5 Biggest Issues Facing Gastroenterologists Today

Here are five of the biggest issues currently facing gastroenterologists.


1.    Increasing complexity and cost of business management

a.    New regulatory demands in the areas of technology, security, staffing, continuous quality improvement, record retention and documentation, etc., have contributed toward making the business of medicine ever more costly and demanding upon physician's time and expertise. This past year alone has brought substantial increased scrutiny of ASCs with new rules on infection control, new CMS rules for Condition for Coverage, new accreditation agency regulations, Red Flag Rules, etc. All of these issues demand more time and consume more capital resources. Full compliance must be achieved in a declining reimbursement environment.

b.    Gastroenterologists, realizing the increased costs and complexities of sustaining their business model, have begun to explore survival alternatives such as hospital employment options and/or mergers into super-groups as well as aggressively exploring the potential capture of ancillary revenues.

2.    Need to define, report and self-monitor a standard of care that will maximize the value of the specialty
a.    Gastroenterologists need to create the tools that will define the value of the specialty for patients, payers and referring physicians. Measures for standard of care and standard of performance need to be well documented and available for scrutiny. The veil is being lifted and patients are beginning to seek evidence of documented quality performance metrics in the areas of quality of care, accessibility and cost.

b.    The three GI societies need to come together and work as one to add value to the specialty. It is important for gastroenterologists to speak with a single voice, to have strong unified representation and to take charge of setting the standard of care and performance metrics that will define, protect and promote the specialty.  

3.     Recruitment/shortage of new physicians/Encroachment
a.    More GI physicians are approaching retirement than there are new physicians joining the specialty to replace them.

b.    There is increasing demand for GI services, as patient demographics continue to change and as patient education improves.

c.    Vastly improved technology is paving the way for non-gastroenterologists to be more aggressive in providing endoscopic services further emphasizing the need for metrics and differentiation.

4.    Change the way GI specialist services are marketed
a.    As patients increasingly take more control over their own healthcare and proactively make healthcare decisions, it will be imperative that gastroenterologists do more to market their scope of services, their quality, their availability and their patient education directly to patients through various forms of media. It is time to recognize that we live in a highly competitive world, and in this market niche, the competition is not other well-trained gastroenterologists, it is the potential encroachment of mediocrity, non-GI endoscopists and failure to clearly differentiate.

5.    Declining reimbursement
a.    Professional fees/facility fees/change in consult fees, etc., are all under attack.

b.    Increasing costs — especially in the areas of staffing and benefits, insurance, new technologies including electronic medical records and processes such as HIPAA, infection control, etc., — all have similar impact upon the chances for continued success.

c.    Gastroenterologists are overworked and increasingly under-appreciated.

d.    The need to see ever increasing number of patients has dramatically increased the use of physician extenders.

Mr. Tanner is president and CEO of Physicians Endoscopy, which specializes in development and management of free-standing, single-specialty ambulatory surgery centers. Learn more about Physicians Endoscopy.

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