ACG Magazine | Vol. 9, No. 2 | Summer 2025

ACG MAGAZINE Summer 2025

MEMBERS. MEDICINE. MEANING.

Fostering

HiGh-Performing TEams

r e t s i g Re Now!

OCTOBER 24 - 29, 2025 | PHOENIX, ARIZONA

OCTOBER

OCTOBER 24 - 29, 2025 | PHOENIX, ARIZONA

OCTOBER

OCTOBER

OCTOBER 24-29, 2025

PHOENIX CONVENTION CENTER, PHOENIX, AZ

REGISTER

OCTOBER

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SUMMER 2025 // VOLUME 9, NUMBER 2

FEATURED CONTENTS COVER STORY

FOSTERING HIGHPERFORMING TEAMS IN THE ENDOSCOPY SUITE Dr. David Greenwald provides guidance on cultivating an open, respectful, and cohesive team atmosphere in the endoscopy suite

PAGE 30

ACG PERSPECTIVES Dr. Jill Gaidos speaks with Anne-Louise Oliphant, ACG's recently retired Vice President of Communications, about her nearly 30 years of service to the College

PAGE 22 PHARMACY CORNER Dr. Shubha Bhat on the benefits of including clinical pharmacists in the GI care team

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Attend an upcoming

ACG POSTGRADUATE COURSE 2025 2025 ACG’s Functional GI & Motility Disorders School & Midwest Regional Postgraduate Course  August 22–24, 2025  Marriott Indianapolis Place, Indianapolis, IN

ACG Weekly Virtual Grand Rounds REGISTER NOW: GI.ORG/ACGVGR ACG VGRs are offered TWICE each Thursday, with a live broadcast at noon (ET) followed by an 8:00pm (ET) rebroadcast!

2025 ACG’s NEW Esophagus School & ACG/VGS/MASGNA Regional Postgraduate Course  September 5–7, 2025  Williamsburg Lodge, Williamsburg, VA

ACG 2025 Annual Scientific Meeting & Postgraduate Course  October 24-29, 2025  Phoenix Convention Center, Phoenix, AZ

2025 ACG''s Hepatology School & Southern Regional Postgraduate Course  December 5-7, 2025  Renaissance Hotel, Nashville, Tennessee

2026 2026 ACG's IBD School Board of Governors / ASGE Best Practices Course  January 30–February 1, 2026  Las Vegas, NV

MORE INFO: gi.org/acg-course-calendar

SUMMER 2025 // VOLUME 9, NUMBER 2

CONTENTS

ACG Executive Director Brad Stillman, Early Career Leadership Program participant Dr. Daniela Guerrero Vinsard, and ACG President Dr. Amy Oxentenko meet with Rep. Debbie Dingell (D-MI).

“When you come up here and share your experiences, it makes an impact. You give a face to the story, because we’re often debating policy, and not the people that it’s actually affecting.”­ —REP. BETH VAN DUYNE (R-TX), ACG ADVOCACY DAY 2025: BRINGING PATIENT AND PHYSICIAN STORIES TO CAPITOL HILL, PG 17

6 // MESSAGE FROM THE PRESIDENT Dr. Amy Oxentenko on coming together to tackle workforce challenges, provide excellent care, and build strong networks of support

7 // NOVEL & NOTEWORTHY CRC Awareness Month, ACG advocacy efforts, training program and research award highlights, in memoriam for Dr. John Fordtran & more

17 // PUBLIC POLICY ACG Governors and rising leaders convene on Capitol Hill for ACG Advocacy Day

19 // ACG PERSPECTIVES 19 INTERNATIONAL TRAINING GRANT Dr. Kerry-Ann Penn-Brown reflects on her training at Massachusetts General Hospital 22 CONVERSATIONS WITH WOMEN IN GI Dr. Jill Gaidos with Anne-Louise Oliphant on her career at ACG and plans for the future

25 INTERNATIONAL TRAINING GRANT Dr. Shria Kumar on her time at the University of Oslo in Norway 27 PHARMACY CORNER Dr. Shubha Bhat on the role of pharmacists in GI care

30 // COVER STORY FOSTERING HIGH-PERFORMING TEAMS Tips to ensure open communication, respect, safety, and quality in the endoscopy suite

37 // TRAINEE HUB INTERVIEWING FOR GI FELLOWSHIP Tips and tricks to make a great impression

41 // GETTING IT RIGHT TEN CARDINAL RULES OF RECRUITMENT Guiding principles when recruiting physicians to join your practice

45 // INSIDE THE JOURNALS 46 AJG Bowel prep recommendations from the MSTFCRC, new ACG Guidelines on gastric premalignant conditions by Morgan, et al., and malnutrition and nutritional recommendations in liver disease by Singal & Wong, et al.

46 CTG Risk of RSV after SARS-CoV-2 infection in patients with IBD by Alsakarneh & Ramirez Ramirez, et al.

46 ACGCRJ Endoscopic Vacuum Therapy for the Treatment of Atrial Fibrillation Ablation-Induced Esophageal Perforation by Lushniak, et al.

47 ACG GUIDELINE HIGHLIGHTS: GASTRIC PREMALIGNANT CONDITIONS Key takeaways from the 2025 ACG Clinical Guideline on Gastric Premalignant Conditions

48 // REACHING THE CECUM PATIENT HANDOUT: LIFESTYLE AND MASLD Diet and exercise strategies for patients, following a MASLD diagnosis

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ACG MAGAZINE MAGAZINE STAFF

CONNECT WITH ACG youtube.com/ACGastroenterology

Executive Director Bradley C. Stillman, JD

facebook.com/AmCollegeGastro Editor-in-Chief | Vice President, Communications Brian C. Davis

Managing Editor | Senior Manager, Communications Becky Abel

Editor Anne-Louise B. Oliphant Art Director Emily Garel

BOARD OF TRUSTEES President: Amy S. Oxentenko, MD, FACG President-Elect: William D. Chey, MD, FACG Vice President: Costas H. Kefalas, MD, MMM, MS-PopH, FACG Secretary: Neil H. Stollman, MD, FACG Treasurer: Nicholas J. Shaheen, MD, MPH, MACG

x.com/amcollegegastro

@amcollegegastro.bsky.social

bit.ly/ACG-Linked-In

CONTACT IDEAS & FEEDBACK We'd love to hear from you.

Send us your ideas, stories, and comments.

ACGMag@ @gi.org

CONTACT ACG American College of Gastroenterology 11333 Woodglen Drive, Suite 100 North Bethesda, MD 20852 (301) 263-9000 | gi.org

Immediate Past President: Jonathan A. Leighton, MD, FACG Past President: Daniel J. Pambianco, MD, FACG Director, ACG Institute: Neena S. Abraham, MD, MSc, MACG

DIGITAL EDITIONS

Co-Editors, The American Journal of Gastroenterology:

GI.ORG/ACG-MAGAZINE

Jasmohan S. Bajaj, MD, MS, FACG Millie D. Long, MD, MPH, FACG Chair, Board of Governors: Sita S. Chokhavatia, MD, MACG Vice Chair, Board of Governors: Harish K. Gagneja, MD, MACG Trustee for Administrative Affairs: Irving M. Pike, MD, FACG

TRUSTEES Brooks D. Cash, MD, FACG Dayna S. Early, MD, FACG Jill K. J. Gaidos, MD, FACG Seth A. Gross, MD, FACG David J. Hass, MD, FACG James C. Hobley, MD, MSc, FACG Vonda G. Reeves, MD, MBA, FACG Aasma Shaukat, MD, MPH, FACG Jay N. Yepuri, MD, MS, FACG Patrick E. Young, MD, FACG

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American College of Gastroenterology is an organization with an international membership of over 20,000 individuals from 86 countries.

The College's vision is to be the preeminent organization supporting health care professionals who provide compassionate, equitable, high-quality, state-of-the-art, and personalized care to promote digestive health. The mission of the College is to provide tools, services, and accelerate advances in patient care, education, research, advocacy, practice management, professional development and clinician wellness, enabling our members to improve patients’ digestive health and to build personally fulfilling careers that foster wellbeing, meaning and purpose.

