5 ways gastroenterology will be affected long after the pandemic

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Gastroenterology saw enormous setbacks during the pandemic — colorectal cancer screening procedures dropped more than 80 percent in the early stages of COVID-19. 

Four GI leaders spoke with Becker's ASC Review on the ways that GI will be affected long after the pandemic. 

1. Telemedicine

Most GI leaders agree that telemedicine, in some capacity, will continue to be used in GI practices long past the pandemic. 

"Certainly, telemedicine is here to stay. I think more studies will be ordered than probably are indicated," Sheldon Taub, MD, a GI specialist based in Jupiter, Fla., told Becker's ASC Review.

This also applies to digital communication tools that became more important with virtual diagnoses. 

"Digital tools for patient communication — OpenNotes, MyChart — will gain traction," said Vivek Kaul, MD, the Segal-Watson Professor of Medicine at the University of Rochester (N.Y.) Medical Center. "GI practices will have to get used to, and plan on, a proportion of the employee base working from home."

Dr. Kaul also said he expects telemedicine malpractice issues may emerge. 

2. GI technology

Latha Alaparthi, MD, is the director of committee operations at the Hamden-based Gastroenterology Center of Connecticut and vice president of the Digestive Health Physicians Association. She told Becker's ASC Review that she suspects virtual continuing medical education will likely continue. 

Dr. Kaul echoed these thoughts, saying simulation-based training for fellows could be more widely adopted. 

He also expects the increase in adoption of GI technology like disposable endoscopes and artificial intelligence.

"The COVID-19 pandemic has completely changed care delivery, but we've learned to adapt and collaborate among each other like never before. Whatever the future brings, we'll be ready," Dr. Alaparthi said.

3. Racial health disparities

COVID-19 also has highlighted the major health disparities and racial discrimination, Dr. Alaparthi said. 

"It has given us a heightened sense of urgency to improve education and awareness, remove barriers for cancer screenings and strengthen the pipeline for physicians of color," she said 

4. Backlogs and delays

Dr. Kaul said screenings for colorectal cancer may continue to be delayed and backlogged because of medical doctorate attrition, significant cancellations from 2020 and the recent age reduction for initiating screening. 

This will likely lead to an increase in the volume of functional GI disease, which will affect the GI industry for years to come, he said. 

Emergency preparedness will also become a priority due to these COVID-19 backlogs and delays. 

"[Personal protective equipment] and emergency and crisis preparedness will be a high priority for units and hospitals going forward," Dr. Kaul said

5. Political environment

Some GI leaders believe that COVID-19 changed the political landscape, which will subsequently affect how GI practices run.

Larry Schiller, MD, of Digestive Health Associates of Texas in Dallas told Becker's ASC Review that he thinks the expansion of healthcare coverage to a larger number of patients could increase GI visits. 

He also thinks, however, that there could be a more concerted effort to constrain reimbursements for medical services. 

"Other economic pressures on gastroenterologists will include increasing the minimum wage to $15 an hour, which will affect some practice employees, and increased taxes on high earners, which include many gastroenterologists," he said.

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