Gastroenterology Viewed Through a Glass Darkly – An IDI Focused Perspective

Abstract

The linear expansion of medical information has already precipitated fragmentation of physician-based clinical care into multiple subspecialties predicated on site of disease dysfunction. Through the widespread expansion and dissemination of information in the areas of diagnostic and case-management, Artificial Intelligence (AI) stands to erode exclusivity of patient care and redirect committed populations to alternate healthcare providers. Governing a broad area of patient care, gastroenterologists have the responsibility to identify the canaries in the coal mine within their area of expertise. When canaries have been disregarded, the fiscal fallout has been significant: e.g. Individuals lacking production of gastric acid who developed peptic ulcer disease are just such canneries. When it was documented that PUD was of infectious disease causation and curable using antibiotics, the income of gastroenterologists dramatically decreased. Largely due to disease entities grouped under the term, Inflammatory Bowel Disease (IBD), gastroenterologists are currently the second-best compensated subspecialists within internal medicine. Not having addressed the discipline’s scientific deficiencies that were unmasked by the PUB debacle, gastroenterologists have set the stage for another fall from fiscal grace. This IDI Perspective is an analysis of gastroenterology’s vulnerable scientific underbelly, why history stands to repeat itself, and what can be done to minimize the consequences.