Why GIs are leaving the field

Administrative burdens and payer challenges are two key factors that could lead gastroenterologists to leave the field.

Two gastroenterologists recently spoke with Becker's about the challenges facing practitioners in the field.

Editor's note: Responses were lightly edited for clarity and length.

Questions: What are some factors that may contribute to gastroenterologists leaving the field?

Nizar Ramzan MD. Gastroenterologist at Arizona Gastrointestinal Associates (Phoenix): In my view, the burden of administrative work imposed by health insurance companies, regulatory agencies of government, human resource problems and the unnecessary practice of defensive medicine because of the threat of malpractice suits consume a practicing gastroenterologist (and other specialists as well) over a period of years. The above are causes of burnout and exit from the practice of medicine.

Pooja Singhal, MD. Gastroenterologist at SSM Health (St Louis, Mo.): In my opinion, the decision to potentially leave the field of gastroenterology that one has spent an average of 14 years of investment to train and practice is based on multiple factors. Higher demands of productivity, constant annual cuts by insurance companies for procedure reimbursements and lack of autonomy ultimately lead to a lack of job satisfaction at the price of personal life sacrifices. Ultimately, sustainability of any job, especially a high demanding job like gastroenterology that requires mastery of procedural and clinical skills, is dependent on feeling a sense of purpose and maintenance of autonomy. It is encouraging that we have more women gastroenterologists now than ever, but the number still remains disproportionate. Women gastroenterologists may face unique challenges like ergonomic-related injuries, fertility issues that may contribute to the decision of leaving or prolonged leave. It is our responsibility as a society to listen, recognize the key issues affecting physicians and be part of the solution. 

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