Impact of Non-Gastroenterologists Performing Gastrointestinal Endoscopy on the Practice of Gastroenterologists and Variations in Practice of Gastrointestinal Endoscopy by Non-Gastroenterologist Endoscopists and Gastroenterologists in Georgia, United States
Bibliographic record
Abstract
Purpose: Most gastroenterologists perform gastrointestinal endoscopies, however all gastrointestinal endoscopies are not performed by gastroenterologists. There exists a perception in the medical community is that the endoscopies are increasingly taken over from the gastroenterologists (GE) by the non-gastroenterologist endoscopists (NGE) causing substantial impact on the practice of gastroenterologists. The goal of this study was to determine whether GE's and NGE's feel threatened by this competition to their practice of endoscopy. Methods: A telephone survey of GE's (N = 100) and NGE's (N = 100, 59 family physicians and 41 general surgeons) was conducted in the State of Georgia, United States in 2004. The names and telephone numbers of the physicians were randomly obtained from the Yellow Pages section of the BellSouth telephone directory. A 12 questionnaire telephone survey was administered and responses were recorded and analyzed. Results: All the GE's practiced in urban areas compared to 65% of the NGE's who practiced in rural areas (p < 0.001). GE's performed an average of 27 endoscopies per week compared to six endoscopies per week by NGE's. GE's claimed that they spent 56% of their time in endoscopy compared to 11% of their time by NGE's (p < 0.001). The average wait time for a non-urgent new patient to see a GE was five weeks compared to one week for NGE. 50% of the GE's were in group practice compared to 14% of the NGE's. The average work week of a GE was 48 hours compared to 62 hours of a NGE. 62% of the GE's performed endoscopies in out-patients surgical centers compared to 90% of the NGE's in hospitals (p < 0.001). 55% of the GE's agreed that compensation for the endoscopy is adequate compared to 70% of the NGE's (p < 0.05). 72% of the GE's believe that there is shortage of gastroenterologists compared to 80% of the NGE's (p= 0.20). 10% of the GE's were willing to refer their patients for endoscopy compared to 26% of the NGE's (p < 0.01). 90% of the GE's thought NGE's are not a threat to their practice whereas 92% of the NGE's thought GE's are not a threat to their practice. Conclusions: Neither GE's, nor NGE's view each other as a threat to their practice of gastrointestinal endoscopy. The numbers of endoscopies performed by the GE's are more when compared to the NGE's. NGE's provide endoscopy services in rural areas that are not served by GE's.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".