Who Diagnoses EPI? Defining Roles Across the Care Team

With symptoms and presentations now established, this episode explores who in the healthcare system is best positioned to make an EPI diagnosis. Dr. Kaul frames the discussion: while gastroenterologists and specialty practices handle referrals, the initial contact is often a primary care provider, surgeon, or endocrinologist who may not routinely order EPI-specific tests.

Jennifer Geremia advocates for widespread awareness across specialties, proposing a multi-modal, collaborative approach. The key expectation is not that every provider must know how to order and interpret every test, but that they should have a sufficient index of suspicion to recognize when referral to gastroenterology is appropriate. She cautions against the assumption that "someone else" will pick it up—diagnosing and acting on EPI is a shared responsibility.

Sarah Enslin echoes this, noting that with the evolving healthcare landscape, NPs and PAs are increasingly managing complex patients in both subspecialty and primary care settings. This further distributes the responsibility for EPI recognition. The growing volume of primary care practices makes platforms like this peer exchange especially critical for disseminating knowledge efficiently.

Dr. Kaul reinforces that this is a disease state touchable by virtually every specialty—and that national conferences, regional courses, and educational programs are essential vehicles for spreading that message. He closes the episode by reminding viewers that every provider who encounters a patient with relevant symptoms or risk factors has a role in moving toward a diagnosis or appropriate referral.

In the next episode, "EPI Testing Strategies: What to Order and When," the panel conducts a practical deep dive into the diagnostic tools available for EPI, from fecal elastase to EUS, covering when to use each and how to avoid common testing pitfalls.