Issue link: https://beckershealthcare.uberflip.com/i/1507957
22 GASTROENTEROLOGY What trends and changes this gastroenterologist predicts in the field By Amelia Ickes B ecker's recently connected with Andrew Boxer, MD, a physician with Woodland Park-based Gastroenterology Associates of New Jersey, to hear his predictions on changes and trends in gastroenterology. Editor's note: Responses have been lightly edited for length and clarity. Question: What are some trends and challenges you've seen or predict in gastroenterology? Dr. Andrew Boxer: I've been doing this for about 15 years and there are two major changes. One is technology, which has impacted the field tremendously over the last few years. ings like AI technology like the Medtronic GI Genius, our devices we are using now are different. We have changes in the scopes and imaging and a whole bunch of stuff like that. Medicines have changed dramatically, especially for inflammatory bowel disease for Crohn's and colitis. ere's really been kind of an explosion. Fieen years ago, there was really one and now you can't count them on your fingers anymore. e other thing that's really different is risk. What I'm talking about specifically is cancer risk, which has gone up in young patients — upper GI and particularly colon cancer risk. When I was in my training, this was not something that was even on the radar and now we're learning that if you take someone today in 2023 under age 40, they're five times more likely to have colon cancer today than in 1970. It's really changing the population we're seeing. Fieen years ago, if a 35-year-old came in saying they have some rectal bleeding, we'd tell them to take something for hemorrhoids and send them on their way. Now you're worried that they have colon cancer. Awareness is different also. Patients are coming in telling me about things, and education starts way before they're even seeing me. It's different; it's way different. n 'The answer is no': Why this GI CEO doesn't put physicians in hospitals By Patsy Newitt U .S. Digestive Health CEO Jerry Tillinger joined Becker's to discuss the obstacles of gastroenterology procedure migration to the outpatient setting. Editor's note: This response was edited lightly for length and clarity. Question: What obstacles are there in terms of the migration of gastroenterology procedures to outpatient settings? Jerry Tillinger: In my world, it's primarily been capacity. Five years ago, generally, physicians were splitting up their time, about 40 percent in endoscopy centers, about 40 percent in the office and about 20 percent at the hospital. That was at a broader market. And what you're seeing now is that we need them in the endoscopy center more and more. You're having less office time as a result, which means we have more advanced practice nurse practitioners and physician assistants covering office time. That's a cultural shift in and of itself. But the next pressure is gonna be on the hospital side, where the hospital is highly inefficient from a business perspective and the quality of life level. Some of my physicians told me the hospital for them is there because the days frequently are 12 to 14 hours. They're racing around. It's the most chaotic part of their life. It's a lot, so when they're looking at their own quality of life as they move through their career, they're more and more starting to question, why am I going to the hospital at all when I've got a four- or five-month waiting list at my endoscopy center? I think that pressure is gonna keep mounting. I get calls every month from hospitals asking if we can provide GI coverage for them, and in every case where I'm not already there, the answer is no, I don't have anybody available and if I did that's the last job they take. n Image Credit: Adobe Stock