Here are three challenges gastroenterology is presented with today:
Declining reimbursements
From 2007 to 2022, the adjusted average reimbursement for GI procedures declined 33%, according to a study published in the American Journal of Gastroenterology.
"There is the well-known issue of decreasing reimbursement over time for procedures that already have existing CPT codes, and that too in the face of the post-pandemic increased demand, higher costs of doing business and staffing issues," Vivek Kaul, MD, Segal-Watson professor of medicine in the gastroenterology and hepatology division at the University of Rochester (N.Y.) Medical Center, told Becker's. "In addition, a real challenge we are facing is the inability to get reimbursed for a host of relatively newer (but well established) endoscopic procedures that have emerged in the last decade or so. Oftentimes, these are minimally invasive, transformational interventions for our patients that help reduce morbidity, length of stay and overall healthcare costs but are poorly reimbursed or not reimbursed at all, in some cases."
Patients not getting screened for colorectal cancer
"I would say that the biggest threat is patients not getting screened and delaying their screening," Benjamin Levy III, MD, a gastroenterologist at University of Chicago Medicine, told Becker's. "Also, trying to get the screening performed on time. We recently changed our screening guidelines from age 50 to 45. I think one of the toughest things that we've been doing is trying to get the word out.
"We were seeing an increase in diagnosis of colon cancer at age 49, it was alarming. So the thought was to change the guidelines to begin screening at age 45. What we're seeing in clinical practice when we screen some of the patients at age 45 who are just doing their due diligence, frequently we'll see a polyp that's one or two centimeters in size. Literally in real-time we're preventing colorectal cancer. But there aren't enough patients within that age range between 45 and 50 that are coming in on time to get their screening colonoscopies."
Gastroenterologists shortages
The gastroenterologist shortage is projected to reach 1,630 by 2025.
"There is currently a GI physician shortage, so for the long term, practices need to develop retention plans for senior physicians and also expand and retain ancillary providers into the practice," Stephen Amann, MD, gastroenterologist at Digestive Health Specialists in Tupelo, Miss., told Becker's. "Recruitment of new GI doctors will also be critical for patient service and support and will be on the minds of all practices."