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Scope Forward: The Future of Gastroenterology Is Now in Your Hands
Azioni libro
Inizia a leggereLunghezza: 380 pagine5 ore
- Editore:
- BookBaby
- Pubblicato:
- Aug 26, 2020
- ISBN:
- 9781544508863
- Formato:
- Libro
Descrizione
No one in the medical field is free from the impact of COVID-19, including gastroenterologists. But the pandemic has only accelerated trends that started years ago. Health systems and insurance companies have become more powerful. Private equity has fueled consolidation. Colon cancer screening options have expanded. Artificial intelligence has embedded itself into endoscopy, and patients have become demanding consumers.
It's clear that GI can no longer rely on pre-COVID business models for survival.
In his timely new book, Scope Forward, Praveen Suthrum provides deeper insights into the structural shift underway in GI. Through expert interviews, Praveen offers practical advice for the industry to thrive, not just survive in the coming decade.
Get the clarity you need in the middle of chaos. Develop a mindset to disrupt yourself before someone else does. Build the future of gastroenterology on your terms.
It's time to scope forward.
It's clear that GI can no longer rely on pre-COVID business models for survival.
In his timely new book, Scope Forward, Praveen Suthrum provides deeper insights into the structural shift underway in GI. Through expert interviews, Praveen offers practical advice for the industry to thrive, not just survive in the coming decade.
Get the clarity you need in the middle of chaos. Develop a mindset to disrupt yourself before someone else does. Build the future of gastroenterology on your terms.
It's time to scope forward.
Informazioni sul libro
Scope Forward: The Future of Gastroenterology Is Now in Your Hands
Lunghezza: 380 pagine5 ore
Descrizione
No one in the medical field is free from the impact of COVID-19, including gastroenterologists. But the pandemic has only accelerated trends that started years ago. Health systems and insurance companies have become more powerful. Private equity has fueled consolidation. Colon cancer screening options have expanded. Artificial intelligence has embedded itself into endoscopy, and patients have become demanding consumers.
It's clear that GI can no longer rely on pre-COVID business models for survival.
In his timely new book, Scope Forward, Praveen Suthrum provides deeper insights into the structural shift underway in GI. Through expert interviews, Praveen offers practical advice for the industry to thrive, not just survive in the coming decade.
Get the clarity you need in the middle of chaos. Develop a mindset to disrupt yourself before someone else does. Build the future of gastroenterology on your terms.
It's time to scope forward.
It's clear that GI can no longer rely on pre-COVID business models for survival.
In his timely new book, Scope Forward, Praveen Suthrum provides deeper insights into the structural shift underway in GI. Through expert interviews, Praveen offers practical advice for the industry to thrive, not just survive in the coming decade.
Get the clarity you need in the middle of chaos. Develop a mindset to disrupt yourself before someone else does. Build the future of gastroenterology on your terms.
It's time to scope forward.
- Editore:
- BookBaby
- Pubblicato:
- Aug 26, 2020
- ISBN:
- 9781544508863
- Formato:
- Libro
Informazioni sull'autore
Correlati a Scope Forward
Anteprima del libro
Scope Forward - Praveen Suthrum
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Advance Praise
Physicians cannot survive the practice of medicine with just a focus on patient care. Scope Forward is a study allowing providers to grasp and conquer the previously shadowy realm of the complete business of medicine. Praveen Suthrum’s deep dive into multiple phases of the medical industry required countless hours of research, interviews, and his astute ability to organize meaningful discoveries into an objective syllabus. Scope Forward will be a definitive resource for healthcare teams as we struggle to become proficient healthcare businesses placing best patient pathways first and at the same time creating enjoyable, efficient, and financially viable enterprises. This text is a must for healthcare leaders charting their course to success.
—Dr. Reed B. Hogan, GI Associates and Endoscopy Center, Mississippi
Most doctors are not very good at the business side of medicine, and as a gastroenterologist, I can say it’s no different in GI. What Praveen has done in his book Scope Forward is to illuminate us (in great detail) about a whole range of issues pertinent to the future of GI, from artificial intelligence to private equity to disruptive technologies. Specifically, in relation to AI, he makes the topic very relevant and real-world - assessing both near and longer-term opportunities for AI in GI. This is a very welcome entry into the ‘must read’ category for all those involved in gastroenterology. You will learn a lot!
