Becker's ASC Review

60 GASTROENTEROLOGY Two GIs on the biggest threats to gastroenterology By Carly Behm M isunderstandings of Cologuard and shis in reimbursement are some concerns gastroenterologists have for the field. Two gastroenterologists told Becker's ASC Review what they feel are the biggest threats to gastroenterology. Note: Responses were lightly edited for style. Brian Dooreck, MD. Gastroenterologist at Memorial Hospital Pembroke (Pembroke Pines, Fla.): I see one of the greatest threats to gastroenterology is through a very well- calculated and well-funded marketing cam- paign and a great degree of misinterpretation of what Cologuard actually "detects." What is the true role in colorectal cancer "prevention" versus its role in colon cancer "detection"? What I recommend to myself and my family is to prevent colorectal cancer, not detect it. Joe Feuerstein, MD. Gastroenterolo- gist at Beth Israel Deaconess Medical Center (Boston): I think in many ways the biggest threats to GI are both changes in reimbursements and evolving with medical advances. On a nearly yearly basis, gastroenterologists need to deal with the concerns of reduced reimbursements for the same work. While this may provide short-term cost savings for insurers, it shis an increasing burden on practitioners to increase their volume to maintain stable revenue. Ideally this process should be more sustainable and changing with inflation as opposed to a yearly debate on whether or not reimbursements should be decreased. Another concerning threat is the need to evolve with changes to clinical practice. Telemedicine is something that practices need to adopt, as patients may prefer the ability to forgo traveling into a clinic/hos- pital setting. Similarly, with the increasing options for colon cancer screening, gastro- enterologists need to embrace these changes and develop pathways for which they can provide patients with shared decision-mak- ing about these tests and utilize noninvasive tests when appropriate and recommend for colonoscopy when appropriate. n Ohio woman granted $10.3M verdict after botched colon surgery By Carly Behm A n Ohio woman won a $10.3 million jury verdict more than four years after an Ethicon Endoscopy stapler malfunctioned during surgery. Nikki Simon, 53, was admitted to Troy, Ohio-based Upper Valley Medical Center to have a benign polyp removed from her colon in December 2016, according to a March 28 statement from Crandall & Pera Law. The procedure would remove the part of the colon with the polyp and then reconnect the intestines. An Ethicon stapler designed to cut through the colon and prevent intestinal leakage was used. However, the device failed to staple during surgery, and Ms. Simon had to have her sigmoid and transverse colon removed. The jury came to a $10.3 million verdict March 27 after a two-week trial. A spokesperson for Ethicon, a Johnson & Johnson com- pany, said an appeal is being considered. "At Ethicon, patient and product safety is always our top priority," the spokesperson said in an email to Becker's ASC Review. "We are considering our options regarding appeal in this case as we believe the verdict contradicts evidence presented at trial that the products were properly designed and that surgeons were informed of known risks." n What's on the horizon for GI? 2 physicians weigh in By Carly Behm S hifts to telemedicine and changes in colorectal cancer screening have some gastroenterologists thinking about how their practices will evolve in the near future. Here's what two GIs anticipate for the next two to three years. Note: Responses were lightly edited for style. Joe Feuerstein, MD. Gastroenterologist at Beth Israel Deaconess Medical Center (Boston): I think the biggest change is how we are going to com- bine our clinical practice with telemedicine and develop a comfort with utilizing newer technologies to enhance our patients' experiences. Addition- ally, I think we are going to be doing a variety of different options for CRC screening and will adopt more evidence-based guidelines for screening and surveillance for colon cancer. Brian Dooreck, MD. Gastroenterologist at Memo- rial Hospital Pembroke (Pembroke Pines, Fla.): Our practice will continue to work smarter, hopefully not harder, and leverage more of a position of strength against the insurance companies and other forces that fail to recognize the true cost of providing high-quali- ty care in a dynamic and ever-evolving world. n

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