CONTRIBUTING WRITERS Shubha Bhat, PharmD, MS, BCACP, FCCP Dr. Bhat is a Gastroenterology Clinical Pharmacist at the Digestive Disease Institute at Cleveland Clinic. She currently serves on the ACG Digital Communications and Publications Committee.

Sita S. Chokhavatia, MD, MACG Dr. Chokhavatia is Chair of the ACG Board of Governors and previously served on many ACG committees and as ACG Governor for Northern New Jersey. She practices at the Valley Health System in Ridgewood, NJ.

Bara El Kurdi, MD Dr. El Kurdi is Assistant Professor of Medicine at Virginia Tech Carilion School of Medicine in Roanoke, VA. He is a member of the ACG Innovation & Technology Committee and Legislative and Public Policy Council.

Shria Kumar, MD, MSCE Dr. Kumar is Associate Program Director for Gastroenterology Fellowship, Director of Endoscopic Research, and Assistant Professor of Clinical Medicine at University of Miami Miller School of Medicine. She received a 2024 ACG North American International Training Grant to train at the University of Oslo in Norway.

Clive Miranda, DO, MSc Dr. Miranda is a GI fellow at Creighton University. He is a member of ACG’s Diversity, Equity, and Inclusion Committee and a social media ambassador for Evidence-Based GI.

Anne-Louise B. Oliphant, MPP

Maysaa El Zoghbi, MD, MSc

Anne-Louise retired as ACG’s Vice President of Communications in March 2025, after nearly 30 years of service to the College. She plans to dedicate the years ahead to pursuing her passion of oil painting and focusing on her wellbeing, family, and friendships.

Dr. El Zoghbi is Assistant Professor of Medicine at NYU Langone Health in Brooklyn, NY, where she is the Brooklyn Site GI Fellowship Director.

Amy S. Oxentenko, MD, FACG

Harish K. Gagneja, MD, MACG Dr. Gagneja is Vice Chair of the ACG Board of Governors and previously served on many ACG committees and as ACG Governor for Southern Texas. He is a physician executive at Austin Gastroenterology in Austin, TX.

Jill K.J. Gaidos, MD, FACG Dr. Gaidos is a Trustee of the College and Associate Professor at the Yale School of Medicine Section of Digestive Diseases and Director of Clinical Research for the Yale IBD Program. She is a member of ACG’s Digital Communications and Publications Committee.

David A. Greenwald, MD, FACG Dr. Greenwald is Director of Clinical Gastroenterology and Endoscopy at Mount Sinai Hospital. He is a past ACG president, past Chair of the ACG Board of Governors, and has served on and chaired many ACG committees.

ACG President Dr. Amy Oxentenko is Professor of Medicine and and Vice Dean of Practice at Mayo Clinic in Rochester, MN.

Kerry-Ann T. Penn-Brown, MD Dr. Penn-Brown is a gastroenterologist at University Hospital of the West Indies in Jamaica and was the first graduate of the institution’s GI fellowship program. She received a 2024 ACG International Training Grant to train at Massachusetts General Hospital.

Lawrence R. Schiller, MD, MACG Dr. Schiller is past president of ACG and is currently Clinical Professor in the Department of Medical Education at Texas A&M University School of Medicine, Dallas Campus.

Andy Tau, MD Dr. Tau practices at Austin Gastroenterology and has been a member of the ACG Practice Management Committee since 2023. He is an alumnus of the ACG Institute's 2022 Early Career Leadership Program.

Syed M. Hussain, MD Dr. Hussain is a gastroenterologist at GI Associates in Kenosha, WI. He was a member of the ACG Practice Management Committee from 2018 to 2024.

Lanre Jimoh, MD, MBA Dr. Jimoh is a dual board-certified internal medicine physician and gastroenterologist practicing at Carolina Digestive Health Associates in Charlotte, NC.

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THE POWER OF TEAMWORK: GOING FARTHER TOGETHER Amy S. Oxentenko, MD, FACG

Dear Colleagues, As we move through one of the most demanding and challenging years in healthcare, I have found myself reflecting often on what truly sustains us—not just as individuals, but as a professional community. One word comes to mind repeatedly: teamwork.

In gastroenterology, the current pace of innovation has accelerated (we are talking race-pace fast!), and the complexity of care is growing exponentially. With these changes, the expectations placed on our practices are greater than ever. We all feel it. And yet, despite these pressures, our field continues to rise to the challenge, and it is incredibly inspiring, not because of any single breakthrough or individual achievement, but rather, it is because of the power of teams. We have demonstrated in GI that many voices are louder than an individual one, many hands make light work, and we get farther when we paddle together.

Teamwork was so remarkably welldemonstrated on Advocacy Day—we came out en masse and our messages were amplified. It was teamwork at its finest. As our ACG groups filled the U.S. Capitol hallways and offices, teams worked hand-in-hand to spread the message on issues most impacting our practices and our patients. With the many changes coming out of the U.S. Capitol impacting our research funding, access to care, reimbursement models, and processes to ensure diversity and inclusivity, there has never been a time when the power of teamwork through advocacy has been more critical.

Now let’s pivot to our clinical practice environments. From the moment a patient schedules an appointment all the way to the performance of a complex

“...many voices are louder than an individual one, many hands make light work, and we get farther when we paddle together.”

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therapeutic intervention, every step of the process is shaped by teamwork and collaboration. Our ability to provide timely, effective, and compassionate GI care relies on nurses, advanced practice providers, endoscopy technicians, schedulers, research coordinators, and countless others who form the backbone of our day-to-day care delivery. When these teams function in harmony, patient care excels. Outcomes improve. And importantly, professional fulfillment thrives. We all want to be a part of a team like this. It sustains us.

Teamwork will play a crucial role in helping us face workforce challenges, which are top of mind for many.

Practices and health systems are experiencing real strain—whether from staffing shortages, increasing burnout, or the growing administrative burden of practice. While there is no quick fix, leaning into team-based care offers a powerful path forward. By building systems that allow each team member to operate at the top of their training and feel valued in their contribution, we strengthen the resilience of our workforce and ensure continuity of care for the patients who depend on us.

But teamwork is not just about those we work with in our clinics or hospitals.

It is also about how we show up for one another within our broader professional community. The American College of Gastroenterology is a living example of this. Across our committees, task forces, Board of Governors, and educational initiatives, we are seeing the best of what collaboration looks like—members from distinct parts of the country (and world!), at various stages of their careers, coming together around a shared purpose.

Whether it’s producing evidencebased guidelines, advocating for legislative reform, or supporting the next generation of GI leaders, our collective impact is far greater than what any one of us could accomplish alone.

I am especially proud of the spirit of mentorship and peer support

that defines our ACG family. In a time when many in medicine report feeling isolated or overwhelmed, our culture of collaboration is something to be celebrated—and something we must continue to nurture. Let us never underestimate the power of reaching out to a colleague, listening to a team member, or creating space for diverse voices at the table. These simple acts build trust, and trust is the foundation of every effective team.

As President of ACG, I have had the honor of witnessing firsthand how strong our community truly is. I have seen the innovation born from cross-institutional collaborations, the power of unified advocacy, and the deep commitment to excellence that characterizes our members. But most inspiring is the generosity with which our members support one another—not out of obligation, but out of a shared belief in something bigger than ourselves.

As we look to the future of gastroenterology, I am confident that our success will be determined not by individual accolades, but by our ability to work together. I encourage each of you to continue investing in your teams—at your institutions, in your communities, and within ACG. This edition is filled with more on the power of teamwork.

Let’s celebrate collaboration. Let’s foster inclusion. Let’s lead by example in showing how much more we can achieve when we come together with purpose, humility, and mutual respect. As the African proverb goes, “If you want to go fast, go alone. If you want to go far, go together.” As ACG, I have no doubt we can go far. After all, look at where we have already come!

