It began as a slow trickle, recalls gastroenterologist Austin Osemeka, MD, of Carolina digestive diseases in Gastonia, N.C. He watched as a few of his patients left Gastonia and traveled to the neighboring city of Charlotte to undergo their screening colonoscopy.
This was in the mid-2000s. Several endoscopy centers had opened in Charlotte, but Gastonia — located in Gaston County — had none.
“Patients would go get their screening done in Charlotte and then come back to Gastonia for the rest of their care,” Dr. Osemeka recalls. “Initially there were just a few patients doing this, but it soon became a pattern. They were getting their screening done at these endoscopy centers because they could have the procedure at a lower cost than what we could provide to them by performing the procedure at the local hospital.”
Gastroenterologist Sam Drake, MD, of Gaston Digestive Disease Clinic in Gastonia, recalls a similar change happening with his practice. “We started seeing patients leaving our county and going to Charlotte. It was strictly from an economic standpoint. Considering their insurance, they were able to get their indicated procedure done financially better than what we could do.”
Over the years, the number of patients leaving Gaston County for their procedures grew significantly, says gastroenterologist William Watkins, MD, of Gaston Gastroenterology in Gastonia. “We were losing about 1,400 colonoscopies a year to endoscopy centers in Charlotte because patients could get their procedure for a co-pay, which was lower than what they needed to pay at the hospital.”
Dr. Osemeka adds, “Many patients are unwilling to pay what the hospital charges, especially those with no medical problems, a high deductible and private North Carolina Gastroenterologists insurance.”
