Analysis of patients referred to a gastroenterologist practicing in a community hospital

A questionnaire was designed to provide information on consecutive patient referrals over a 12-mo period to a consultant in gastroenterology practicing in a community hospital serving approximately 100,000 people. Data were entered into a computer for ease of storage and analysis. One thousand two hundred seventy-six consultations were seen in 1188 patients. Ages ranged from 1 to 97 yr; most were in the 5th to 7th decade. The majority of consultations were from 11 general internists (66.2%); fewer consultations were from 7 general surgeons (16.0%), 8 general practitioners (10.3%), and 6 pediatricians (2.7%). The most frequent reasons for patient referral were abdominal pain (27.8%), consideration of a procedure (23.7%), and an x-ray abnormality (16.6%). The gastroenterologist performed 1217 procedures as part of 1026 consultations; the most frequently performed was upper gastrointestinal endoscopy (60.1%). The gastroenterologist made 1604 diagnoses in his subspecialty; diagnoses relating to the esophagus were made at 276 consultations, the stomach at 317, the duodenum at 204, the small bowel at 26, the colon-rectum at 321, the liver/biliary tree at 184, and the pancreas at 66. The major objective of this investigation was realized by the prospective collection of the experience of a practicing gastroenterologist. This data collection was accomplished without apparent omissions or encumbrance on the practice routine. These data provide a perspective on the role of a practicing consultant gastroenterologist and appear relevant to considerations of the training of gastroenterologists.