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This article appears in the December 2021 issue of the


David Young, President & CEO
December 7, 2021

6 key takeaways from a roller-coaster year

As we approach the end of 2021, it’s an apt time to look back at the year. And what a year it was. It’s safe to say that 2021 did not go the way anyone likely expected.

David Young, President and Chief Executive Officer of PE GI Solutions, puts himself in this bucket. He recalls feeling optimistic over the summer that the end of pandemic was nearing. This was before the Delta variant hit with full force. It slowed down the momentum that was building thanks to the rollout of vaccines and improved COVID-19 testing and treatments.

It’s looking like 2021 will end with the pandemic as a significant presence. However, that doesn’t mean it was a bad year. In fact, for the GI industry, Young sees many positives and remains greatly optimistic about the future of the specialty. He also recognizes that there is significant work to be done for GI to emerge with positive momentum. This will help further solidify the specialty’s critical role in our healthcare delivery system.

Here are six of David Young’s key takeaways for the GI industry from 2021:

The industry showed its resilience

2020 was undoubtedly one of the most challenging years for healthcare and the GI industry. However, Young says 2021 wasn’t that far behind. “Consider how we came through the worst of COVID-19, then how we responded from a period of no vaccine to vaccine to the decisions we’ve needed to make concerning vaccinated and unvaccinated staff and patients. We’ve had to figure out how to live with Delta and hotspots. We’re continuing to adjust to the experiences and developments that have changed the way practices and surgery centers have operated, such as telehealth, testing, and masking. Then there are all the things we’ve learned and needed to consider during these periods.”

The fact that GI remains strong is quite a testament, Young says. “I’m particularly proud of the way the industry has learned how to deal with COVID-19 and become more sophisticated with decision-making around it. When cases rise, we don’t panic and race to shut down. We apply what we have learned from our experiences and help ensure we can keep moving forward.”

Efforts around patient engagement have been commendable

During a time when coordinating care has proved difficult at best due to factors including disruption in patient job status, housing, and insurance coverage, Young says the GI industry has still managed to achieve high levels of engagement.

“Whether via telehealth, recall programs, or triaging, the ability to get patients to the appropriate care environment has been really impressive,” he says. “The focus on patients has been incredible during this period. That’s not just around delivering care but getting patients to the right place at the right time for the right service and for the right payer. This hasn’t been an easy feat, and yet this is an area where the industry has excelled.”

Providers continue to face and respond strongly to pressure

The fact that the GI industry is performing as well as it is speaks volumes. This is especially considering the ongoing challenges facing gastroenterologists and their practices and ASCs, Young says. This includes backlogged patients who still require GI care and services, overworked physicians and staff, a tougher safety and personal protective equipment environment, and the ever-lingering uncertainty that COVID-19 has introduced into day-to-day operations.

“Unfortunately, we have the same number of GIs trying to fit in all these patients and prioritize and catch up on the more critical patients,” he says. “You’re working harder than ever, and it’s tiring.”

This makes the U.S. Preventive Services Task Force’s recently updated guidelines on colorectal cancer screenings, which dropped the recommended age for screening from 50 to 45, a bit of a mixed bag for the GI industry. While this is certainly a positive for patient care, Young says, and payers are beginning to implement coverage for this younger age, the revised guidelines expand the patient population that should be receiving GI care at a time when gastroenterologists are already struggling to support patients.

“This development and our current situation make it all the more important that we continue finding ways to keep engaging with patients, dealing with mental challenges for our doctors and staff, and identifying opportunities to improve access, experience, and the diagnosis of issues,” he says.

Technology is helping and positioned to do even more

Technology is taking on greater importance in the delivery and coordination of care. Young says that will only continue to grow. Clinical and information technology advancements—everything from computer-aided polyp detection systems to reputation management tools to cloud solutions—are helping GI practices and ASCs improve their operations and performance across the board. There’s also the emergence of telehealth, a topic that now feels synonymous with the pandemic.

Telehealth is here to stay, Young says, bringing with it many pros and cons. “We’re still learning how to effectively incorporate and leverage telehealth. We know it can enhance patient access and provide gastroenterologists with even greater control over their practice. On the other hand, it brings some challenges around patient engagement, and there remain barriers to access for some of our most vulnerable populations. It will take some time until we fully understand how telehealth will affect GI.”

Consolidation shows no signs of slowing down

Even with all the disruption in the GI industry during 2021, consolidation is proceeding at a rapid pace, Young says. “The business of GI is hard at work across the country, and that’s leading to more consolidation to support practices, which have generally been under-supported. We are now seeing second deals and financings completed and a lot of new consolidation underway.”

For consolidation to be successful and beneficial to the industry, it requires a focus on creating value through operational delivery versus simply growing in size, Young says. “We must be able to repair income, improve scaling and leveraging of services and solutions, and strengthen our value proposition—not just become bigger for the sake of becoming bigger. That’s the next test for the piece of the consolidation play.”

Improving the care of gastroenterologists should be a priority

So much attention is on patient care, often followed by the wellness of staff. Therefore, the needs of doctors are often overlooked or not given the attention they deserve. It’s imperative, Young says, that this changes.

“We’re seeing organizations trying to find solutions to deal with succession problems and transition planning to the evolving needs of doctors in this post-COVID environment,” he says. “These efforts have been good, but they must be even better if we want to ensure a strong path forward for the industry and successful transition into future generations of GI.”

Read more of Young’s reflections on the year and thoughts on the future of the GI industry in this issue’s “Message From the President” on page 2 of the full issue of our December journal: