Virtual Colonoscopy; A Three Part Series - The Facility

After a short absense while I attended the Abdominal Radiology Course (great content for a future blog or two), I wanted to wrap up my discussion on the series of virtual colonoscopy by looking at the facility.

CTC should offer facilities a unique way to differentiate themselves from everyone else. There are many different places that could offer the procedure including hospitals and diagnostic imaging centers. But, the place that I want to focus is the physician's office, namely the GI office.

Right now, it seems that many gastroenterologists are fighting the idea of CTC. They don't want to take the scope out of their hands. But, they are missing a golden opportunity to market to the communities they serve, grow their business, and even make their work more enjoyable.

Here's an ideal scenario. As a practice they structure themselves to offer both VC and OC. They structure the facility so that the patient comes in and goes through the VC screening. If there are any questions or lesions, they are sent over to OC for a procedure. For the 88% that are clean, they are done, and they go home (the 88% is from the ACRIN trial where it was concluded that 88% of participants would not have had to undergo an optical colonoscopy based on the CTC findings).

As a facility, you can then market this concept to the physicians and patients in the area. Non-invasive screening, but the option for same day removal. One single prep. Go about your day, and feel good. What are the chances that the number of patients increases? Initial studies indicate it will be better than good.

Next, market this to insurance companies as a package. Say they pay one flat rate regardless of outcome. This means you win on VC, lose a little on OC, but end up ahead because you are doing far more VC than OC. Plus by covering screening, they are less likely to have to pay on the back end for the treatment of cancer.

Lastly, market to the physicians. To the GI guys, it's not about taking the scope out of their hands. Rather, it's allowing them to forego the mundane, basic, non-polyp colons and focus on more challenging cases and polypectomies, thus being more stimulating for them (the same thing is occuring with the cardiologists as they realize it's more "fun" to deal with the challenging cases and leave the basic, routine ones to CT). For radiologists, this allows them an opportunity to do some additional reading, or it allows teleradiology practices the opportunity to increase their workload.

All-in-all, if this is properly positioned, it should be a win-win for everyone. It is going to take some education of the parties involved, but in the end, I think the advent of VC is going to lead to increased screening, which will lead to increased survival rates and increased revenues for the GI facilities. Because, when we get right down to it, it's not about taking the scope out of their hands, it's the fear of taking the dollars out of their pockets.