This article appears in the December 2022 issue of the
PE GI Journal
PE GI Solutions' CEO and President, David Young goes through the changes, advancements and challenges of 2022.
2022: The Year of Changes, Advancements and Challenges
7 key GI Industry Takeaways Heading into Next Year
Looking back at 2022, PE GI Solutions President and Chief Executive Officer David Young says the year has been difficult for GI providers, and he expects some of the challenges facing the industry to continue into the new year. But he’s also encouraged by recent developments and recognizes that opportunities exist to help alleviate burdens facing the GI community.
The following are some of Young’s most significant takeaways from 2022:
1. The GI Doctor Role Is More Important Than Ever
Young sees what he describes as an “increased awareness” around the importance of GI and digestive health and the role of the GI provider in maintaining that health. This is resulting in encouraging changes for the industry.
“There seems to be much more patient awareness of and comfort with GI health, including colonoscopies. This is opening up dialogue between patients and providers,” Young says. “In addition, you’re seeing the likes of pharmaceutical companies, research organizations, medical device organizations and technology companies all trying to figure out how and where to invest to enhance clinical outcomes and the patient experience. Payors and the government are also paying closer attention to GI these days.”
Such recognition by so many different constituents is further elevating the importance of GI in the broader healthcare system, Young says. “These constituents are all recognizing GI doctors have a significant role to play in effectively being the primary care doctor for many patients and having a substantial impact on the downstream cost of care and outcomes.”
David Young, President & CEO, PE GI Solutions
2. Increasing Interest in Colon Cancer and Colonoscopies
It’s been more than 20 years since Katie Couric broadcast her colonoscopy—a decision that helped raise awareness of the importance of the screening and led to a surge in the number of procedures performed. Over the past few years, efforts to further awareness have received boosts from a variety of sources.
“Like Couric, one of the most significant factors has been high-profile celebrities coming out with cancer issues or publicizing their colonoscopy,” Young says. Among them: Jimmy Kimmel undergoing his first screening on camera in 2018, Chadwick Boseman’s death from colorectal cancer in 2020, and Ryan Reynolds and Rob McElhenney getting colonoscopies on camera in September 2022. “Publicly recognized people talking about digestive health is definitely making a difference. Their messages are getting amplified and reaching millions of people thanks to social media. Telling people you had a colonoscopy now doesn’t seem as big of a deal as it did even just five years ago.”
Young also praises the efforts of associations and GI doctors to provide more clinical education and make such materials more easily accessible online. “When someone thinks something might be wrong with them, the default first step for many people is going online to do research. The ability to find information through websites and mobile apps about GI diseases and specialists is helping people get more comfortable with GI and digestive health. When patients understand why they need to take these more seriously, they are more likely to reach out to a specialist and get involved in the GI experience.”
3. Provider Burnout Requires More Recognition and Attention
GI doctors deserve a great deal of praise for their efforts this year as they worked to reduce the backlog of patients and treatments caused by the COVID-19 pandemic, Young says. But those efforts have had consequences.
“When you look at the productivity of these doctors during the first several months of the year, it was incredible,” he says. “They worked their tails off to try to get caught up, but they’re still not really caught up. The result is there’s a lot of fatigue, both mental and physical, which is why we’re seeing doctors justifiably taking more vacations and time off. We’re at a point as an industry where we must be looking at ways to create better work-life balance for the doctors, as well as their teams and staff, if we’re going to maintain long-term consistency of patient access.”
4. Staffing Challenges Add More Pressure
GI providers continue to encounter and are trying to navigate various staffing challenges, Young says. This includes nursing availability and wage pressures, which are making it more difficult to maintain stable teams and work environments and have made recruitment and retention more difficult. “Doctors are feeling it from both ends,” he says. “It’s hard to keep your head in a good place under all those pressures.”
