Clinical Gastroenterology Journal

How do Hospitalists Perceive the Quality of Inpatient Gastroenterology Consultations and Procedures?: A National Survey

Abstract

Christian D Stone, Edward Makarewicz, Afshin Khaiser and Gayatri Vengayil

Background: Hospitalists frequently consult gastroenterologists (GEs) for inpatient care, but few studies have queried hospitalists for their opinions about how well GEs provide consultative and endoscopic services.
Objective: To determine how hospitalists 1) perceive the quality of consults and procedures provided by GEs, and 2) rate the procedural skills between GEs and surgeons.
Design: Web-based questionnaire.
Setting: Hospitals throughout the United States.
Results: Of 785 surveys analyzed, most respondents (75.3%) agreed/strongly agreed that they were satisfied with consultation services provided. Similar rates (>70% agreed/strongly agreed) of satisfaction were reported with regard to appropriateness of consultation and confidence in performing procedures. When asked if GEs were more interested in performing procedures than in treating disease, 38.4% agreed/strongly agreed, while 41.7% disagreed/ strongly disagreed (P=0.3). On this question, younger respondents (<30 years) were less likely to agree (25.4%) compared to older age groups (as high as 44.5%). When asked whether GE and surgeons were equally skilled at performing endoscopy, 47.4% disagreed, 37.8% were neutral, and 14.8% agreed. Of those who disagreed, 99.4% rated GEs as the more skilled proceduralist.
Conclusions: Overall, hospitalists expressed high satisfaction rates on various aspects of gastroenterology consultation quality and procedural skills. By a large majority, they ranked GEs as superior to surgeons in endoscopic proficiency. However, more than one-third of respondents agreed that GEs may overemphasize procedures, a perception that may unfavorably impact gastroenterology as a specialty.