What will gastroenterology look like in 10 years?

Five leaders in gastroenterology joined Becker's to discuss what they think the profession will look like in 2031. 

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

Question: What will gastroenterology look like in 10 years? 

Michael Dragutsky. Chairman of One GI (Nashville, Tenn.): Two clinical emerging areas, which will be mainstays of practice, are targeted preventive screening based on patients' individual genetic information and therapeutic adjustment of individual microbiomes, as the role the gut primarily plays in a multitude of diseases (such as autoimmune diseases, brain health and obesity) becomes better understood. Additionally, consolidation will continue with eventual development of regional and supra-regional mega-gastroenterology groups. 

Andy Paulson. Executive director of Central Illinois Endoscopy Center (East Peoria): I believe that in 10 years gastroenterology will be made up of large groups that are private equity-owned and hospital-owned. I believe the specialty will be in high demand but will experience provider shortages.

Nate Merriman, MD. Medical Director for GI and Digestive Health at Intermountain Healthcare (Murray, Utah): Gastroenterology 10 years from now will be more human-centered, team-based and data-informed. There will be predictive analytics in place at the population health level and the individual level to help us better predict and prevent disease, in particular, cancer, before it happens. Based on individual-level data using personal genomics in combination with aggregate population-level data and individual patient health monitoring, we will be able to identify early relevant patterns. We will then be able to reach out to patients in a team-based, proactive care format to help support patients with needed testing or procedures, or with specific diet, activity or medication recommendations, to help patients and families achieve the health and wellness goals they are striving for.  

Kelly Rhineberger. Administrator of Bayfront Health-Florida Endoscopy & Surgery Center (Brooksville): If CMS continues to pay physicians more for doing these procedures in their offices, then gastroenterology will be very minimal in an ASC setting in the next 10 years.  We are hoping this does not continue with CMS, and they realize these procedures should be performed in an ASC setting. They are much safer for the patients, and the quality of care is much better for the patients.

Thomas Hutchinson: Executive director of Digestive Health for Hoag Memorial Hospital Presbyterian (Newport Beach, Calif.): The next 10 years will bring sweeping changes in gastroenterology as processes, technology and research will continue to rapidly evolve. Artificial intelligence and machine-learning advances in both upper endoscopy and colonoscopy will continue to improve diagnostic capabilities and decrease screening times while leading to increased detection, and ultimately, an improvement in cancer prevention and disease mitigation. New quality metrics will be developed and implemented in ASCs nationally to continually improve performance and prevention. As advanced techniques improve and become standard, the line between advanced endoscopy and surgery will continue to blur and shift from hospitals to surgery centers. Finally, as the microbiome conversation becomes more prevalent with patients and the industry, integration of these biomedical advances will be demanded and become part of digestive care in the ASCs. 

James Leavitt. President and Chief Clinical Officer of of Gastro Health (Miami): I think consolidation will continue and will be a driving force in healthcare. You're going to see way more consolidation on the provider side, on the payer side and on the hospital side. Augmented intelligence, big data analytics and predictive analytics will be a driving force in this consolidation. In order to do all this stuff, you're going to need to be consolidated.No. 1, with consolidation, you can create big data.No. 2, you can afford the infrastructure to create the big data and to manipulate the big data. You're also going to see more personalized medicine that will drive better population health. I think we're going to deal with individual people's personalized medicine to drive better outpatient care and better population health. 

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