Overcoming the Screening Bottleneck
Patients with IBD, chronic liver disease, or complex GI disorders need professional, sustained care. They require clinical monitoring, medication management, and treatment adjustments based on disease progression. While these patients achieve better long-term outcomes and more sustainable practice revenue than high-volume screening colonoscopies, they get squeezed out when schedules fill up with screening colonoscopies.
Shifting the emphasis toward treatment doesn’t mean abandoning screening; it means improving operational efficiency so screening doesn’t cannibalize treatment capacity.
Here are three strategies to help with the shift.
- Automate What Doesn’t Require Clinical Judgment
Screening patients need reminders, preparation instructions, and follow-up scheduling. All this creates an administrative burden that scales linearly; more screenings mean more phone calls, more rescheduling, and more instruction delivery. And none of this requires physician time, let alone substantial staff time.
Automation breaks that linear relationship; the same system handles 50 patients as easily as 500. With automated patient reminders, patients receive prep instructions, appointment confirmations, and post-procedure follow-up directions with minimal in-person calls. HIPAA-compliant text and email automation communications reach patients reliably and document that the information was delivered.
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Treatment patients need different touchpoints. Their care involves hands-on clinical decision-making that can’t be fully automated. Freeing staff from screening administration creates capacity for treatment and patient communication that requires human judgment.
- Stratify Scheduling Based on Complexity
Not all colonoscopies are created equal. Average-risk screening patients with no symptoms and clean prior exams are straightforward. And, while it’s true that high-risk patients with prior polyps, family history, or surveillance needs require greater clinical attention, their procedures still largely follow the same predictable protocols.
Conversely, treating patients presents unpredictable variables.
- Symptoms change.
- Medications stop working.
- Imaging reveals new concerns.
These patients need flexible scheduling that accommodates emerging, sometimes urgent, needs.
Dedicating specific clinic days or time blocks to treatment consultations prevents them from competing with procedure scheduling. Some practices handle this complexity by running procedure-heavy days for screening volume and clinic-heavy days for treatment management.
- Extend Capacity Without Extending Physician Hours
Advanced practice providers (APPs) expand treatment capacity. APPs handle medication refills, routine monitoring visits, and stable patient follow-up. They escalate complex cases to physicians while managing the substantial middle tier of treatment patients who need ongoing care but not constant physician intervention.
This delegation operates within clear protocols that define when APP management is appropriate and when physician involvement is required.
Screening Supports Treatment, Not Replaces It
High-performing gastroenterology practices use screening revenue to fund comprehensive treatment programs. They don’t let screening consume all available capacity.
The practices that build sustainable, long-term success recognize that treating patients accounts for the bulk of the clinical work that requires gastroenterology expertise. Treatment is specialized care that patients can’t get elsewhere.
Operational choices determine which work dominates your practice. Automation, scheduling strategy, and intelligent delegation create space for all patients.