5. Demand for Outpatient GI Care Is on the Rise
The rise in provider burnout and staffing challenges come at a particularly inopportune time for those doctors working at outpatient facilities like GI centers and other ambulatory surgery centers. Numerous factors have steadily been contributing to the rising number of patients and procedures making their way to these facilities. More advanced clinical technology, improved anesthetics and physicians becoming more comfortable with minimally invasive approaches to care were already fueling outpatient migration. In the last few years, additional factors like price transparency laws, commercial payor preference, federal initiatives and physician alignment with management services organizations (MSO) rollup groups have further accelerated this migration of care.
There was also the significant 2021 issuing of new U.S. Preventive Services Task Force recommendations for colorectal cancer stating that people at average risk should start screening at age 45 instead of the traditional 50. “You have the pleasant fact that there are now a lot more patients qualified for care, and so many of these patients are dealing with preventive issues,” Young says. “Preventive management leads to really good long-term patient outcomes and cost of care. But the challenge is there are simply not enough GI doctors. This has the potential to contribute to an even larger backlog of patients—both those coming for their first GI experience like a screening colonoscopy at 45 and those coming for a revisit—and scheduled appointments being pushed out further than we would like.”
6. GI Doctors Must Share the Workload
Given the growth in number of patients and patient appointments being delayed, Young says GI doctors must figure out how they can see more patients at the times when patients would benefit most from this encounter—in other words, when GI doctors are practicing at the top of their license. To accomplish such a goal requires GI doctors to assemble clinical teams capable of supporting patients through their various levels of GI care. This team would comprise advanced practice providers, physician assistants and nurses, among others.
“If we hope to better manage availability for and access to GI doctors, we must start working more toward these ‘top-of-your-license’ teams,” Young says. “By doing so, we can better triage patients and ensure they see the right licensure at the right time. Many GI doctors have not followed this model in the past, but considering there are already too many patients for doctors, if we don’t embrace this approach, patient care may suffer. We may limit the preventive access that’s needed.”
7. Advancements in Technology Can Improve Care—and Won’t Make GI Doctors Irrelevant
Technology is rapidly advancing, and Young understands why recent developments in this area may have GI doctors concerned about their futures. “A big fear is that the need for GI services will decline as technology changes. If I were a GI doctor, I would probably be wondering when there will be a pill patients can take, so they don’t need to have a colonoscopy anymore.”
Rather than fear technology, Young recommends that GI doctors welcome it. He points to a solution like GI Genius, which uses artificial intelligence (AI) to assist clinicians in detecting lesions during a colonoscopy, as a technology that won’t replace GI doctors but can help provide better care and outcomes. “The use of AI thorough a device like GI Genius can identify polyps that maybe a doctor might have missed. The doctor is essentially getting a second set of eyes when they use this technology. We recognize that colonoscopy is the gold standard, but there’s nothing that says we can’t improve on the gold standard with technology.”
The addition of technologies like GI Genius and others won’t make a GI doctor redundant or replaceable because the doctor remains the clinical expert, Young says. Technology will simply continue to change the ways patients can receive care and how doctors provide care. “That’s good news if it can enable more patient access to care, even if the care delivery system now involves the use of AI, infusion, oral drugs or other mechanisms. What we’re likely looking at are different modalities of care. Eventually, some patients may be able to move to popping a pill versus having an endoscopy or other procedure. But there will always be plenty of patients who need care that can only be delivered by a GI doctor.”
A New Partnership May Be a Path to Success in 2023
To GI doctors who are concerned about their future or unsure how to best grow their practices and centers, Young emphasizes that assistance is available. “There are organizations like PE GI Solutions working on behalf of doctors to help with staffing and recruiting, compensation analysis and retention management; changing work processes to better incorporate additional clinical team members; and adding transformative technology. The right partnership can help GI doctors alleviate some of the significant pressures they are facing. This should translate to a better work-life balance for doctors and their clinical teams and more patients receiving the timely care they need.”