—Dr. Michael Byrne, CEO and founder of Satisfai Health, and founder of ai4gi, Vancouver, Canada
Scope Forward offers a refreshing perspective on many aspects of health care within and outside of GI. Narrative also allows readers to access views of many GI thought leaders.
—Dr. Latha Alaparthi, Gastroenterology Center of Connecticut, vice president, DHPA, Connecticut
Scope Forward may at first appear to give a foretelling of the GI landscape in the distant future. Instead, Praveen gives an accurate, unbiased and thoughtful assessment of changes occurring right before our eyes. We need to thoroughly understand and embrace these changes so that we can prepare for the immediate future. Particularly striking is the recognition that digitalization and emerging technologies will rapidly transform the way we practice gastroenterology.
—Dr. Michael Dragutsky, chairman of One GI and board member, DHPA, Tennessee
There’s no one way to describe Scope Forward. It is a treasure trove of insights for anyone in the field of gastroenterology. The book helps you understand the changes that are rapidly affecting medicine from the lens of GI. Among several other topics, Scope Forward succeeds extremely well in explaining the wave of business consolidation in private practice and the forces influencing it. I strongly recommend this book.
—Dr. Kenneth Rubin, The Gastroenterology Group of Northern New Jersey
Sir William Osler, one of the fathers of modern medicine, said he who studies medicine without books sails an uncharted sea. Praveen’s book is an essential map for those who seek to navigate the future of GI without hitting icebergs.
—Dr. Naresh Gunaratnam, Huron Gastroenterology and chair, Data Analytics, DHPA, Michigan
As physicians, we have spent our entire training in sharpening clinical acumen to optimize patient care. Scope Forward gives great insight on the intersection of the business side of medicine with the clinical aspect. Praveen Suthrum’s book is a must read for physicians to sustain financially viable practices. It will serve as a valuable resource for healthcare leaders.
—Dr. Mehul Lalani, US Digestive Health and treasurer, DHPA, Pennsylvania
Navigating the surreal environment we currently face with COVID is challenging, yet we don’t have to be alone. In this climate, work efficiency and positioning ourselves for the future with restructuring is needed. Fresh ideas and different perspectives on addressing challenges make a welcome guide. Praveen Suthrum’s focus on gastroenterology, the challenges and how others are adapting is timely, insightful and invaluable. A must read!
—Dr. J Steven Burdick, Advanced Endoscopy, Texas
We are in amazing times where exponential technologies like digital health and AI can enable us to deliver scalable and highly efficient care like never before. The COVID pandemic has given us a glimpse into the future of care. What is missing is how to align technology with the new business models. Scope Forward does exactly that by providing a roadmap to all in the field of GI and healthcare.
—Dr. Ashish Atreja, associate professor and chief innovation officer, Medicine, Mount Sinai and scientific founder and board member, Rx.Health, New York
Gastroenterology is an industry that is rapidly changing as new technologies and business models emerge. Scope Forward is a comprehensive guide that will serve as a key navigation tool for physicians as they learn to operate in and find success in the new healthcare environment. I commend Praveen’s unbiased evaluation and objective commentary throughout the book as well as his ability to draw parallels between gastroenterology and other industries that may seem unrelated on the surface. I highly recommend this book to anyone in the gastroenterology field.
—Abe M’Bodj, Provident Healthcare Partners, California
This is a prescient piece of work. In the face of the COVID-19 pandemic, it seems like Praveen had a crystal ball when he wrote Scope Forward. His message to disrupt yourself before getting disrupted is more relevant than ever for gastroenterology today. The importance of investigating new technology and new business structures is critical to a successful career. This book is recommended reading for every gastroenterologist wanting to stay relevant in the future.
—Dr. Michael Weinstein, president & CEO, Capital Digestive Care, past president, DHPA, Maryland
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Copyright © 2020 Praveen Suthrum
All rights reserved.
ISBN: 978-1-5445-0886-3
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For C. K.
Thank you for putting that monkey on my back.
Fifteen years later, your trick is still working.
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Contents
And Then the Pandemic Hit
Introduction
Part 1: Where Are We Going?
