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When this editorial is published, we will know the results of the national election (hopefully) and whether there will be a smooth transition of power. We should know whether the Affordable Care Act will remain intact, and we will have indications about the impact of a COVID/flu combination. Health care will never be the same.

Dr. John I. Allen

According to a recent Medscape survey, 62% of U.S. physicians saw a reduction of monthly income (12% saw a reduction of over 70%) in the first 6 months of this year. Almost a third of the physician workforce is contemplating retirement earlier than anticipated. As worrisome, according to a JAMA article (Aug 4, 2020;324:510-3) the United States saw a 35% increase in excess deaths because of non-COVID etiologies, an indication of health care deferral and avoidance. We all are scrambling to catch up and accommodate an enormous demand.

We are witnessing a “K” shaped recovery for both individuals and GI practices. If your health care is covered by Medicare, you own a mortgage-free home and your wealth is based on a balanced equity/bond portfolio, then all of your assets increased in value compared to last year’s peak valuations. For the other 90% of Americans, the recovery is modest, neutral, or more often nonexistent. Gastroenterologists who work in academic centers or large health systems did not lose income this year and were protected by billion-dollar credit lines and cash-on-hand accounts from robust days available to these entities. Independent practices (critically dependent on monthly cash flow) were decimated, furthering the trend towards consolidation, retirement, and acquisitions. With the new CMS E/M valuations we will see further reduction in procedural reimbursement.

Our postpandemic world will be dramatically different from pre-COVID times. However, disruption always precipitates innovation. Challenges are great but opportunities are clearly evident for those willing to risk.
 

John I. Allen, MD, MBA, AGAF
Editor in Chief

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When this editorial is published, we will know the results of the national election (hopefully) and whether there will be a smooth transition of power. We should know whether the Affordable Care Act will remain intact, and we will have indications about the impact of a COVID/flu combination. Health care will never be the same.

Dr. John I. Allen

According to a recent Medscape survey, 62% of U.S. physicians saw a reduction of monthly income (12% saw a reduction of over 70%) in the first 6 months of this year. Almost a third of the physician workforce is contemplating retirement earlier than anticipated. As worrisome, according to a JAMA article (Aug 4, 2020;324:510-3) the United States saw a 35% increase in excess deaths because of non-COVID etiologies, an indication of health care deferral and avoidance. We all are scrambling to catch up and accommodate an enormous demand.

We are witnessing a “K” shaped recovery for both individuals and GI practices. If your health care is covered by Medicare, you own a mortgage-free home and your wealth is based on a balanced equity/bond portfolio, then all of your assets increased in value compared to last year’s peak valuations. For the other 90% of Americans, the recovery is modest, neutral, or more often nonexistent. Gastroenterologists who work in academic centers or large health systems did not lose income this year and were protected by billion-dollar credit lines and cash-on-hand accounts from robust days available to these entities. Independent practices (critically dependent on monthly cash flow) were decimated, furthering the trend towards consolidation, retirement, and acquisitions. With the new CMS E/M valuations we will see further reduction in procedural reimbursement.

Our postpandemic world will be dramatically different from pre-COVID times. However, disruption always precipitates innovation. Challenges are great but opportunities are clearly evident for those willing to risk.
 

John I. Allen, MD, MBA, AGAF
Editor in Chief

When this editorial is published, we will know the results of the national election (hopefully) and whether there will be a smooth transition of power. We should know whether the Affordable Care Act will remain intact, and we will have indications about the impact of a COVID/flu combination. Health care will never be the same.

Dr. John I. Allen

According to a recent Medscape survey, 62% of U.S. physicians saw a reduction of monthly income (12% saw a reduction of over 70%) in the first 6 months of this year. Almost a third of the physician workforce is contemplating retirement earlier than anticipated. As worrisome, according to a JAMA article (Aug 4, 2020;324:510-3) the United States saw a 35% increase in excess deaths because of non-COVID etiologies, an indication of health care deferral and avoidance. We all are scrambling to catch up and accommodate an enormous demand.

We are witnessing a “K” shaped recovery for both individuals and GI practices. If your health care is covered by Medicare, you own a mortgage-free home and your wealth is based on a balanced equity/bond portfolio, then all of your assets increased in value compared to last year’s peak valuations. For the other 90% of Americans, the recovery is modest, neutral, or more often nonexistent. Gastroenterologists who work in academic centers or large health systems did not lose income this year and were protected by billion-dollar credit lines and cash-on-hand accounts from robust days available to these entities. Independent practices (critically dependent on monthly cash flow) were decimated, furthering the trend towards consolidation, retirement, and acquisitions. With the new CMS E/M valuations we will see further reduction in procedural reimbursement.

Our postpandemic world will be dramatically different from pre-COVID times. However, disruption always precipitates innovation. Challenges are great but opportunities are clearly evident for those willing to risk.
 

John I. Allen, MD, MBA, AGAF
Editor in Chief

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