From prior authorization burdens to the advent of new AI, three gastroenterology specialists spoke with Becker's about the key factors that will make or break the field of GI in 2025.
Omar Khokhar, MD. Gastroenterologist at Illinois GastroHealth (Bloomington): The two factors to watch are pre-authorization burden and reimbursements. It's understood that cost cutting is part of the picture, but reducing reimbursement puts additional pressure on clinician practices which may lead to delayed care and diagnoses. GI wait times are already snowballing nationwide, and I fear that delayed cancer diagnoses may be a result.
Linda Lee, MD. Medical Director of Endoscopy at Brigham and Women’s Hospital and Brigham & Women’s Faulkner Hospital (Boston): I'm not sure there is one thing that will make or break GI care in 2025, but an ongoing issue that will become more pressing as it continues to fester is reimbursement. Specifically, the issue of ongoing decreasing professional fee reimbursement in the face of increasing expenses and pressure on physicians to do more. Related to this is the ongoing lack of appropriate reimbursement to gastroenterologists for performing cutting-edge procedures that often obviate the need for more expensive and morbid surgeries. Yet these procedures typically go unrecognized when it comes to professional billing, with physicians often receiving no or very little compensation for often very complex procedures. There must be a better global mechanism for recognizing the professional value of these procedures even before official professional CPT codes have been assigned.
Benjamin Levy III, MD. Gastroenterologist at University of Chicago Medicine: 2025 will be an important year for the rollout of artificial intelligence in gastroenterology, including AI-assisted endoscopic tools to help us identify polyps during gastroenterology procedures. Increasingly, gastroenterologists will use AI dictation software in clinic, which will help improve the accuracy of notes, decrease the amount of time we spend typing, lower the potential for repetitive stress wrist/hand injuries for endoscopists and hopefully allow gastroenterologists to increase the number of patients we can see in clinic each day.
In 2025, we will see a dramatic expansion of intestinal ultrasound use for [inflammatory bowel disease] patients so that we can monitor disease activity in clinic. Intestinal ultrasound does not require fasting or a "bowel prep." This will allow gastroenterologists to determine response to biologic therapies in clinic, even before a colonoscopy is performed.
In addition, we hope to increase the percentage of patients nationally being screened for colorectal cancer. We have many screening options today, including colonoscopies, which can prevent colorectal cancer by removing polyps, [fecal immunochemical test], Cologuard and the new Shield blood test, which received FDA approval in 2024. It's important for us to continue educating patients to begin colorectal screening at age 45 due to the increasing number of early onset colorectal cancers being diagnosed.