In this episode, I speak to Naresh T. Gunaratnum, MD, who completed his GI fellowship at Univ of Michigan and an advanced endoscopy fellowship at Mayo Clinic. He shares his perspective on transitioning from a large academic medical center to private practice in a community hospital. He also talks about balancing clinical practice with research, gives his thoughts on direct-to-consumer screening tools and presents pearls for gastroenterology fellows.

• Intro :10
• The interview :58
• Cultural differences between academic and community centers 1:31
• How did you create a path that allows you to publish research but maintain a busy clinical practice? 3:02
• Research challenges in a community setting 4:24
• What motivates you to spend time coordinating and conducting research? 6:00
• Do you feel that community advanced endoscopists must defend their outcomes compared with large academic centers? 8:38
• How do private practice centers afford expensive machines and technology that may or may not be covered by payors? 12:42
• What are the challenges of creating a community weight loss program from the ground up? 15:15
• What are your thoughts on direct-to-consumer tests like Cologuard? 22:10
• Do you see an at-home, noninvasive test on the horizon that will be just as good as colonoscopy? 24:51
• Do you have a routine to help you stay abreast of the literature? 27:00
• You mentioned earlier that 80% of your time is spent gathering patient data, and that in the future that will be cut down to 20%. What do you mean by this and how will this happen? 28:30
• Are you using midlevel providers such as NPs and PAs? What is your take on their role in the future? 30:55
• If you had a magic wand and could change one thing regarding socioeconomics and social determinants of health, what would you change? 33:28
• If you could go back to GI fellowship, what's one thing you could do differently? 35:44
• Thank you, Dr. Gunaratnum 37:44

Naresh Gunaratnum, MD, is a gastroenterologist in private practice at Huron Gastro Center for Digestive Care in Ypsilanti, Michigan, and 2019 recipient of the American Gastroenterological Association's Distinguished Clinician Award.

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