Gastroenterologist Dr. Edwin Levine answers questions about healthcare consolidation, the keys to success and his work outside of day-to-day practice. Edwin Levine, MD, is a board-certified gastroenterologist with GI Health Specialists/PriMed Physicians, based in Trumbull, Conn. He also serves as the medical director of Fairfield Country Endoscopy Center. Dr. Levine shares his thoughts on the future of his practice in a time of healthcare consolidation, bundled payments and launching a start-up company.
Question: How has healthcare consolidation affected your practice?
Dr. Edwin Levine: I am personally part of a six-person GI group, but we are part of a larger multispecialty group of about 160 physicians. Our group has been approached by hospitals, practice management companies, venture capitalists and other large physician groups to be bought or partnered with. We are trying to get our bearings, but I wouldn't be surprised if we were acquired or partnered with a larger entity within a year.
Q: What do you think gastroenterologists need to be successful in the current healthcare environment?
ED: We are not controlling a large part of the healthcare dollar like orthopedics or cardiology, but gastroenterologists are an important part of preventative medicine. Colonoscopy is a high volume test and it can save lives. We need continue to do it well but we also need to learn how to do it more efficiently. Bundled payments, where facility fees, gastroenterologist fees, pathology and anesthesia fees are all lumped into one payment, will be a large step forward. The most successful GI physicians will be those that figure out how to do their high volume procedures in a cost efficient, high-quality manner.
Q: What has your practice done over the past few years to keep up with the evolving healthcare environment?
ED: We have an endoscopy center and are able to control our costs there. We work closely with a pathologist and have discussed partnering with an anesthesiologist. We are working towards bundling payments.
We are also working on quality initiatives. In colonoscopy, quality has become second nature. We are using quality benchmarks and documenting our withdrawal time and adenoma detection rates. This data can be used to present to insurance companies and negotiate savings.
Q: How do you weigh the benefits of private practice against the likelihood of consolidation?
ED: One of the beauties of being in private practice is being your own boss. Now, many physicians will lose control of their style of practice. Those that remain as outliers may face limited employment opportunities. Though there will be a loss of independence to a degree, there is an upside. There is plenty of wasteful medicine and inefficiencies in healthcare that will be made much better. Up until now, physicians have been running the system, but now will become a cog in the wheel, granted a very important cog.
Q: How can gastroenterologists expand their interests beyond day-to-day practice?
ED: A lot of physicians are looking for other things to do. You practice medicine for years and often find yourself doing the same things everyday. I've always thought that running a start-up company would be an exciting challenge.
For years patients have asked me about what they can do about the constipation they develop when travelling. As it turns out, this is an incredibly common problem. Traditional over the counter constipation remedies are designed to treat the problem once it’s already started and once the symptoms that accompany it are have kicked in. My wife, also a physician, and I realized that it would be better to take something to prevent traveler’s constipation from occurring at all. We put together a four day regimen of all natural, safe, gentle, proven ingredients that travelers begin when they get to their destination. It's called Good To Go and we're currently bringing it to market.
A start-up company is a huge challenge. The expense involved is much more than you would expect, including everything from consumer research to the design and manufacture of the product. The ultimate challenge is of course bringing the product to the market. Running a consumer product goods business is a totally different world than healthcare. Everyday brings a new problem. Entrepreneurship calls for a great deal of problem solving. But now both tracts of my career, my GI practice and this exciting new product launch, enable me to do what I love to do, help people and improve their quality of life.
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