Thank you for all you do to advance the care of our patients, support your colleagues, and strengthen the fabric of our profession. I am honored to serve alongside this one-of-a-kind team.

With deep appreciation, —Amy

Note hy wor t HEADING INTO THE SUMMER season, we reflect on the excellent work of ACG members. The College proudly supported many Colorectal Cancer Awareness Month initiatives and championed the lifesaving benefits of CRC screening to the nation’s highest court. We celebrate the achievements of rising stars and promising investigators in GI through ACG’s training programs and ACG Institute Research Awards. Finally, Dr. Lawrence Schiller pays tribute to the late Dr. John Fordtran, whose research led to the development of colonoscopy prep and oral rehydration solutions.

Novel & Noteworthy | 7

THE SLEEPING

N&N GI EYE: ARTWORK FROM ACG MEMBERS

Maysaa El Zoghbi, MD, MSc

Location: Jason Harbour, South Georgia I visited South Georgia with my husband as part of an Antarctic expedition over Christmas and New Year's. South Georgia is a remote island in the South Atlantic Ocean, part of the British Overseas Territory of South Georgia and the South Sandwich Islands. It lies approximately 1,400 kilometers (870 miles) east of the Falkland Islands and is known for its rugged landscapes, rich history, and abundant wildlife. Jason Harbour, a small bay about one mile (1.6 km) wide, is located on the north side of Cumberland West Bay. It was charted by the Swedish Antarctic Expedition (1901–1904) under Otto Nordenskiöld, though it had been visited earlier in 1894 by Jason, the ship of Captain C.A. Larsen.

Despite its modest size, Jason Harbour offers excellent wildlife viewing, particularly when rough weather makes other landing sites inaccessible. Near the zodiac landing site stands an old hut, built in 1911 as a refuge for mail deliveries. Beyond the hut, a short walk over the tussac grass (carefully avoiding elephant seal wallows) leads to a narrow isthmus overlooking the quiet waters of Little Jason Lagoon. This hidden spot, largely sheltered from the wind, is perfect for exploring by kayak. A small king penguin colony of around 40 breeding pairs thrives there, alongside brown skuas, kelp gulls, and blue-eyed shags nesting on the nearby cliffs.

8 | GI.ORG/ACG-MAGAZINE

Equipment Used: iPhone 6 Pro, Portrait Mode What Caught My Attention: Penguins have an incredible ability to sleep while standing up. Unlike humans, they never truly fall into a deep sleep. Constantly on alert for predators like leopard seals, orcas, skuas, and giant petrels, penguins take multiple short naps throughout the day, each lasting only a few minutes.

To enhance their safety, they sleep in groups—known as rookeries—which not only provide protection but also additional warmth, even for their already well-insulated bodies.

Technical Challenges: Using an iPhone to capture wildlife has its limitations, particularly the lack of a powerful zoom.

To get a great shot, I had to get as close as possible to the subject while still being mindful of the penguins’ space.

Personal Reflection: Photography is my way of expressing love for the world around me, capturing fleeting moments, and being fully present. It sharpens my attention to detail and helps me see the beauty in my surroundings. Every photograph is a frozen moment—one that will never happen again in the exact same way.

With this picture, I wanted to highlight that you don’t need expensive equipment to take meaningful photos.

A good photograph isn’t about having the latest gear—it’s about noticing what captivates you and preserving that moment in time.

Dr. Maysaa El Zoghbi is Assistant Professor of Medicine at NYU Langone Health in Brooklyn, NY, where she is the Brooklyn Site GI Fellowship Director.

KING

Novel & Noteworthy | 9

// N&N

[HIGHEST COURT]

ACG FILES SUPREME COURT “FRIEND OF THE COURT” AMICUS BRIEF In March, ACG represented the interests of GI providers and patients in filing a “friend of the court” amicus brief with the U.S. Supreme Court in Kennedy v. Braidwood. ACG championed the lifesaving benefits of CRC screening and alerted the court of the practical implications on access to screening for millions of Americans.

Oral arguments in the case were heard in April, with a decision due sometime this summer. The court will ultimately decide the validity of the U.S. Preventive Services Task Force (USPSTF) and its recommendations that guide policy decisions under the Affordable Care Act’s preventive services mandate.

READ MORE: bit.ly/ACG-Amicus

[CRC MONTH HIGHLIGHTS]

MARCH COLORECTAL CANCER AWARENESS MONTH For 2025, the College’s CRC Month celebration featured advocacy, music, and patient education!

CRC Month was off to a great start with “Dress in Blue Day” on Friday, March 7, 2025. During March and throughout the year, ACG’s goal is to inspire, uplift, and celebrate our members in their efforts to increase visibility of CRC prevention while providing educational resources, tools, messaging, and graphics to support their efforts with patients and in their communities. Explore patient handouts, including translations into many languages: bit.ly/ACG-CRC-toolkit [DRESS IN BLUE DAY]

LBJ Hospital with Dr. Brooks Cash (center)

Wilcox Medical Center, Hawaii Pacific Health, with Dr. Romeo Esquivel, Jr. (fifth from left)

ACG EXPANDS PARTNERSHIP WITH THE COLON CANCER COALITION ACG proudly expands its partnership with the Colon Cancer Coalition, sponsoring their popular “Get Your Rear In Gear” 5Ks and other events throughout the country.

The proceeds from these events stay local, ensuring they support their communities by raising screening rates, reducing health disparities, researching early-onset CRC, helping patients and caregivers, and more.

Find an event near you: donate.coloncancercoalition.org

Valley Medical Group with Dr. Sita Chokhavatia (front, third from right)

Austin Gastroenterology with Dr. Harish Gagneja (center)

Colon Cancer Coalition President Chris Evans with Dr. Amy Oxentenko at the United In Blue rally and installation.

10 | GI.ORG/ACG-MAGAZINE

[ON THE RUN]

CHERRY BLOSSOM 10-MILER ACG President Amy S. Oxentenko, MD, FACG, and ACG members local to Washington, DC, made sure GI was represented at the annual Cherry Blossom 10-Miler on April 6, 2025! They designed and wore gut-themed shirts and rounded the course, with proceeds from the race benefiting Children’s Miracle Network Hospitals.

L-R: Dr. Nicole Harrison, Dr. Kathryn Driggers, Dr. Amy Oxentenko, Abby Oxentenko L-R: Abby Oxentenko, Stumpy, Dr. Amy Oxentenko, Dr. Kathryn Driggers

JOINING FORCES WITH PATIENT ADVOCATES IN WASHINGTON, DC On March 10, 2025, on the National Mall, ACG President Amy S. Oxentenko, MD, FACG, represented the College at the “United in Blue” rally and installation organized by the advocacy group Fight Colorectal Cancer.

ACG is proud to be part of a coalition of organizations standing with CRC patients, survivors, and caregivers who gathered to visit with legislators and bring attention to colorectal cancer, the trends in young-onset disease, and to demand that the U.S. Congress prioritize CRC research and screening. A dramatic installation of 27,400 blue flags near the U.S. Capitol was a powerful visual representation of those younger than 50 who will be diagnosed with colorectal cancer in 2030 unless we do more to educate, screen, and raise awareness.

ACG President Dr. Amy Oxentenko addresses the United in Blue rally in Washington, DC.

TUNE IT UP CONCERT FOR COLORECTAL CANCER AWARENESS An evening of musical inspiration on March 26th marked the near end of CRC Month, when Benjamin H. Levy, MD, of the ACG Public Relations Committee organized a virtual concert featuring artists from a wide array of musical genres who donated their time and performances. ACG’s Tune It Up Virtual Concert to Raise Awareness of Colorectal Cancer included performers such as legendary band Blues Traveler, Lisa Loeb, Rufus Wainwright, violinist Hilary Hahn, Adam Lambert, Switchfoot, Michael Franti & Spearhead, and many more! You can listen to a recording of this outstanding program at gi.org/concert.

In honor of Dress in Blue Day 2025, the ACG Board of Trustees shows its dedication to colorectal cancer screening!

