Opportunities for Success in the Future: 6 Gastroenterologists Discuss

Here are six gastroenterologists discussing the biggest opportunities for success in 2014.

William KatkovWilliam Katkov, MD, Saint John's Health Center, Santa Monica, Calif.: There are a lot of exciting things happening on the medical front, and gastroenterology continues to evolve rapidly. In terms of the business of medicine, it is important to be an active participant and to be personally invested in any new entity.  Active participation in the process allows you to have some control over your future. I'm an advocate of joint ventures whenever possible as opposed to simply becoming an out-and-out employee.

Gastroenterologists should become well informed about these issues and explore as many options as possible before making a decision or choice regarding realignment and employment. But at the same time, you don't want to put your head in the sand. Accept and recognize that change is occurring rapidly, formulate a plan, and make informed decisions for the future.

Lawrence Kim, MD, South Denver Endoscopy: Fortunately, gastroenterology services are still needed in the new healthcare market. The world as we know it is going to change and how we Lawrence Kimreimburse for services will change. The way we provide services will also change, but successful practices will adapt and thrive in these changes. They will have to adapt and consolidate relationships, working more closely with payers, hospitals, accountable care organizations, and other entities that will control access to patients.

Gastroenterologists who can define common goals with these other entities will succeed. In order to do that, we will need to accurately measure and publicize patient outcomes and demonstrate the value of our care. We will also need to find ways to reduce overall cost to the system. The bottom line is gastroenterologists are the best-equipped providers to direct cost-effective and quality care for digestive disorders. We need to stake claim to this segment of the healthcare system and embrace our responsibility.

If we can do that as professionals, we will thrive.

Lawrence KosinskiLawrence Kosinski, MD, MBA, Illinois Gastroenterology Group, Elgin: There are opportunities for gastroenterologists to improve the patient experience. We opened our center in 2006, and if you look at our strategic plan from back then, our focus was on building a center that would attract patients independent of the physicians' practicing there. We created a center that is more spa-like in its appearance. Every patient has a private room and access to a private bathroom. We created a center that would be the place everyone wanted to go to have their colonoscopy done.

When we first built the center, we were more dependent on primary care referrals, but we wanted to be able to market directly to patients more. We also found that patients prefer to have anesthesiologists administering their anesthesia. You want the patients to be comfortable. Approach each procedure with the concept that every patient deserves the appropriate sedation. Who gives the sedation is less important than the ultimate outcome for the patient. We are well positioned to compete in the era of bundled payments and at the same time can provide excellent patient experience.  

Blair Lewis, MD, Mount Sinai Hospital, New York: As we go forward, I see the move of technology that used to live within the hospital setting into the ASC. My surgical colleagues who have ASCs Blair Lewisare doing outpatient gull bladder surgery, appendectomies and other procedures there. They are driving business to the ASC, which allows them to be much more efficient and patients can go home the same day.

In the ambulatory endoscopy center, I see technologies I thought we couldn't do in the outpatient setting moving there. Treatment for Barrett's disease is coming to the ASC with radiofrequency ablation. ASCs are no longer just for screening and surveillance.

Harry Sarles, MD, President of American College of Gastroenterology, Digestive Health Associates, Rockwell, Texas: One of the opportunities we have lies in our ability to measure the quality of the work we do. Being able to define, measure and report it, and then market our outcomes, is a huge advantage. The second Harry Sarlesadvantage, especially in an ASC setting, is the ability to bundle services connected to a particular procedure like pathology and anesthesia services. Depending on the ASC's position and ability to negotiate with payers, bundled payments could be an attractive option.

My vision is that bundled payments could be a huge market driver in the future, especially when contracting directly with ACOs, hospitals and insurance companies. If you have a service that is verified as equal or greater quality, and you can deliver it at a lower cost, the surgery will be done at your center. Our group has found hospitals, ACOs and payers reluctant to partner with us, but as things evolve, I think market forces will drive the popularity of the ASC.

Richard Zelner, MD, Orange Coast Memorial Medical Center, Fountain Valley, Calif.: Success for the physician should always be defined as providing the highest level of care to each patient.Richard Zelner In our dramatic push to control health costs all measures that will lower costs and or improve efficiency without impairing quality provide potential for significant opportunity. Right now the cost of care sometimes overrides our nation’s ability to care for patients. For physicians and surgeons involved with ASCs, there are opportunities to set up locations in new areas that are underserved and provide care independent of big health systems. This potentially will significantly lower costs and provide improved access to patients for care.

More Articles on Gastroenterology:
Stay Competitive: 5 Enhancements for GI/Endoscopy Groups

6 Gastroenterologists on Evolving to Meet Challenges in Today's Healthcare Market

The Latest in GI Cancer: Q&A With Dr. Neville Bamji of New York Gastroenterology Associates


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