Louis Wilson, MD, managing partner of Wichita Falls (Texas) Gastroenterology and president of the Texas Society of Gastroenterology and Endoscopy, shares six insights he thinks will be crucial for gastroenterology practices to achieve success in 2021.
Note: Response was edited for style and content.
Question: What will make or break your practice in 2021?
Dr. Louis Wilson: 1. Nothing will determine which practices survive and thrive in 2021 [more] than their relationship with the local or regional hospital. Now is the time to visit and revisit your professional services agreement with your local hospital.
Now is the time to approach your hospitals for expansion of your current professional service agreements, or for new ones. Hospitals are in ongoing crisis mode but are also busy and scrambling for strategies to remain efficient and profitable. Now is the time to negotiate or renegotiate a long-term PSA to cover GI services in the hospital and to improve call pay.
The COVID-19 pandemic is not going to resolve quickly, and hospitals are under severe stress as they handle the surge of patients. Hospitalists and intensivists require significant support from specialists in every part of the hospital. My practice successfully petitioned our hospital for financial support for a second GI on call during the crisis and then negotiated a long-term agreement to meet all the GI-related needs at the hospital. Nothing is more beneficial for a practice than a solid and well-compensated arrangement with the local or regional hospital. The care that we provide helps to reduce admissions, hospital stays and improve quality of care.
2. Maintaining outpatient endoscopy access regardless of what happens during the pandemic.
ASCs are in a unique position to provide safe and efficient outpatient urgent and urgent elective endoscopic procedures. This is not the time to push such procedures to the hospital setting. We have moved to set up comprehensive and effective screening at our endoscopy center and expanded use of personal protective equipment for physicians and staff. The hospital system should be fully supportive of these efforts. Currently, we have reduced our staffing profile to keep one endoscopy room open. As the pandemic [continues], the pressure of patients with urgent or urgent elective needs will likely increase. The basic infrastructure of the endoscopy center also needs to be protected for future use.
3. Support your staff.
The staff at our offices and ASCs represent critical infrastructure that must be protected during these difficult times. We have made protecting their jobs and wages a top priority in our practice. The physicians in our practice are willing to work for little or no compensation to meet payroll despite substantial revenue reductions. The Paycheck Protection Program administered through the Small Business Administration included in the CARES Act should be of considerable help.
4. Participate in transitional care.
Hospitals will be aggressively seeking ways to reduce length of stay over the next several months. Hospital patients without insurance or adequate financial resources are challenged as they transition to the outpatient setting. Our hospital system has a transitional care clinic to facilitate hospital discharges, coordinate outpatient care and provide immediate access for patients recently discharged from the hospital. GIs can support these efforts by scheduling once-a-week office hours at the clinic for recently discharged patients with digestive issues. [Practices should] request financial support for this through the PSA for GI coverage.
5. Improve transfer center access.
Hospital transfer centers receive many calls from referring hospitals and providers for patients who may require transfer or specialty consultation. These calls are an excellent opportunity for our on-call GIs to advise these referring providers, reduce hospitalizations and improve care coordination of patients. Many low-risk patients can be sent to the ASC instead of the hospital, and even transferred back after appropriate procedures have been performed. Other patients can be scheduled for telemedicine consultation or outpatient follow-up. Now is the time to communicate these goals with the staff of the transfer center.
6. Stay in the fight.
GIs are critical members of the healthcare team during this time of crisis. With crisis comes opportunity. Now is the time for action and leadership. These steps are helping our practice contribute to the broad effort to overcome the pandemic.