Front L-R: Dr. Neil Stollman, Dr. Costas Kefalas, Dr. Amy Oxentenko, Dr. William Chey, Dr. Nicholas Shaheen.

Back L-R: Dr. Jonathan Leighton, Dr. Daniel Pambianco, Dr. Jasmohan Bajaj, Dr. Jay Yepuri, Dr. Sita Chokhavatia, Dr. Neena Abraham, Dr. Vonda Reeves, Dr. Dayna Early, Dr. Irving Pike, Dr. Patrick Young, Dr. Millie Long, Dr. Harish Gagneja, Dr. Seth Gross, Dr. James Hobley, Dr. Aasma Shaukat, Dr. Jill Gaidos, Dr. Brooks Cash

Novel & Noteworthy | 11

// N&N [PIPELINE]

[NACGF]

The Summer Scholars Program is an initiative of the ACG Committee on Diversity, Equity & Inclusion that pairs medical students from groups underrepresented in medicine with mentors for a research project and provides a stipend of $5,000.

Congratulations to the 2025 ACG Summer Scholars! These promising medical students will undertake a summer research experience in GI with a mentor:

Since 1990, ACG has sponsored The North American Conference of GI Fellows (NACGF). GI fellows have a unique opportunity to present their research to colleagues in a small group setting and receive coaching on presentation skills from experienced faculty.

Congratulations to the 2025 NACGF Distinguished Achievement Awardees: Krystal Mills, MD; Alicia Muratore, MD, MBA; and Walker D. Redd, MD. These fellows presented at the conference in March and were scored highly by the faculty on their presentation skills including confidence while presenting, clear and concise slides, and ample time allowance for Q&A from the audience. The winning presenters received a $1,000 travel stipend to attend ACG 2025 in Phoenix, AZ.

Sunita Brimmer (Sam Houston State University) will work with mentor Eric D. Shah, MD, MBA, FACG (University of Michigan)

Benedicte Deshommes (Quinnipiac University) will work with mentor Natalee S. Campbell, MD (Mayo Clinic, Scottsdale)

Kiana Nowlin (SUNY Upstate) will work with mentor Kajali Mishra, MD (Cook County Hospital, Chicago)

NACGF Course Directors Dr. Jill Gaidos (left) and Dr. David Hass (right) with 2025 NACGF Distinguished Achievement Awardees Dr. Walker Redd, Dr. Krystal Mills, and Dr. Alicia Muratore

2025 NACGF Attendees Front L-R: Dr. Mouhand Mohamed, Dr. Krystal Mills, Dr. Tilak Shah, Dr. Jill Gaidos, Dr. David Hass, Dr. Amy Oxentenko, Dr. Lisa Deng, Dr. Vanisha Patel, Dr. Jalpa Devi, Dr. Sanjeevani Tomar.

Second Row L-R: Dr. Eleazar Montalvan-Sanchez, Dr. Linda Anh Nguyen, Dr. Alicia Muratore, Dr. Lakshmi Subbaraj. Third Row L-R: Dr. Pujan Kandel, Dr. Himesh Zaver, Dr. Peerapol Wangrattanapranee, Dr. Raj Mohan Ram Mohan, Dr. Kyaw Min Tun, Dr. Giovannie Isaac-Coss. Fourth Row L-R: Dr. Lasha Gogokhia, Dr. Rewanth Katamreddy, Dr. Muhammad Haseeb, Dr. Melvin Joy, Dr. Fred Karaisz, Dr. Passisd Laoveeravat, Dr. Walker Redd. Back L-R: Dr. Christian Karime, Dr. Ahmed Telbany, Dr. Khaled Alsabbagh Alchirazi.

[INVESTING IN THE FUTURE OF GI]

2025 ACG INSTITUTE RESEARCH AWARDS For 2025, the ACG Institute for Clinical Research & Education awarded nearly $2.3 million to support outstanding clinical research in gastroenterology, hepatology, and endoscopy. Overall, since 1994, over $34.2 million in awards have funded 764 investigators. The “jewel in the crown” is the ACG Junior Faculty Development Grant which provides career development funding for promising junior investigators working toward independent careers in clinical research related to gastroenterology or hepatology.

2025 ACG Junior Faculty Development Awards Claire Beveridge, MD Cleveland Clinic Foundation Alternatives to Endoscopic Biopsies in Eosinophilic Esophagitis Erica J. Brenner, MD, MSCR University of North Carolina at Chapel Hill Safety and Effectiveness of Nonsteroidal Anti-Inflammatory Drugs in Women with Crohn’s Disease Phillip Gu, MD Cedars-Sinai Medical Center A Multiorgan Radiomic Approach Towards Precision Medicine in Acute Severe Ulcerative Colitis

See all 2025 grantees: bit.ly/acg-research-grantees

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[EAVP]

2025 VISITS *Adjoa N. Anyane-Yeboa, MD, MPH Advocate Lutheran General Hospital April 9

*Seth Gross, MD, FACG, Mount Sinai West & Morningside, March 5

Michelle K. Kim, MD, MSc, PhD St. Louis School of Medicine May 13-16 Jonathan A. Leighton, MD, FACG UNC Blue Ridge May 16 Rena H. Yadlapati, MD, MSHS, FACG Cook County Health May 16 Anita Afzali, MD, MPH, MHCM, FACG University of New Mexico May 21

Nancy S. Reau, MD, FACG, West Virginia University, March 13-14

Amy S. Oxentenko, MD, FACG Michigan Medicine May 21-23 Paul Y. Kwo, MD, FACG The University of Texas at Austin Dell Medical School June 25 *Victor Chedid, MD, MS Mercy Medical Center August 14

*Baharak Moshiree, MD, MSc, FACG, Wayne State University, March 14

Amandeep K. Shergill, MD, MS, FACG Houston Methodist September 11-12 Nicholas J. Shaheen, MD, MPH, MACG University of Virginia October 1 *Visits requested an ACG Visiting Scholar in Equity, Diversity, and Ethical Care

*Christopher D. Vélez, MD, Northwell Lenox Hill Hospital, March 27

Novel & Noteworthy | 13

// N&N [IN MEMORIAM]

[BOOK REVIEW]

AN APPRECIATION OF JOHN S. FORDTRAN, MD Lawrence R. Schiller, MD, MACG, Dallas, TX

THE SHIFT: HOW DIGITAL INNOVATION IS IRREVERSIBLY TRANSFORMING GASTROENTEROLOGY AND HEALTHCARE

By Praveen Suthrum, MBA

John S. Fordtran, MD, was the most consequential gastroenterologist of the 20th century. His studies of the physiology of water and electrolyte transport in the human gut—using innovative methods that he invented— provided the scientific basis for oral rehydration therapy, a life-saving therapy for severe diarrhea which has been responsible for the survival of millions of children and adults.

These physiology studies also resulted in the development of oral colon preparation solutions for colonoscopy, such as Golytely® and SuPrep®, which made colonoscopy screening for colon cancer more effective, and Miralax®, which is widely used for treatment of constipation.

His research studies of gastric acid secretion proved the importance of acid inhibition in the treatment of peptic ulcer disease and were instrumental in the development of histamine-2 receptor antagonists, such as cimetidine and ranitidine, and proton pump inhibitors, such as omeprazole.

These drugs still are used by millions every day for the treatment of gastroesophageal reflux disease and ulcers.

He was a keen clinician and identified microscopic colitis syndrome as a common cause of chronic diarrhea, and chronic idiopathic secretory diarrhea as a self-limited illness. He viewed every patient as an opportunity to learn more about how the body works and to develop ways to treat others.

These brilliant scientific accomplishments tell only part of the story. Dr. Fordtran was a humble man who did not allow fame to go to his head.

He was scrupulously ethical in all that he did. He was a curious man who was not only interested in the causes of illness, but also in people afflicted with the ailment. His interest in people led to a raft of stories about colleagues, and his expertise as a storyteller made his recollections special. He was always willing to help others, and to try to find solutions for problems, whether they be clinical, scientific, or administrative.

