing physicians to visualize disease inside the body through natural openings. The second introduced therapeutic capabilities, enabling doctors to treat conditions once requiring major surgery.
Now, a new wave of technologies is poised to transform the field again.
“Endoscopy 3.0 is promising to not only be an evolution of the first two, it’s going to be transformative,” he said.
Three technologies are driving that shift: robotics, digital intelligence and novel energy platforms.
“The era of robotic platforms, novel energies and digital intelligence is going to be transformative to our field,” he said.
Together, these tools could enable physicians to perform increasingly complex procedures through minimally invasive techniques, and potentially automate parts of routine care.
“One example is that in the future we’re going to have platforms that map polyps in the colon and allow robots to guide you to where these polyps are,” he said. “Then use energy to efficiently ablate these lesions rather than resecting them.”
For Dr. Abu Dayyeh, these advances represent more than technological progress. They reflect a broader shift toward faster innovation cycles and more patient-centered solutions in medicine.
“I’m very optimistic about the future of where this field is going,” he said.
