Healthcare reform has been one of the central aims of President Barack Obama's time in office. How has this affected the field of gastroenterology?
William Katkov, MD, Providence Saint John's Health Center, Santa Monica, Calif.: Most of the changes in the medical marketplace affecting gastroenterology, and all of medicine, during the
Obama presidency have been taking place over a number of years and are not necessarily related to the administration's policies. These include, most significantly, the move towards alignment and consolidation by physicians with hospitals and health systems. There is an associated shift away from the traditional fee-for-service model. In addition, the importance of colon cancer screening is recognized in the Affordable Care Act. However, it remains to be seen if the ACA affects physician supply including whether there will be adequate numbers of gastroenterologists to meet the needs of the population in the future
Patrick Takahashi, MD, CMIO and Chief of Gastroenterology Section of St. Vincent Medical Center (Los Angeles): The Obama Presidency has affected the field of gastroenterology in a negative light. Starting from his decision to forego screening colonoscopy in lieu of virtual colonoscopy, the President's actions have not helped the general public to understand initiatives and the importance of such tests as screening colonoscopy. Instead of leading the way and demonstrating the utility of the most widely available test, he opted for virtual colonoscopy, an examination which is not readily available or considered the standard of care for screening at this point.
The President's decision to sign HR 4302, essentially a one-year patch for SGR legislation, has put gastroenterology in jeopardy. It gives CMS the ability to further alter payments on codes, which are being utilized, similar to what was enacted recently for both upper and lower endoscopies. Reimbursements continue to drop to a level that will significantly impact the ability of independent physicians to provide high-quality care, especially considering the fact that office overhead expenditures continue to increase due to such forces as inflation, the job market, malpractice insurance rates and supply costs.
With further changes coming down the pipeline regarding Obama's healthcare plans, I think gastroenterology will have to brace itself just like other specialties, as reimbursements and the like are still in flux.
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William Katkov, MD, Providence Saint John's Health Center, Santa Monica, Calif.: Most of the changes in the medical marketplace affecting gastroenterology, and all of medicine, during the
Obama presidency have been taking place over a number of years and are not necessarily related to the administration's policies. These include, most significantly, the move towards alignment and consolidation by physicians with hospitals and health systems. There is an associated shift away from the traditional fee-for-service model. In addition, the importance of colon cancer screening is recognized in the Affordable Care Act. However, it remains to be seen if the ACA affects physician supply including whether there will be adequate numbers of gastroenterologists to meet the needs of the population in the futurePatrick Takahashi, MD, CMIO and Chief of Gastroenterology Section of St. Vincent Medical Center (Los Angeles): The Obama Presidency has affected the field of gastroenterology in a negative light. Starting from his decision to forego screening colonoscopy in lieu of virtual colonoscopy, the President's actions have not helped the general public to understand initiatives and the importance of such tests as screening colonoscopy. Instead of leading the way and demonstrating the utility of the most widely available test, he opted for virtual colonoscopy, an examination which is not readily available or considered the standard of care for screening at this point.The President's decision to sign HR 4302, essentially a one-year patch for SGR legislation, has put gastroenterology in jeopardy. It gives CMS the ability to further alter payments on codes, which are being utilized, similar to what was enacted recently for both upper and lower endoscopies. Reimbursements continue to drop to a level that will significantly impact the ability of independent physicians to provide high-quality care, especially considering the fact that office overhead expenditures continue to increase due to such forces as inflation, the job market, malpractice insurance rates and supply costs.
With further changes coming down the pipeline regarding Obama's healthcare plans, I think gastroenterology will have to brace itself just like other specialties, as reimbursements and the like are still in flux.
More articles on gastroenterology:
7 gastroenterologists making headlines
Breaking down the cost of Hepatitis C treatment: 7 things to know
Defining the idea GI physician partner