This same altruism extended to teaching medical students, residents, and fellows. Many of his trainees went on to be respected teachers, investigators, and physicians—all heavily influenced by his example.

Dr. Fordtran was a fastidious writer, editor, and teacher. He crafted his manuscripts and lecture slides with great care to provide exactly the meaning that he wanted to convey. He would go through dozens of drafts to perfect the order of ideas and the ideas themselves. New concepts that emerged during writing might result in more experiments; in a sense, writing was an extension of his scientific method. He would listen to criticism, assess its validity, and incorporate it as appropriate without taking it personally. In his work as an editor, he would give constructive criticism and suggestions that invariably optimized the author’s writing.

Dr. Fordtran was a great role model. He cared about people; he cared about accuracy; he cared about doing the right things the right way.

He was a hard worker willing to put in the time to achieve the best results possible. In an era when academicians traveled widely to make their reputations, Dr. Fordtran took as his motto, “Travel is the road to nothingness.” He stayed at home and worked diligently. I think that is why he achieved so much in life; he focused on what was important and pursued it.

His legacy lives on in his writings and in the hearts and minds of his trainees and colleagues. The world is a better place for his hard work and love. He will be long remembered.

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Reviewer: Bara El Kurdi, MD, Virginia Tech Carilion School of Medicine Praveen Suthrum’s The Shift is a thought-provoking exploration of the digital revolution reshaping health care, particularly in the field of gastroenterology. As AI, automation, and other exponential technologies continue to disrupt traditional health care models, this book serves as both a guide and a wake-up call for medical professionals, administrators, and entrepreneurs navigating the rapidly evolving landscape.

At its core, The Shift delves into the transformative impact of digital innovation on patient care and the business of health care. Suthrum presents compelling insights from leading innovators, demonstrating how AI-driven diagnostics, automation, and novel health care delivery models are redefining gastroenterology.

More than just a technological analysis, the book challenges readers to reconsider entrenched mindsets and embrace a future-oriented approach to medicine.

One of the book’s key strengths is its practical approach. Rather than offering abstract predictions, Suthrum provides concrete strategies for thriving in a healthcare system that is being fundamentally restructured. The inclusion of real-world examples and interviews with experts adds depth and credibility, making The Shift both informative and engaging.

Another standout aspect is the book’s emphasis on the intersection of technology and human-centered care. While highlighting AI’s potential to revolutionize diagnostics and treatment, Suthrum underscores the importance of preserving the doctor-patient relationship. This balanced perspective ensures that the book is not just about disruption but also about the thoughtful integration of innovation into existing health care frameworks.

Whether you are a gastroenterologist, a health care leader, or someone interested in the future of medicine, The Shift offers invaluable insights.

It is a must-read for anyone looking to stay ahead of the curve in an industry that is undergoing unprecedented change. Suthrum’s work is both a roadmap and an inspiration, making this book a highly recommended addition to the discourse on digital health transformation.

PUBLIC POLICY

ON THURSDAY, APRIL 3, more than 100 ACG

ACG Advocacy Day 2025:

Bringing Patient and Physician Stories

to the Capitol

Sita Chokhavatia, MD, MACG & Harish Gagneja, MD, MACG

leaders from 45 states met with your House Representatives and Senators. Across more than 200 meetings, our tireless advocates expressed the continued challenges we face within gastroenterology, while highlighting key legislative opportunities that would benefit our patients and practices.

The highlight of the day was our annual luncheon, where five Members of Congress and two senior Congressional staffers offered a wide array of perspectives. Collectively, they addressed the relevance of patient and physician advocacy on Capitol Hill and provided insight into the current Congress’ health policy priorities. We are grateful to all of our speakers: GOP Doctor’s Caucus members Rep. Andy Harris, MD (R-MD) and Rep. Rich McCormick, MD (R-GA); Small Business Committee Chair Rep. Beth Van Duyne (R-TX); two newly elected physicians Rep. Herb Conaway, MD (D-NJ) and Rep. Maxine Dexter, MD (D-OR); Drew Keyes,

Public Policy | 17

// PUBLIC POLICY

senior policy adviser for House Speaker Mike Johnson; and Abigail Chance, professional staff member on the House Ways and Means Committee.

As our group reflected at the end of the day, advocacy in Washington, DC, reminded us of the Confucius quote: “It does not matter how slowly you go, as long as you do not stop.” Though we discussed similar issues as in years past, it was encouraging to hear many stories of Congressional meetings where staff recognized our Governors and our legislative priorities. Our hope is that the frustration we conveyed and the legislative opportunities discussed have laid the groundwork for meaningful progress.

THIS YEAR’S KEY MESSAGES AND LEGISLATIVE REQUESTS: Support the Reducing Medically Unnecessary Delays in Care Act (H.R. 2433). This physician-led, bipartisan legislation from Rep. Mark Green, MD (R-TN), Rep. Greg Murphy, MD (R-NC), and Rep. Kim Schrier, MD

(D-WA) would require all Medicare plans to have only medically necessary prior authorization policies for both prescription drugs and services. The bill would also require that all appeals and peer-to-peers be conducted by a doctor in the specialty associated with the patient’s condition.

Ensure patients have access to the full colorectal cancer screening continuum of care, by requiring insurers to correctly classify surveillance colonoscopy as a preventive service. ACG is renewing efforts to secure appropriations language that guides action at the U.S. Department of Health and Human Services. With colorectal cancer cases among young Americans increasing at a staggering rate, now is the time to act.

Support the Medicare Patient Access and Practice Stabilization Act (H.R. 879) and reforms to the Medicare physician reimbursement system that center patient access to care, while ensuring pay keeps up with inflation and the cost of providing services.

As always, we are grateful to the College’s leadership, to ACG President

Amy Oxentenko, MD, FACG, to Louis Wilson, MD, FACG, Chair of our Legislative & Public Policy Council, as well as everyone who dedicated time and effort to the success of our 2025 Advocacy Day! “When you come up here and share your experiences, it makes an impact.

You give a face to the story, because we’re often debating policy, and not the people that it’s actually affecting.”

—Rep. Beth Van Duyne (R-TX) “Healthcare policy needs to be more than just dollars and cents and focus on patients and outcomes. That’s what I hope you’ll see in many of the reforms this Congress will consider.”

—Drew Keyes, senior policy advisor to House Speaker Mike Johnson (R-LA)

“For too long, the people in this building have not been acting with the best interests of patients in mind. But when you show up, legislators listen.”

—Rep. Maxine Dexter, MD (D-OR)

Dr. Sita Chokhavatia is Chair of the ACG Board of Governors and previously served on many ACG committees and as ACG Governor for Northern New Jersey. She practices at the Valley Health System in Ridgewood, NJ.

Dr. Harish Gagneja is Vice Chair of the ACG Board of Governors and previously served on many ACG committees and as ACG Governor for Southern Texas. He is a physician executive at Austin Gastroenterology in Austin, TX.

Clockwise, from top left: Rep. Rich McCormick, MD (R-GA); Rep. Maxine Dexter, MD (D-OR); Rep. Andy Harris, MD (R-MD); Rep. Beth Van Duyne (R-TX); Dr. James Hobley, Drew Keyes, Abigail Chance, Dr. Louis Wilson; Dr. Adam Elfant, Rep. Herb Conaway, MD (D-NJ), ACG Board of Governors Chair Dr. Sita Chokhavatia, and Dr. Ashwin Agrawal

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Clinical Observership

at Massachusetts General Hospital:

e c n ie r e p x E l a n o s r e AP Kerry-Ann T. Penn-Brown, MD

There have been significant advancements in the management of gastrointestinal pathologies, especially in developed countries, due primarily to technological leaps. Middle- to lowincome countries, such as Jamaica, have not been able to keep pace with these advancements. Jamaica, a Caribbean country with persons predominantly of African descent, has approximately 15 gastroenterologists to care for a population of 2.8 million, as well as patients transferred to Jamaica from nearby Caribbean islands who may also require care from a gastroenterologist.

