Becker's ASC Review

16 GASTROENTEROLOGY 3 forces disrupting gastroenterology By Riz Hatton Artificial intelligence, prior authorization and decreased reimbursements all have a big role in the future of gastroenterology. Here are three physicians' opinions on some of the major disruptors in GI: Artificial intelligence "I've been doing this for a long time and [gastroenterology] has changed dramatically in the last 10 years," Sheldon Taub, MD, a gastroenterologist at Jupiter (Fla.) Medical Center, told Becker's. "I anticipate further change in the next 10 years, or certainly a lot more. Artificial intelligence — I'm not smart enough to know where it's going to play out, but it's certainly going to have a role in the decision-making. It will have a role with radiology, with pathology and certainly with endoscopy." Prior authorization "No matter what kind of physician you are, prior authorizations are something that physicians are concerned about because of the amount of extra time required to take care of those phone calls," Benjamin Levy III, MD, a gastroenterologist at University of Chicago Medicine, told Becker's. "On average it takes about 20 to 30 minutes per prior authorization for a physician outside of their clinic time. So anytime we have to do that, we have to set up the prior authorization and frequently it requires talking with several different people at an insurance company just to set up the prior authorization. It doesn't matter whether it's for a procedure or for a medication to get approved, we have to take time out of our schedules, in terms of taking care of patients, in order to have a conversation with the insurance company." Decreasing reimbursements "My major concern regarding procedure reimbursement is continued increase in costs of doing procedures and denials from payers with decreasing payments, especially by government payers," Pankaj Vashi, MD, department head of gastroenterology and nutrition at City of Hope Chicago in Zion, Ill., told Becker's. n Male, female GIs see significant gap in Medicare reimbursement By Claire Wallace M ale and female gastroenterologists see a significant gap in CMS reimbursements, according to a 2023 report published by the University of Virginia Health System in Charlottesville. Despite a growing need for gastroenterologists nationwide, only about 23% of practitioners were women in 2019. That number is on the rise from 17.6% in 2017. While more women are practicing gastroenterology, a pay gap persists. According to CMS data cited in the report, male gastroenterologists receive an average of $94,416.28 a year in total Medicare payments. Female gastroenterologists receive significantly less, at $56,014.14 a year. On average, female GIs have been in practice for shorter periods of time, with a median 17 years of experience compared to 28 years of experience for male GIs. Men also perform more total services, with a median of 1,047. Male GIs also bill an average of 39 unique codes. Female GIs perform a median of 633 services and 32 unique codes. "But even after adjustment for region, practice setting, number of services performed, average complexity and range of Medicare beneficiaries, and number of years of physician experience, female gastroenterologists are receiving less CMS payments, which can comprise a significant portion of their annual income," the study authors wrote, adding that further research is needed to understand and address gender pay gaps. n Olympus issues Class I recall for endoscopy devices following patient death By Claire Wallace O lympus Corporation has issued a Class I recall for its high-flow insufflation unit UHI-4 used to facilitate laparoscopic and endoscopic observation, diagnosis and treatment. Olympus has requested patients discontinue use of the device until further notice except when an alternative is not available or cannot be obtained, according to an Oct. 27 release. Olympus is assessing the issue after receiving reports of patients suffering complications from over insufflation — including arrhythmias reported as "short cardiac arrests," gas embolism, and one death — during surgical procedures where UHI-4s were used. Olympus is requesting the devices be quarantined to prevent use, providing users with detailed information about risks and recommending extreme caution if alternative devices are not available and they must use the device. Class I recalls are the most serious type of recall issued by the FDA. n

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