One Year of Scope Forward

One Year of Scope Forward: Here’s what I’ve learnt


It’s funny how they say a book can change your life. Scope Forward did that for me.


While it’s still too early to say, it also seems to be influencing the course of gastroenterology. Well, it prompted some to change careers as private practice doctors.


Every now and then, someone or the other sends a message like this (from today):

“My team and I are building a Crohn’s Disease/Ulcerative Colitis company and have found Scope Forward super helpful as we build our commercial approach.”

It’s a UK based digital GI company in the works.


From the beginning, my interest was depth of impact. The objective was to spur action – to scope forward.


So, taking action had to start with myself. The outcomes have pleasantly surprised me.



Our team used Scope Forward as a guide book to build a digital GI company to reverse NAFLD via weight loss. The company raised ~$1M since incorporation in Sept ’20. More important, we are helping people heal using a digitally-enabled model. The surprise: we built the company in two global markets simultaneously (US and India).


CB Insights has put the company on the watchlist for Digital Health 150 (results in Dec ’21).


If you are interested in NovoLiver, click here.

Scope Forward Show and podcast


When the pandemic hit, Scope Forward inspired me to ask, how do we help GI doctors weather through the storm? The answer was a platform that gathered insights through conversation-style interviews (30+). Guests have included Dr. Gene Overholt, Dr. John Allen (CMO, Michigan Medicine), Dr. Michael Weinstein (President & CEO, Capital Digestive Care), Dr. Scott Ketover (President & CEO, MNGI), Dr. Jim Leavitt (CCO, Gastro Health), Dr. Michael Dragutsky (Chairman, One GI) and Dr. Naresh Gunaratnam (CEO, Huron Gastro).


If you are interested in nominating a guest for the SF show/podcast, click here.

GI Mastermind


Scope Forward made me wonder what would the future of GI be like if the best minds in the space collaborate? The outcome was a mastermind group that includes some of the best GI groups in the country, both non-PE and PE – with members from AGA and DHPA. A few initiatives that the group is working on: AI in GI pathology, breath biopsy, and microbiome. Guests include digital GI startups, associate dean of Michigan Ross, Medtronic GI President and CMO of Cologuard.


If you are interested in a future GI Mastermind or coaching from me, click here.


Of course, keynote talks, podcasts, strategic retreats, and interviews followed. Click here to book me for a talk or consulting.

4 Trends – How’s Scope Forward playing out in the industry


All four trends outlined in Scope Forward have been accelerating.



The most controversial aspect of the book was comparing Cologuard to self-driving cars (created mixed feelings for GIs). In the last year, Exact Sciences (and many other companies) accelerated. At least, a portion of the GI community now understands that they cannot rely on screening colonoscopies for ongoing livelihood.


Some predictions have come true. For example, the book foresaw “second bites” from 2022 to 2026 (page 80). Gastro Health recapitalized itself in 2021 becoming the first PE platform to do so. It saw the coming of supergroups – 500 to 1,000 GIs (page 85). GI Alliance is now bigger than that.


Download GI consolidation infographic  >



Some big tech companies started and withdrew initiatives in healthcare. But Amazon has a full-blown plan underway. UnitedHealthcare has become the largest employer of physicians in the country.



The GI community isn’t experiencing this trend directly. But it will. During the last year, startups like Oshi Health and Bold Health have begun offering alternatives to the GI practice. We will only see more of digital GI.


What happens next?


Even with the advent of supergroups, there’s plenty of CONSOLIDATION left in GI. Recently, one of the PE in GI funds I spoke to said that only 10-15% of the market was consolidated. They expect consolidation to continue over the next five years – both regionally and nationally.


Influencing hospitals will dramatically vary region to region. With the move to value-based care, insurances will be more open to data-driven, cost-saving conversations with GI practices.


Expansion of screening guidelines to 45 years of age wouldn’t dramatically impact screening colonoscopy revenues. Because the overall insurance reimbursement pie for screening will continue to shrink.


The direction of Scope Forward was to build up ancillary revenues before liquid biopsy makes screening revenues go away altogether. One of the best pieces of wisdom was from Dr. Scott Ketover: Step back and say, ‘how do we do our cognitive work better?’


For example, GI practices are sitting on a gold-mine of endoscopy data that can be repurposed to train AI to more accurately spot and classify polyps. However, I suspect most GIs will not be inclined to make time to do just that.


Finally, a new stream of digital GI companies will take shape by following trends in PATIENT BEHAVIOR. This space will attract massive amount of venture capital. The capital and technology trends will in turn create more digital GI solutions. Many upcoming GI doctors will choose digital GI companies over private practice. It’s just a matter of salaries catching up.

Scope Forward on your terms


I’m writing this note from my dining table in Mumbai. In fact, the initiatives you’ve read above (and more) took shape at home.


For me, influencing an industry from anywhere in the world is scoping forward on my terms. Ask, what scope forward means to you?


The pandemic has put into question many of our assumptions. On time and location. On work and collaboration. On speed and influence.


We need to take a hard-look at all the limitations that we put in front of us.


Make magic – wherever you are, whatever your current situation is.


Doctors – especially gastroenterologists – are some of the most brilliant minds in the world. It’s just that the scalpel of medicine is rapidly going digital. Adapt. That’s how you scope forward!

Scope Forward:
The Future of Gastroenterology Is Now in Your Hands

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About the author:


Praveen Suthrum is the cofounder and president of NextServices. His writing has been featured in Forbes, Inc., The Economic Times, The Detroit News, STAT News, Huffington Post, Becker’s ASC, and The Healthcare Blog.


He has an engineering degree from Manipal Institute of Technology and an MBA from University of Michigan’s Ross School of Business. He also completed the Exponential Medicine program at Singularity University.

Books by Praveen Suthrum:

Private Equity in Gastroenterology: Navigating the Next Wave

#1 New Release on Amazon in Private Equity and Gastroenterology categories

Scope Forward: The Future of Gastroenterology in now in your hands

Based on research and interviews with industry leaders, Scope Forward paves the way for GI practitioners to lead the change, transform their practices and the industry.