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Related Experiment Videos

The gastroenterologist: physician or technician?

J A DiSario1, J P Waring, R A Sanowski

  • 1Department of Gastroenterology, Veterans Administration Medical Center, Phoenix, Arizona 85012.

Gastrointestinal Endoscopy
|May 1, 1991
PubMed
Summary

Gastroenterology is largely procedure-based, with 65% of consultations leading to endoscopic procedures. Referrals for gastrointestinal bleeding and abnormal barium studies most frequently result in these interventions.

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Area of Science:

  • Gastroenterology
  • Medical Practice Analysis

Background:

  • Growing concerns regarding the potential overuse of gastrointestinal endoscopic procedures.
  • Need to differentiate between procedural and cognitive aspects of gastroenterology practice.

Purpose of the Study:

  • To quantify the proportion of gastroenterology practice that is procedure-related versus cognitive.
  • To compare procedural rates between a Veterans Affairs Medical Center and a private group practice.

Main Methods:

  • Comparative analysis of 303 gastroenterology consultations from two distinct practice settings.
  • Categorization of consultations based on referral reason and specialty.

Main Results:

  • 65% of all consultations resulted in an endoscopic procedure.

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  • Highest procedure rates observed for abnormal barium studies (100%), percutaneous endoscopic gastrostomy (97%), and gastrointestinal bleeding (83%).
  • Consultations from medical specialties (69%) were more likely to result in endoscopy than those from surgical (44%) or other specialties (45%).

    • Conclusions:

    • Gastroenterology functions predominantly as a procedure-oriented subspecialty.
    • Procedures are most commonly performed for conditions necessitating biopsy or therapeutics and on referrals from medical specialists.