Gastroenterology has traditionally been a procedural specialty. Endoscopy and colonoscopy are a gastroenterologist's bread and butter, but reimbursement for those procedures is declining. Three gastroenterologists weigh in on how to expand beyond the procedural and ways to improve overall GI practice and endoscopy center performance in 2015.
Ask a Gastroenterologist is a weekly series of questions posed to GI physicians around the country on business and clinical issues affecting the field of gastroenterology. We invite all gastroenterologists to submit responses.
Next week's question: What do you think are the biggest stories in gastroenterology for 2014?
Please submit responses to Carrie Pallardy at cpallardy@beckershealthcare.com by Thursday, December 18, at 5 p.m. CST.
Thomas Deas, Jr., MD, MMM, FASGE, Gastroenterology Associates of North Texas (Fort Worth): Improve, automate and intensify the patient recall process for colon adenomas, IBD and Barrett's at appropriate evidence-based intervals. Create patient loyalty, improved quality of care and increased revenue.
Patrick Takahashi, MD, CMIO and Chief of Gastroenterology Section of St. Vincent Medical Center (Los Angeles): 
Gastroenterology is looked upon as a procedural-based specialty and rightfully so. However, there are ways in which gastroenterologists can look to expand their practices outside this moniker. There are many subdivisions within the specialty which are generating a tremendous amount of interest among the general public. These areas specifically revolve around hepatitis as well as irritable bowel syndrome. For instance, with IBS, there is a tremendous amount that can be offered outside of just performing procedures for patients. Dietary management and management of bacterial colonization within the digestive tract are two burgeoning areas, which are garnering a plethora of interest among patients, and can serve as a potential "niche" area for gastroenterologists. Similarly, the field of hepatology will continue to offer potential for growth as novel and less toxic treatments for the disease continue to evolve.
David L. Vastola, DO, Your Good Health Medical Group (Palm Beach Gardens, Fla.): It's a basic premise of any business that unless you change with the times, you will not survive. Since the beginning of time, medicine has been a monopoly, but now it has a cast of characters all vying for the same patient. Like in the movie, "Other People's Money" with Danny DeVito, an outdated high-tech company was about to be bought and broken up into parts to make money for the shareholders. He used a buggy whip as a prop to explain why the buggy whip was no longer relevant. Medicine is no different, and unless gastroenterologists like myself change, they will become a buggy whip.
In my opinion, gastroenterologists need to encapsulate their practices around ALL aspects of internal medicine and not just GI. Under one roof, they can provide all the services that patients need and stop being procedure oriented. They are paying so little, they probably aren't even worth the time spent doing them. That's called profit margin.
Physicians should offer personal caring service without the electronic medical records taking up all of their time typing and not even examining the patients. It's also important to be available and get rid of the menu answer service telling patients to go to the ER. Gastroenterologists should encompass all these medical needs just the way they have been trained and be less dependent on referrals or face-time being replaced with giant clinics, hospitalists and nurse practitioners.
Stay in small groups of one to three physicians and avoid the herding of patients that you see in large groups, which are very inefficient and expensive to run. Our once procedure-oriented specialty has been replaced, and if you don't change, you will be replaced just like that buggy whip!