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 are the best investment ideas for gastroenterologists?
Please submit responses to Carrie Pallardy at cpallardy@beckershealthcare.com by Thursday, March 19, at 5 p.m. CST.
Larry Good, MD, FACG, founder, CEO Good Pharmaceutical Development, CEO, Compassionate Care Center of New York: It is unclear how repeal of the Affordable Care Act will affect gastroenterologists, because it is unclear how the Act itself will affect practitioners. First of all, repeal is unlikely. If all or portions of the Act were repealed, it would create havoc in the insurance market place and would disrupt the economic impact assumptions of many institutions.
So far, the ACA has not lessened the load on emergency rooms. So little time has passed since its inception, there is no way to assess its effect on disease prevention. The Congressional Budget Office has recently released data suggesting that the rate of increase in government healthcare spending is rising less rapidly than anticipated.
One effect of repeal might be to lower rapidly rising deductibles (often $6000 per person per year) for patients with private insurance plans. That might increase utilization of necessary, but expensive, screening procedures like colonoscopy. This is, after all, Colon Cancer Awareness Month.
But, the ACA did not occur in a vacuum. It was created in a social and political environment that has shifted away from the conventional medical model. We are not going back to cottage industry medicine. The fundamental changes are here to stay.
Patrick Takahashi, MD, CMIO and Chief of Gastroenterology Section of St. Vincent Medical Center (Los Angeles): If the PPACA were actually repealed, it would be very intriguing to see what would happen within the field of gastroenterology. The wheels have already been set in 
motion in terms of patients moving towards managed care plans and the like. The question begets, “Where would these patients end up going to?”
I can’t imagine that things would magically revert back to the way they were. There is not enough financial backing to support such an endeavor. It is not as though reimbursements would magically increase either. The biggest change would be access for patients, as it appears as though the PPACA has limited the number of physicians who are actual providers for the patients who are members of these plans. By repealing it, I would hope that patients would once again have greater access to a larger pool of gastroenterologists, as well as other physicians.
More articles on gastroenterology:
Penn State Hershey Medical Center uses less invasive screening for colon cancer
Mid-South Gastroenterology Group partnerships aim to increase colonoscopies
Loyola University Health System adds Dr. Lesley Rhee