1. Exponential Technologies
Stool DNA Tests and Self-Driving Cars
AI in GI
The Microbiome to Ingestibles
Implications for Gastroenterology
Interview with Mark Stenhouse and Dr. Paul Limburg, Cologuard
Interview with Dr. Michael Byrne, Satisfai Health, ai4gi
2. Business Consolidation
Private Equity in Other Specialties
The PPM Debacle of the 1990s
Big Picture: System vs. Consumer
Implications for Gastroenterology
Interview with Dr. Lawrence Kosinski, SonarMD
Interview with Dr. Michael Dragutsky, Gastro One
3. Big Brothers
Big Insurances
Big Health Systems
Big Tech and Big Marts
Implications for Gastroenterology
4. Patient Behavior
Feel Good
Look Good
Live Forever
Implications for Gastroenterology
Interview with Dr. Jeffrey Gladden, Apex Health, Human Performance and Longevity
Part 1 Takeaways: What’s Unlikely to Happen?
Part 2: Outside Scope
5. GI beyond Medicine
Pursuit of Standardization
Engaging Patients—Strategy vs. Tactics
EHRs as Building Blocks of Data
Outsourcing as a Strategy
Growth Mindset
Three Models of Physician Compensation
Collaborating with Health Systems
6. A Call for Alignment
The Competition Is out There
The DHPA Story
What’s Possible with Greater Collaboration in GI
Part 2 Takeaways: An Offer You Can’t Refuse
Part 3: Choose Your Own Adventure
7. Choosing Solo, Small, or Midsize
A Seven-Doctor Group in Texas
What to Consider about Choosing Solo, Small, or Midsize and Independent
Interview with Dr. Narayanachar S. Murali, Gastroenterology Associates of Orangeburg
8. Choosing Large
An Independent Day in Mississippi
What to Consider when Choosing Large and Independent
Interview with Dr. Scott R. Ketover, MNGI
9. Choosing Private Equity
A $130 Million PE and GI Wedding in Pennsylvania
What to Consider about Choosing Private Equity–Funded Platforms
Interview with Dr. James Leavitt, Gastro Health
Interview with Jerry Tillinger, US Digestive Health
10. Choosing Alternative Models
A Strategic MSO: CDC and Physicians Endoscopy
Other Alternatives
What to Consider about Choosing Alternative Models
Interview with Dr. John Allen, University of Michigan School of Medicine
Part 3 Takeaways: Choosing an Adventure That Matters
Part 4: Gastroenterology 2.0
11. Three Stories of Disruption
Toilet Papers to Telecom: Disruption Isn’t a One-Time Event
Netflix vs. Netflix: Disruption when Life’s Good
Cloud to Haven: Disruption Inside-Out
What We Can Learn from Stories of Industry Disruption
12. Convergence
Healthcare 2.0 Startups—Five to 100 Years Old
What We Have to Learn from Examples of Convergence
Convergence in Gastroenterology
13. Next Steps
14. Disruption Is a Mindset
Afterword
Thrive, Not Just Survive
Acknowledgments
Notes
About the Author
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And Then the Pandemic Hit
Scope Forward was written before COVID-19 to help gastroenterologists create a future on their terms. By amplifying trends that were underway, I wanted to draw the industry’s attention to what seemed obvious to me. If gastroenterology (GI) practices didn’t disrupt themselves, something else would.
Once the COVID-19 pandemic exploded, an early reader of the book commented, It’s actually crazy that Scope Forward was written well before the pandemic hit and how things are even more relevant now.
We’ll look back at 2020 as the year that healthcare was compelled to shift gears. The industry adapted to telemedicine almost overnight. Restrictive laws changed in a matter of days. Cloud technology scaled up. Doctors and patients suddenly found themselves inside each other’s homes. More importantly, we could no longer look away from the mirror that the pandemic was showing us. With widespread infections and deaths, our healthcare system’s failures have been too hard to ignore.
Recent changes are not limited to telemedicine. As you’ll find out in the following pages, there are many technology and business trends that are changing gastroenterology. They have been intersecting and multiplying quietly until now. Disruption was brewing under the surface. What COVID-19 has done is accelerate that disruption by throwing most limitations out the door.
The pandemic is creating a new void in gastroenterology, leaving us no choice but to think differently. Patients are delaying or canceling elective procedures, fearing risk of infection in medical facilities. Today’s business of gastroenterology relies on electives such as colonoscopy. Further, social distancing, staff absences (or furloughs), and additional costs of personal protective equipment (PPE) are making unprecedented demands on GI offices and surgery centers.
