Editor’s note: This response was edited lightly for length and clarity.
Question: What obstacles are there in terms of the migration of gastroenterology procedures to outpatient settings?
Jerry Tillinger: In my world, it’s primarily been capacity. Five years ago, generally, physicians were splitting up their time, about 40 percent in endoscopy centers, about 40 percent in the office and about 20 percent at the hospital. That was at a broader market. And what you’re seeing now is that we need them in the endoscopy center more and more. You’re having less office time as a result, which means we have more advanced practice nurse practitioners and physician assistants covering office time. That’s a cultural shift in and of itself. But the next pressure is gonna be on the hospital side, where the hospital is highly inefficient from a business perspective and the quality of life level. Some of my physicians told me the hospital for them is there because the days frequently are 12 to 14 hours. They’re racing around. It’s the most chaotic part of their life. It’s a lot, so when they’re looking at their own quality of life as they move through their career, they’re more and more starting to question, why am I going to the hospital at all when I’ve got a four- or five-month waiting list at my endoscopy center?
I think that pressure is gonna keep mounting. I get calls every month from hospitals asking if we can provide GI coverage for them, and in every case where I’m not already there, the answer is no, I don’t have anybody available and if I did that’s the last job they take.
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