A study of gastroenterologists in the United States.

A two-part study of gastroenterologists (GEs) was conducted. One component was the analysis of 1987 Part B Medicare Annual Data to assess volume of services and patterns of reimbursement to gastroenterologists. This study demonstrated that two-thirds of services billed by GEs are medical visits, whereas two-thirds of GEs' income is derived from endoscopies. Five endoscopies account for 50% of GEs' allowed charges. Correcting for case-mix and geographic location, GEs' charges for endoscopies are still 10% higher than other physicians performing the same procedures. The second component of the study was a survey of 379 members of three major gastroenterological associations. Demographic and practice characteristics are reported and compared, when possible, with other physician specialties. Respondents estimated they spent 52 h/wk in inpatient and outpatient activities, of which 17.5 h were spent performing endoscopies. Fewer than 50% of respondents billed for 31.4 h of professional activity each week. Medicare patients comprise 38.2% of their patients. Most physicians did not balance-bill, or balance-billed Medicare patients only when they were able to pay. Malpractice premiums have risen from $6,511 to $9,540 during the past 3 yr. Over 95% of respondents were able to correctly identify those conditions requiring upper gastrointestinal (UGI) endoscopy and colonoscopy.