Before we can imagine a future after COVID-19, we must understand gastroenterology from the lens presented in Scope Forward. I’ve resisted the temptation to make changes to the book because of COVID-19. It’s important to see things as they were. A tsunami was already on its way. What the pandemic has done is crunched the time we had at hand. Now we are in the midst of it all.
I’ve added an afterword on the impact of COVID-19. Through the pages that lead up to it, it’ll become apparent to you—as it is to me—that the future of gastroenterology will change. Such a future will not resemble the past. Whether that’s a good thing or not depends on what we do with the information that follows.
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Introduction
Ninety-five percent of private practices in the region were gone. There were hardly any independent physicians left to refer patients around. Two health systems dominated the landscape by buying up practices. People who showed up at the remaining independent facilities usually had low-paying insurance plans. Then there were those willing to pay cash for opioids.
I was visiting a private medical practice in the area to understand why they were bleeding money. The physician owner had returned from retirement to manage the practice. The administrator of the facility said she was stuck in this job.
The owner’s son, also a physician, gave up on medicine to work on the business. Wasn’t it just a matter of time before they would spin out of control?
That experience served as a poignant reminder of what healthcare would become if we let industry forces dominate us. Out of respect for the region and the facility, I won’t tell you where it is. But doesn’t some of it already sound familiar to you? In truth, couldn’t it be Anytown, America? Couldn’t at least some aspect of it be Yourtown, America?
You know it already. Gastroenterology is in the midst of massive structural disruption. Stool DNA tests for colon cancer are disrupting screening colonoscopy. If that technology fails, then there are many companies working on liquid biopsy. These are blood tests that look for not one but many cancers at the same time. If that doesn’t disrupt, then there’s artificial intelligence (AI). AI has the potential to classify cancerous polyps and spot what endoscopists might miss.
Most gastroenterology (GI) practices are too busy to worry about technology. They’ve been more concerned about business consolidation led by private equity. In 2019, there were at least 16 private equity transactions in gastroenterology. Compare that to two deals in 2018. There’s a race to get bigger faster.
But taking private equity for the wrong reasons is like playing with fire. In the 1990s, Physician Practice Management companies (PPMs) burnt billions of dollars. They tried to merge practices and went bust. In the end, doctors and PPMs sued each other.
Leaving that aside for a moment, look at Big Brothers who want a piece of gastroenterology. Hospitals want to hire you. Big insurance companies are acquiring medical practices. Big Tech wants to lead healthcare using algorithms. Even Walmart is entering the game of healthcare.
Note: GI is an abbreviation for gastrointestinal. However, for the sake of readability, I’ll be using GI to refer to the field of gastroenterology or gastroenterologists.
Meanwhile, patients are changing their expectations from GI. Some are biohacking their way into the microbiome. Some others want their colon cleansed to showcase a flatter belly. Not exactly reasons doctors went to medical school.
When I talked about these emerging trends, gastroenterologists had these responses: Some felt threatened. Some brushed them away. Some got excited. But many were in a state of confusion.
Now, that’s a problem.
When we take action in a state of fear or confusion, we regret those decisions later. In such a state, we tend to be reactive, we follow the trend of the herd for safety, or we simply go where others want us to go out of our own indecision.
When a large cohort like GI takes action in a state of disarray, the industry risks implosion. Hospitals laying off doctors with limited notice. Private equity (PE) deals going bust. Technology changes catching the industry off guard. At its worst, implosion can mean doctors rebuilding their practices from scratch. That would put countless people at risk, including patients. Once, a doctor told me, Distracted doctors do more harm than good.
To make more empowered choices, we must first understand the future with an open and curious mind. We must be willing to look at every area—be it clinical, technological, or business—without judgment. We must take stock of our own situation. And then we must take action in defined timelines.
I began writing this book as a way of inviting gastroenterologists to peek into the future. I conducted over 30 interviews in various parts of the country. From Minnesota to Mississippi and from California to New York. Gastroenterologists in various phases of their journey generously shared their time and perspective. More importantly, they shared their views so candidly. Their concerns about PE or hospital consolidation or DNA testing. Their dreams about a better future for healthcare. The challenge for me was to reflect and connect the dots as objectively as possible.