ACG Perspectives | 19

// PERSPECTIVES

To obtain training in gastroenterology in first world countries, Jamaican doctors depend on the ability of GI training programs to accommodate candidates, and the ability of Jamaican candidates to financially sustain themselves or obtain scholarships while at these institutions.

Since 2022, the University of the West Indies has embarked on local training of gastroenterologists within the Caribbean, which will provide human resources to fill the gap, and thereafter provide equipment for use by these doctors. However, there will remain a deficiency with locally trained gastroenterologists who may not experience the progress seen by developed countries during their training. It is therefore important that gastroenterology fellows or gastroenterologists in the Caribbean are exposed to the practices outside their own, with an aim of appreciating what is possible for the future.

As the first candidate to be trained in gastroenterology at the University Hospital of the West Indies (UHWI), I was fortunate to have been chosen for an observership by the Massachusetts General Hospital (MGH). I spent six months in total, the first of which was in interventional gastroenterology with my mentor Dr. Akwi Asombang.

MGH has an excellent faculty of interventional gastroenterologists who freely allowed me to observe and ask questions. I was able to see innovative procedures performed by interventional gastroenterologists such as Dr. Brenna Casey, Dr. Brian Jacobson, Dr. Jonah Cohen, Dr. Kumar Krishnan, and Dr. Asombang. They performed advanced procedures, inclusive of ERCPs, EUS, and EMR. I now have an appreciation of the importance of onsite cytopathologists delivering real-time results, impacting decision making. No longer are choledochoscopy and pancreatic necrosectomy just words on a page for me—they became real during my time at MGH, where I witnessed these procedures.

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Additionally, I spent three months on the hepatology service, where I had the opportunity to see the impact of interventional radiology in the management of patients with chronic liver disease, aiding not only diagnoses but also treatment with procedures such as splenic artery embolization and TIPS in patients with portal hypertension. I also had the privilege of spending time on the infectious disease (ID) service with MGH scientist Dr. Jodian Pinkney, who allowed me to observe their ID Grand Rounds and participate in the management of patients referred to the service during that time.

The hepatology teams were warm and engaging. While on this rotation, I saw how cases common to both MGH and UHWI were managed in the different resource settings, rich versus poor. This period also allowed me to see for the first time rare cases of diseases, such as erythropoietic protoporphyria (EPP), which I am likely never to see again. I was able to observe the management of patients pre- and post-liver transplant.

Currently in Jamaica, there is no adult liver transplant program for patients who need it, and the alternative of going to a country that provides this life-saving procedure is not financially feasible for most Jamaicans. My knowledge gained while in transplant hepatology will assist my patients in advising them of appropriate options available to aid their decision making. I am deeply appreciative of all the doctors who assisted me during this time, including Dr. Raymond Chung, Dr. Wei Zhang, Dr. Andrea Reid, Dr. Jay Luther, Dr. Nneka Ufere, and Dr. Eric Przybyszewski. Their assistance was key to my understanding of some of the fundamental concepts in hepatology.

My time spent in neurogastrointestinal medicine was eye-opening, where I had the opportunity to see the diagnostic tests of esophageal and anorectal manometry performed. I was taught how to interpret these tracings, for which I am especially indebted to Dr. Jennifer Dimino for her time and patience. The patients I interacted with were open to my presence during their interviews. The neurogastrointestinal team who assisted me during this rotation, inclusive of Dr. Christopher Vélez, Dr. Kyle Staller, Dr. Brad Kuo, and Dr. Barbara Nath, were incredibly supportive.

The gastroenterology fellows during my stay allowed me to have insight into their approach to patients with various acute GI emergencies while we were on call, and I benefited from the various educational opportunities afforded to me such as Grand Rounds, Kelsey Rounds, Pathology Rounds, and IBD forums, which were quite instrumental in my understanding of certain pathologies. I would like to thank the nurses with whom I interacted who were themselves stalwarts in their field. They also freely shared their knowledge with me and assisted during my stay.

Community is important to support goals and encourage dreams, and I was inspired by the wider GI community through exposure to the Association of Black Gastroenterologists and Hepatologists Conference, Digestive Disease Week, and the 2024 American College of Gastroenterology Annual Scientific Meeting held during my stay in the United States.

I am deeply indebted to MGH for embarking on knowledge sharing with the UHWI GI program and to the ACG West Indies Governor, Dr. Mike Mills, who made the initial link between UHWI and MGH. I hope that this is just the beginning of a long and fruitful relationship between the MGH and the UHWI. I am certainly more empowered through this experience to impact the community in which I live. I also acknowledge the sacrifice of my husband, Najah, and sons, Kyle and Zane, in allowing me the time to pursue my dreams.

Thank you also to the ACG for choosing me as one of the International Training Grant recipients, which helped me to experience GI in this widely different space. Lastly, to my mentor, Dr. Asombang, without whom this whole experience would not have been possible.

About

Dr. Kerry-Ann Penn-Brown is a gastroenterologist at University Hospital of the West Indies in Jamaica and was the first graduate of the institution’s GI fellowship program.

Clockwise from top left: Dr. Braden Kuo, Dr. Penn-Brown, Dr. Jennifer Dimino; Dr. Brenna Casey, Dr. Penn-Brown, Dr. Jonah Cohen; Dr. Penn-Brown with MGH endoscopy nurses Brian Blau, Laura Shannon, and Jenny Mean; Dr. Penn-Brown at MGH Gastroenterology Department

ACG Perspectives | 21

Conversations with Women in GI An Inflection Point

Retiring After a Long Career at ACG and Looking Ahead to Life as a Painter

Jill K.J. Gaidos, MD, FACG, in conversation with Anne-Louise Bateman Oliphant, MPP, ACG Vice President, Communications (RETIRED)

to reform health care in the United States would cover preventive screening services for colorectal cancer. Starting in 1993, Patton Boggs lobbied to amend the Social Security Act. Ultimately, the legislation passed as part of an omnibus budget reconciliation bill in 1997 and became law on January 1, 1998. That was the start of Medicare’s coverage of preventive screening. While at Patton Boggs, I met Tom Fise, ACG’s Executive Director at the time, and I had the good fortune to meet ACG leaders when they came to Washington to visit members of Congress, including Board members Dr. Seymour Katz, Dr. Larry Brandt, Dr. Bill Carey, Dr. Luis Balart, and Dr. Joel Richter. I was deeply impressed by their compassion and their commitment.

Health care reform had been really at the top of the political agenda in the first few years of the Clinton administration, but as the issue cooled off, I was looking for a new opportunity and Tom Fise offered me a job, so I went to work for ACG. That was September of 1995. I was 30 years old.

JG: Were you initially involved with lobbying and advocacy?

ANNE-LOUISE BATEMAN OLIPHANT JOINED THE ACG STAFF IN SEPTEMBER 1995 and retired March 31, 2025. She served as Director of Communications from 1995 to 2001. As Deputy Director for the ACG Institute from 2001 to 2015, Ms. Oliphant collaborated with Institute Directors Dr. Joel Richter, Dr. Edgar Achkar, and Dr. Nicholas Shaheen while at the same time serving as Vice President of Research & Communications, overseeing the Institute’s clinical research grant program. Beginning in 2015, she focused her ACG role as Vice President of Communications, and in 2017 became Editor-in-Chief of ACG MAGAZINE. Her ACG portfolio spanned strategic communications counsel, media relations, publications, partnerships, archival displays of ACG history, social media strategy and engagement, as well as support for the Public Relations Committee and the Digital Communications & Publications Committee, among many other contributions to the life of the College.

22 | GI.ORG/ACG-MAGAZINE

JG: What got you interested in joining the ACG? ALBO: The short answer is that I was so impressed by the integrity and the commitment of the physicians who I met while working on behalf of ACG at its lobbying firm, Patton Boggs, from 1993 to 1995, that they inspired me to come to work for the College. I finished my graduate degree in American Government and Public Policy at Georgetown in 1993. I went to grad school at night and during the day I worked in the United States Senate for the late Senator Frank Lautenberg (D-NJ). After grad school and time on Capitol Hill, I went to work as a legislative paralegal at Patton Boggs, where one of the clients was the American College of Gastroenterology.

