Gastroenterology is a rapidly developing field as the demand for services increases among the U.S. population and advances in clinical technology open up new possibilities within the specialty.
Peter Muscarella, MD, a GI surgeon at Southern Ohio Medical Center Surgical Associates in Portsmouth, recently joined Becker’s to discuss the developments and concerns he believes will play the biggest role in shaping the future of care in the specialty.
Editor’s note: This response has been lightly edited for clarity and length:
Question: What clinical or technological advancement has had this biggest effect on gastroenterology in the last five years?
Dr. Peter Muscarella: There are so many recent advances in gastroenterology, but I think that the two things that have the potential to make the biggest impact would be the development of targeted agents and immunotherapy for the management of benign and malignant disorders of the GI system and the use of artificial intelligence and advanced imaging technology to visualize mucosal lesions at the time of endoscopy.
Q: What is your biggest concern in the specialty right now?
PM: The biggest concern that I have in the field of GI surgery and gastroenterology would be related to disparities of care delivery for patients in rural and underserved areas. Most advanced GI care and procedures occur in large urban areas, generally at tertiary referral centers. There are usually numerous practicing gastroenterologists in these areas, but access to trained, board-certified gastroenterologists in rural and underserved areas is suboptimal. General surgeons are often asked to provide these services, and this could potentially represent a disparity for patients. There should be efforts to ensure that quality standards are uniform for all patients. Furthermore, barriers resulting in delays in referrals to advanced GI care could result in worse outcomes for patients who reside in these geographical areas. I believe that the contributions of general surgeons to the routine management of GI disorders in underserved areas do not receive the attention that they deserve. Appropriate resources for training, support and ongoing quality improvement should be provided for these physicians.