You can say this book will serve as your tour guide to the future of gastroenterology, but I have to caution that my aim isn’t to be exhaustive. For example, I’m not covering several important topics, such as the pharmaceutical industry, policy, or the mounting costs of healthcare. Instead of talking about all the sights on this tour, I wish to give you a decent slice to help you develop your perspective across technology and business. Also, if you are a hospital or insurer, you’ll find I’m unabashedly biased toward doctors. Doctors come first and the rest of the industry after. In their success lies the success of healthcare. Their failure risks a total collapse of the system.
If there’s any cohort of medicine I understand, it would be gastroenterology. Through NextServices, the company I co-founded, I have worked with GI doctors since 2005. We help gastroenterologists with billing, technology, compliance, and more recently, private equity. My team and I built a cloud-based software platform called enki.
Once, a gastroenterologist asked me, How do you know the inside stories? Do you have any family members who are gastroenterologists?
I said, No, but I have friends who are.
Then he mused, Oh, then in your past life, you must’ve been a gastroenterologist!
I’ll take that.
I contributed to two books by C. K. Prahalad, a management guru and my teacher at the University of Michigan. The Fortune at the Bottom of the Pyramid and The New Age of Innovation (coauthored with M. S. Krishnan) both became management best sellers. That experience provided a method for me to not only see the future but to connect the dots for others.
More recently, I wrote Private Equity in Gastroenterology: Navigating the Next Wave (Amazon #1 New Release in Private Equity and Gastroenterology). The book offered much-needed clarity on the subject.
They say writers use writing as a way to work out topics they wish to understand. You can say that’s what happened to me through this book. I learned a lot through the interviews and research.
Reading Scope Forward will give you enough depth to develop your own point of view of the future. By the end of these pages, you will come away excited about the way forward because you’ll develop a clearer vision. You’ll have a sense of what to do next and how to direct not only yourself but others.
My vision is for the GI industry to use this book to shift the course of gastroenterology. We must come together and align. We must change the space for good. To not only help us thrive in our professional lives but to sleep well at night, knowing we’ve made healthcare better for those who need it the most.
By picking up this book, you’ve set something into motion for yourself and the industry. That something is to take the future head-on and be willing to shape what’s to follow in the next decade.
Let’s scope forward.
A Quick Note on Professional Advice
This book is not intended to provide financial or legal advice or steer you in a particular direction. It won’t answer all your questions. Rather, it’ll help you ask the right questions to make decisions that work for you. All opinions expressed belong solely to me as the author and do not belong to the organizations I may be associated with. This book isn’t a substitute for professional expertise from attorneys, accountants, or investment bankers.
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Part 1
Part 1: Where Are We Going?
In this section, we’ll explore where the gastroenterology industry is headed. In particular, our conversation will center around four themes:
Exponential technologies
Business consolidation
Big Brothers
Patient behavior
Exponential technologies are technologies that have the capacity to double in performance every few years. Computers are the most common example of exponential technologies. Once room-sized mainframes, computers now snugly fit into our pockets. There are many advanced technologies accelerating today, such as DNA testing, artificial intelligence (AI), synthetic biology, robotics, and 3D printing. In chapter 1, we’ll explore the future of GI through the lens of these technologies. We’ll especially consider DNA testing and AI.
Fueled by private equity, the business of gastroenterology is consolidating. In chapter 2, we’ll take stock of the state of consolidation. We’ll also learn the underlying reasons for this consolidation. And we’ll look back at the PPMs of the 1990s.
Gastroenterology is under tremendous pressure from health systems and big insurances. If that were not enough, big technology companies are entering healthcare. Healthcare is now an important vertical for Amazon and Walmart. In chapter 3, we’ll look at the strategies of these Big Brothers.
Finally in chapter 4, we’ll explore an unusual trend: changes in patient behavior. Today’s patients are seeking more than a solution to sickness. They expect healthcare to make them look good, feel good, and even live forever. And they are willing to try out new solutions if healthcare isn’t equipped to answer them. That chapter will help you explore strategies to continue engaging your patients in the future.
This part of the book serves as the basis for understanding the convergence of trends that will shape GI over the next decade. It’ll prepare you for later chapters where you’ll get to scope forward on your terms.
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Chapter 1
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