I worked there during a very intense time in the early Clinton administration when health care reform and health care policy were at the top of the legislative agenda. ACG’s goal was to ensure that any bill that purported

ALBO: Yes. While I had a communications role from the very beginning and my title was Director of Communications, Tom Fise had a very lean staff and so I did have a handle on the key policy issues, mostly from a communications perspective. I supported ACG’s policy agenda when physicians came to Washington, DC, to visit members of Congress.

JG: What were those early years like?

ALBO: ACG got grant money back in the mid-1990s through the early 2000s from Astra Merck, and then AstraZeneca, to do a major public awareness campaign on gastroesophageal reflux disease (GERD). I was the primary staffer on that campaign that started in March 1996 and lasted until 2003. ACG was doing television advertising about GERD symptoms and multimedia public awareness efforts—really a huge, coordinated communications campaign. We worked with the Washington office of a global PR

firm called Porter Novelli, so I learned a lot from them. Quickly, my role at ACG evolved to include not just the GERD campaign but all external communications for the College, support for the launch of the ACG Institute, and oversight of its first capital campaign that raised $17.2 million. Overall, I always joke that since the very beginning of my time at ACG, I have worked on all the projects that interest me—and there’s not much that doesn’t! I really have had a wonderful opportunity to learn and [have done] work that has fulfilled me.

JG: You mentioned that initially the staff was kind of small, pretty lean.

How have you seen ACG grow over your 30 years?

ALBO: In my early years on staff, ACG really did operate with a very lean and loyal staff and needed an “allhands-on-deck” team, one in which everyone pitched in on everything and knew all that was going on. Inevitably, with growth, the staff has become more departmentalized, but we work very, very hard to make sure that everyone who is on our staff feels like they’re part of a family, and that they understand what’s going on across departments. We meet regularly at the senior managers’ level, and we also meet with key staffers as a larger management team, and finally we meet monthly as an entire staff. Brad Stillman, our Executive Director, goes to great effort to make sure that we’re all together and feel connected, since many work remotely some or all of the time. I believe the growth of our staff is good growth. We need to have lots of people to do the work of the College and to fulfill its mission. So, we are no longer very small, and we don’t have that same all-hands-on deck staffing model, but that spirit of being nimble and flexible, that remains.

JG: And too, I imagine, the initiatives within the College have changed, just sort of blown up for lack of a better word.

ALBO: Yeah, but in a good way.

JG: Oh, absolutely.

ALBO: I believe that the size of the staff is just right to make sure that we have the capabilities and talents to be thoughtful and intentional about what we do, and to grow in directions that make sense with ACG’s mission. As I look across our organization, I believe that that’s really happening.

JG: Absolutely. And I hope you see it, but I absolutely see it, that any of our initiatives, even though we say they’re sort of physician-driven or memberdriven, they absolutely are. But there’s always the staff that says, “Well, you know, let’s think about that.” The staff share a history that’s known and can help ACG leaders understand feasibility.

There’s a lot of experience that I think the members appreciate when they work with the ACG staff. I don’t know if you feel that as well or you see that in your interactions, but hopefully you do.

ALBO: I’m glad to hear that. I believe that Brad Stillman would agree with me if he were at this interview that there are projects when the staff know that they’re “ripe”—meaning there’s a champion, there’s a budget, there’s an interest, there’s a need, and you can tell there’s a good idea. We’ve just gone through a strategic planning process and lots of great ideas came out of that. As I look back, I believe that the projects that have succeeded—those I see that have really flourished within ACG—they were projects that were ripe, and they had a champion who was an ACG leader and a doer. When you have those factors, then the staff can bring its experience to support a project or initiative, but it’s always aligned with the College’s mission and vision. It was Dr. Mark Pochapin, several years ago

“My goal is to devote the years ahead to cultivating my creativity, and to seeing how far I can go as an artist.”

in his update to the ACG Strategic Plan before the pandemic in 2019, who really encouraged everyone at the clinician leadership level and the staff level to remain true to the ACG mission and vision. Another great test of whether a project is ripe is also to ask, “Does this align with ACG’s mission and vision?” I’m very proud that there is a collaborative conversation between the staff and leaders in ACG. JG: Absolutely. So, you have accomplished a lot in your 30 years.

Is there anything in particular that was most meaningful to you or something that you’re most proud of?

ALBO: I am very proud of the College’s leadership role on colorectal cancer education and advocacy. We have worked hard to provide excellent materials for our members to use.

ACG staff and our members have been spirited participants in the national observance of Colorectal Cancer Awareness Month. We’ve worked to cultivate relationships with patient advocacy organizations such as Fight Colorectal Cancer, the Colon Cancer Coalition, and the Colorectal Cancer Alliance. I went to the first meeting ever of the National Colorectal Cancer Roundtable (NCCRT) back in 1997 and have rarely missed NCCRT over the years, so I had the opportunity to be the staff representative for the College at NCCRT with leaders from government, academia, public health, and industry. My goal as Vice President of Communications has always been to focus on how ACG can help patients and the public understand the value of colorectal cancer screening, colonoscopy’s role as a screening test, and its quality. I’m very proud of that work. When it’s Dress in Blue Day and everyone puts on their blue finery, that’s fun. But on a deeper level, I look back on the breadth and depth of ACG’s leadership on colorectal cancer education and I like to think of the lives that ACG has touched by sharing the message about the safety, importance, and lifesaving potential of colorectal cancer screening by colonoscopy with polypectomy.

ACG Perspectives | 23

// PERSPECTIVES

JG: Right, so even though there’s Dress in Blue Day, it’s a 365-days-ayear issue that we face.

JG: You launched the ACG MAGAZINE, tell me about that.

ALBO: The ACG MAGAZINE has been a labor of love for me since 2017. The College for many years published the ACG Update newsletter that came out six times a year. My idea in launching ACG MAGAZINE was to create a publication that fosters a sense of community for our members, shares their stories, and looks beautiful— something our members can be proud of. ACG MAGAZINE is special and unique in GI because we feature our members not only by showcasing their clinical and professional lives, but also by celebrating their personal interests and endeavors. That’s been very fulfilling for me and exciting to see how the publication has unfolded. I’ve had a wonderful creative collaboration with the magazine team, which is small, but mighty, and includes Emily Garel, the College’s Art Director. Emily and I have been partners from the start, and her work is very important to the way that the magazine looks.

Becky Abel, who’s the College’s Senior Communications Manager, is a talented copywriter and a creative brainstorming partner for me. I have relied on both their talents to bring ACG MAGAZINE to life. I want to say that it’s such a privilege still to be able to put ink on paper in the digital era. For that I want to recognize our incredible printer, Doyle Printing.

Doyle is a family business in Maryland, and the College has done its printing with them for almost 40 years. Dennis Doyle heads the company now, and his father, Arthur Doyle, taught me everything I know about printing. It’s been a real joy to work with them.

Brad Stillman has been unfailing in his support for the work of the magazine.

There have been so many people who have been incredibly instrumental helping the magazine to publish great stories. There is too little space to name them all, but I appreciate them deeply. I’m very grateful to all the ACG members, GI patients,

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and others who’ve helped me publish the magazine by generously sharing their news, interests, expertise, insights, photos, recipes, favorite books and music, passion for their work, and glimpses of their families and colleagues. I’m honored that so many people have shared their successes and triumphs as well as their trials and challenges—all with such candor, grace, and humility.

deeply value those friendships and the collaborations we’ve forged, but it’s time to retire. Why now? It’s because it’s time for me to put the focus on my own creative life and see where that will take me.

JG: Many people in health care, physicians especially, don’t know when to call it quits. What about now signaled for you that it’s time to retire? Why now?

