3 major disruptors of gastroenterology

Neal Kaushal, MD, a gastroenterologist at Adventist Health's Foothill Specialty Group in Sonora, Calif., connected with Becker's on Nov. 10 to discuss three major disruptors of gastroenterology.

Editor's note: Responses have been lightly edited for length and clarity.

Question: What are the biggest disruptors in GI?

Dr. Neal Kaushal: The GI industry as a whole is at a unique place right now. Traditional care models are being challenged across many different specialties in an effort to increase access to care, reduce overhead costs, and continuously innovate for the betterment of patient care. This dynamic is being seen both on the clinical front and in the care delivery space.

1. Artificial Intelligence in medicine is here to stay. Many different ideas come to peoples' minds when they hear the words "artificial intelligence." This conjures everything from images of robots walking our dogs to autonomous driving vehicles. The truth about AI in medicine is that it is often overlooked, though it is not actually a new phenomenon when it comes to the evolution of a major American industry.

When Henry Ford built the Model T in 1908, he didn't just build a car. He started a revolution. How? Automation. He showed the world the assembly line manufacturing model, which essentially figured out how to automate an otherwise labor-intensive, costly process, for the benefit of the masses.

AI in medicine, especially gastroenterology, will likely be a similar force that will fundamentally change the industry. This is already happening in a clinical sense as shown by AI-based polyp detection systems becoming a growing presence in mainstream GI practices. From a care delivery and business standpoint, endoscopy centers, especially ASCs, will likely see an increase in leveraging data analytics tools in order to optimize their operations and reduce overhead costs. This can include everything from predictive procedure and staff scheduling to automated patient engagement tools to enhance patient experience. AI certainly has its detractors even amongst younger generation physicians, but overall it will be interesting to see how this plays out in the coming decade and see how AI changes the GI landscape as a whole.

2. While the number of smaller, independent group practices continues to dwindle across the United States, not all are being absorbed into large health systems or integrated delivery networks. Many physicians in community practice are turning to private equity firms for capital in order to form larger or mega groups of their own, as a means of increasing purchasing and negotiating power with payers and vendors. Also, while venture capital in healthcare has seen a boom in terms of technology and pharmaceuticals ever since the early 2000s, private equity in GI represents a paradigm shift in the care delivery model. Simply put, gastroenterologists are increasingly saying to themselves, "Why do I have to be a cog in the wheel of a health system machine? How can I retain autonomy of practice as much as possible but still be part of an organization that is a profitable enterprise?" I have to give private equity firms credit where credit is due — they seem to recognize that physicians are innovators, and when faced with financial pressures from current health system issues, they are adept enough to find new avenues to maximize their earning potential while still serving their patients.

3. Let's face it, we all know that inflation is at an all-time high, groceries and gas are more expensive than ever, and healthcare costs are no exception to the basic principles of economics. Regardless of reason, healthcare costs continue to rise, which constantly exerts pressure on providers and ultimately patients to coexist in a system where healthcare is both profitable and affordable. Value-based care is becoming increasingly prevalent as a means of trying to either curtail or at least contain costs by payers and insurers. Bundled payments will likely be on the rise as increased pushback against fee for service medicine continues. This may likely push more care to the outpatient and especially ASC setting as it pertains to GI, which will compel GI physicians to seek care delivery models that can adapt to this changing environment.

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