RamaOnHealthcare: You’ve explored many trends in the book from technology to business. Let’s talk about exponential technologies first. How is it affecting gastroenterology
Praveen Suthrum: Yes, the trends we discuss in Scope Forward cut across technological, business, and societal areas.
Consider the impact of exponential technologies such as DNA testing, artificial intelligence, and the microbiome. In last couple of decades, gastroenterologists have largely relied on screening colonoscopy to detect colon cancer. But now DNA testing services offer tests that screen for colon cancer via a stool sample. There is plenty of research underway to detect not just cancer of the colon but fifteen types of cancers using a blood sample. That field is called liquid biopsy. Consider the business disruption that this may cause to gastroenterologists who do not adapt.
Artificial intelligence in endoscopy is now able to point to polyps (growths in the gut) and even classify them. If an AI is able to show and tell you what’s cancerous, consider how that might impact the training and role of an endoscopist. Also think about what would happen if insurances link reimbursements to quality and count of polyp detection and removal. Everyone would be compelled to rely on AI.
The important thing to remember about exponential technologies is that they are not developing in isolation. The growth of one field affects the other. Advances in sensors improves robotics. Advances in robotics makes advanced endoscopic surgery possible. In the coming years, we will see a rapid multiplication of these technologies. That will result in an exponential change in gastroenterology and all of healthcare.
RamaOnHealthcare: What about business consolidation? Has there been a lot of private equity activity in gastroenterology?
Praveen Suthrum: Yes, private equity (PE) has fueled consolidation within gastroenterology and many other specialties in healthcare. When I wrote my earlier book Private Equity in Gastroenterology, there were five PE transactions in gastroenterology. Not surprisingly, my predictions about consolidation played out throughout 2019. There were 16 transactions during the year. In 2020, there are already four or more, including a PE platform that went live in the middle of COVID-19.