The biggest challenges gastroenterologists are facing

The ebbs and flows of the evolving field of gastroenterology come with a host of challenges, including patients' stressors and whether to seek funding from private equity.

Three GI experts weighed in to answer: "What is the biggest challenge gastroenterologists are facing?"

Editor's note: These responses were edited lightly for clarity and brevity.

Peter Barrow. Consultant Gastroenterologist at Wits Donald Gordon Medical Centre (Johannesburg, South Africa): As a gastroenterologist in private practice in South Africa, the biggest challenges I think we are facing are:

1. The funding of biologic and small molecule medications for all patients with inflammatory bowel disease.
2. The copayments from private funders (insurers) for endoscopy.
3. We also have a challenge with properly trained specialist gastroenterology support staff such as endoscopy and inflammatory bowel disease trained nurses.
4.The rising cost of private healthcare in general.

Susan Chu, MD. Gastroenterologist at Sharp Memorial Hospital (San Diego): In the last five to 10 years, there has been a notable increase of stressors in our patients' lives and COVID just tops it. The confluence of these factors contribute to an increase of all kinds of GI diseases including functional GI diseases, alcoholic liver diseases, worsening obesity and COVID related long hauler disease that are affecting our patients' health. Another reflection of our time, some patients have also expressed that despite having more sources available for their health information, they are sometimes unsure as to which source to trust. It has been a challenging and yet a unique time to manage the complexities of our GI patients.

Ray Keate, MD. Assistant Professor of Medicine at VCU Health (Richmond, Va.): What I see in the young people finishing fellowship is that they all want to be successful, but they have a lot of concerns. They have concerns about joining groups that have already been bought out by private equity. They have concerns about staying in academics because of the challenges within academics such as publish or perish, grant money and other factors. Many of them are seeking hospital employment positions because of that.

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