Understanding Gastroenterology Data on DocTransparency
Understanding Gastroenterology Data on DocTransparency
What Gastroenterologists Do
Gastroenterologists diagnose and treat conditions of the digestive system — the esophagus, stomach, small intestine, colon, liver, pancreas, and gallbladder. Common conditions include acid reflux, irritable bowel syndrome, inflammatory bowel disease, hepatitis, colon polyps, and gastrointestinal cancers. Gastroenterologists perform both diagnostic and therapeutic endoscopic procedures, making this a procedurally active specialty.
Many gastroenterologists also subspecialize in hepatology (liver disease), advanced endoscopy, or inflammatory bowel disease.
Common Procedures in Medicare Data
- Colonoscopy — Screening and diagnostic examination of the colon; one of the highest-volume procedures in all of Medicare
- Upper endoscopy (EGD) — Examination of the esophagus, stomach, and upper small intestine
- Colonoscopy with polypectomy — Colonoscopy with removal of polyps found during the procedure
- Capsule endoscopy — Swallowed camera to image the small intestine
- Endoscopic retrograde cholangiopancreatography (ERCP) — Procedure for bile duct and pancreatic conditions
- Liver biopsy — Tissue sampling to evaluate liver disease
What Normal Volume Looks Like
Colonoscopy volume is high for practicing gastroenterologists — a full-time GI physician may perform 500 to 1,500 colonoscopies per year. High procedure counts in this specialty are expected and should be read in context. Notably, Medicare data captures screening colonoscopies in patients 65+, which is a core part of the specialty.
Pharma Payments in Gastroenterology
Pharmaceutical payments in gastroenterology are driven primarily by companies marketing biologic drugs for Crohn's disease and ulcerative colitis — high-cost medications with significant consulting and speaking fee activity. Physicians who manage inflammatory bowel disease practices are the most likely to have substantial pharma payment profiles.
Questions to Ask Your Gastroenterologist
- How many colonoscopies do you perform per year, and what is your adenoma detection rate?
- Do you have financial relationships with the makers of the biologic medications you prescribe?
- If a polyp is found, will it be removed in the same procedure or will I need to return?