Becker's ASC Review

31 GASTROENTEROLOGY Independent vs. employed: where do gastroenterologists fall? By Francesca Mathewes B etween 2012 and 2022, the number of physicians who were self- employed dropped to 42%, according to the American Medical Association. is marks a clear shi from independence to employment –– but where do gastroenterologists fall? Gastroenterologists are slightly more likely to be practice owners, at 42.7% self-employed. According to data from career site Zippa, 88% of gastroenterologists work in private practice –– the second highest of any specialty. But the line between independence and employment for gastroenterologists may be growing thinner. "Many young gastroenterologists are running away from private practice," Adam Levy, MD, a gastroenterologist in Macon, Ga., told Becker's. "is is due to the high cost of educational loans and an environment where hospitals are offering large salaries to graduates. It is difficult for private practice to compete upfront due to declining reimbursements." However, gastroenterologists also earn more in self-employed settings. Median compensation for gastroenterologists working at hospital-owned groups or MSOs increased 4%, compared with a 15% increase for those at physician-owned groups, according to the Healthcare Appraisers' 2023 GI "Industry Outlook" report. For those with "an appetite for risk," private practice could still prove beneficial in the long run, Gabriel Oinescu, MD, and gastroenterologist at Wyckoff Heights Medical Center in New York City, told Becker's. "e challenge is that each physician is trading in a comfortable [employed] position, albeit with limited autonomy, for potential financial risk," he said. "Keeping a practice open will take more effort to comply with government regulations and reporting, so reducing the burden may help. Eventually, building and monetizing the equity of the practice should be enough to incentivize physicians to seek alternatives to employment." n Colon cancer blood test raises eyebrows By Francesca Mathewes I n July, the FDA approved a new blood test for colorectal cancer screenings that was able to detect 83% of Stage 1, 2 or 3 colorectal cancers in studies. But as Amol Akhade, MD, and medical oncologist, argues in an Aug. 27 commentary in Oncology News Central, the test is not accurate enough to surpass colonoscopies, long considered the gold standard in diagnosis. "Finding a blood-based test to screen for cancer is a dream for every oncology researcher. Imagine a simple blood test that can detect precancerous lesions or Stage 1 cancer in asymptomatic individuals," Akhade writes. "is would greatly benefit both oncologists and patients, potentially reducing cancer-specific mortality in the long term. e catch is that the test needs to be highly sensitive and specific to be clinically useful. Unfortunately, the recent approval of a blood-based colorectal cancer screening test by the FDA sets the bar too low, opening a dangerous Pandora's box," he added. Akhade argues that the study used for FDA approval presents "a significant dilemma" for oncologists interpreting test results. e recently approved Shield test has a 65% sensitivity to Stage 1 cancer alone, with a 10.1% false positive rate. Other noninvasive screenings had an 88% sensitivity for Stage 1 when using DNA for testing and 64% with fecal immunochemical testing. "Questions arise about the certainty of a negative test, the ability to reassure patients, legal and ethical responsibilities if a precancerous lesion or Stage 1 cancer is missed by this test, counseling for false- positive results, and the frequency of test repetition," he writes. While the non-invasive nature of these tests might mean that more people receive CRC screenings overall, Akhade maintains that questions about the tests' accuracy and ability to detect aggressive precancerous lesions sets the bar too low. n AmSurg, LifeBridge Health partner to open GI ASC By Claire Wallace A SC management services provider AmSurg has partnered with Owings Mills, Md.-based LifeBridge Health and Pikesville, Md.-based Woodholme Group to open a gastroenterology outpatient surgery center in Westminster, Md. The EndoCentre of Westminster totals 5,400 square feet and features two procedure rooms, according to an Aug. 26 press release. EndoCentre of Westminster is accredited by the Accreditation Association for Ambulatory Health Care and provides both diagnostic and preventive procedures. n

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