ALBO: Yes, this is a goal of mine. I love to paint “en plein air” outside on an easel, so I can observe and paint from life. My husband and I bought a beautiful house in Maine, and so I will be spending a lot of time up there painting the rugged coast of Maine.

Our house is on the St. Croix River that is the border with Canada, across from New Brunswick, so I’ll have a dramatic river view and paint in the landscape there.

And yes, I do plan to launch a website with my paintings and news of my artistic adventures. I believe that writing will also play a role in my creative endeavors. I am eager to see what unfolds in my journey, but it’s bittersweet to say goodbye to all my many ACG friends.

ALBO: That’s a wonderful question. I’ve given a lot of thought to the idea that time is a luxury. I’m in a place in my life and in my marriage, fortunately, where I can take advantage of the luxury of time. I’ve always been creative. I started to paint when my daughter Emily Oliphant went away to boarding school at Phillips Exeter in the fall of 2017. She’d always done art classes at a wonderful community art center outside of Washington as a child, and I realized when she left home that I wanted to take art classes too! I started to paint then, and it’s grown into much more than a hobby, it’s really a calling.

My goal is to devote the years ahead to cultivating my creativity, and to seeing how far I can go as an artist. To grow as a painter, you have to paint miles of canvas.

So, that is my plan. I also want to bolster my relationships with my family and with my friends. I plan to dedicate this time to deepening my inner life and putting my health and wellbeing at the center of my life. I’m an extreme extrovert, and so for me, I believe it’s really important to cultivate quiet. When you were working with me on a book review for ACG MAGAZINE back in 2024 about “The Art of Stopping” by Dr. David Kundtz, you and I talked about the importance of pausing.* This time of my retirement is a critical pause, a real inflection point for my life. I am very grateful for the long and meaningful career that I’ve had at ACG, but I also look forward to a time when the first fruits of my creativity, my singular focus, and my zest will be used to advance projects and priorities that are important to me as a painter and as a person. I love what I do for ACG, I have incredible friends around the world in GI, and I

JG: Awesome. I’ve seen your Instagram (@aloliphant). You do amazing paintings. Will there be an Etsy page? Will you sell paintings?

*Read Dr. Gaidos’s book review on “The Art of Stopping” by Dr. David Kundtz in ACG MAGAZINE Summer 2024.

Dr. Jill Gaidos is a Trustee of the College and Associate Professor at the Yale School of Medicine Section of Digestive Diseases and Director of Clinical Research for the Yale IBD Program.

Ms. Anne-Louise Bateman Oliphant retired as ACG Vice President of Communications in March 2025, after nearly 30 years of service to the College.

ACG NORTH AMERICAN INTERNATIONAL TRAINING GRANT:

Fr om Miami to Oslo Shria Kumar, MD, MSCE

I was honored to receive a 2024 ACG North American International GI Training Grant to spend four weeks at the University of Oslo in Norway.

I am an advanced endoscopist with a clinical epidemiology research program, in which I seek to develop strategies to reduce the burden of gastric and colorectal cancers.

Gastrointestinal cancers are the most common form of cancer in the United States, yet prevention strategies still need optimization. My ultimate career goal is to provide personalized risk estimates to patients to reduce their risk of developing GI cancers, and to that end, I spent time training in clinical effectiveness research methodologies from the Clinical Effectiveness Research Group in Oslo. The group is led by Dr. Michael Bretthauer and Dr.

“...the Oslo group is unique— it is a 'one-stop shop' for clinical effectiveness research studies, from development to implementation, with a focus on GI cancers. They conduct groundbreaking research, with an eye towards ensuring screening strategies truly reduce cancer burden.”

Mette Kalager, two of the most wellknown clinical researchers in the GI cancer prevention arena.

In the U.S., we have centers with a clinical effectiveness focus, but the Oslo group is unique—it is a “onestop shop” for clinical effectiveness research studies, from development to implementation, with a focus on GI cancers. They conduct groundbreaking research, with an eye towards ensuring screening strategies truly reduce cancer burden. I spent my time there participating in their lab activities, including clinical trial setup for studies focused on surveillance after polyp removal and artificial intelligence in colonoscopy, as well as execution and dissemination of results. I had meetings each day with different team members to learn the

ACG Perspectives | 25

// PERSPECTIVES

different roles that everyone plays within such a group. The team consists of physician-scientists, coordinators, research nurses, and administrators, and I was able to connect with each of them. This was facilitated by joining their annual retreat, set on a remote island within the Oslofjord, and experiences such as attending one of the team physicians’ PhD dissertation.

Systemically, I was able to understand how Norway’s universal healthcare system facilitates their research but also gained an understanding of how to conduct studies across different healthcare systems. For example, the group conducts clinical trials across multiple European countries, and learning the logistics of such an endeavor was important as I seek to develop multi-center clinical trials in the U.S. Most of my efforts were spent developing an ongoing collaboration with the team, focused on reducing the burden of gastric cancer within at-risk populations in the U.S. This included meetings to discuss background, my prior research efforts, and development of a larger grant, which I spent time writing and revising with feedback from my new colleagues.

This grant is presently under review, and thanks to the opportunity provided to me via the ACG, I am confident that this ongoing collaboration will result in a reduction of GI cancer burden within the U.S. I was also fortunate to spend time on the outpatient and inpatient gastroenterology units at the University of Oslo. The experience shadowing endoscopists in a different healthcare system was my first exposure to healthcare outside the U.S. and was invaluable to my growth as a physician.

Finally, I was able to take in Norway’s beauty, exploring Oslo and its abundant and accessible nature. I am so grateful to the ACG for making this international experience possible, and to my new colleagues and friends at the University of Oslo’s Clinical Effectiveness Research Group.

Dr. Shria Kumar is Associate Program Director for Gastroenterology Fellowship, Director of Endoscopic Research, and Assistant Professor of Clinical Medicine at University of Miami Miller School of Medicine.

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A P rescription for

OPTIMAL PATIENT CARE: EMBEDDING CLINICAL PHARMACISTS INTO GI PRACTICE

Shubha Bhat, PharmD, MS, BCACP, FCCP

Gastrointestinal (GI) diseases affect nearly 70 million Americans, leading to substantial health care utilization and expenditures—around $120 billion.1 One factor driving these costs is the surge in innovative therapies for various GI conditions, including direct-acting antivirals, potassiumcompetitive acid blockers, biologics, small molecules, and thyroid hormone receptor-beta agonists. While these advancements have revolutionized treatment options, improved patient quality of life, and deepened our understanding of disease pathophysiology, they come at a high cost, often exceeding $500-$1,000 for a 30-day supply.2 Consequently, challenges such as step therapy requirements, prior authorizations, and increased risks of medication

non-adherence arise. Patients may also face difficult financial tradeoffs, further complicating treatment and associated outcomes.3 With the growing array of GI medications and complexities of the modern health care system and insurance processes, incorporating clinical pharmacists into GI practices may be a prescription toward optimizing patient care and outcomes. Clinical pharmacists, with their specialized training in medication management, work collaboratively with health care providers and patients to ensure appropriate medication use, accessibility, and effectiveness. This article explores the education, training, and roles of clinical pharmacists and underscores the value of integrating them into multidisciplinary GI teams.

“With the growing array of GI medications and complexities of the modern health care system and insurance processes, incorporating clinical pharmacists into GI practices may be a prescription toward optimizing patient care and outcomes.”

Education and Training of Clinical Pharmacists Most pharmacists today hold a Doctor of Pharmacy (PharmD) degree, typically earned through a fouryear accredited graduate program.

These programs primarily focus on pharmacotherapy and pharmacology across various therapeutic areas, as well as foundational sciences such as biology, chemistry, and anatomy.

To qualify for licensure, pharmacy students must complete internships and log a designated number of hours—often around 1,500—before taking the North American Pharmacist Licensure Examination (NAPLEX).4 Additionally, as pharmacy practices are regulated at the state level, pharmacists need to pass the Multistate Pharmacy Jurisprudence Examination (MPJE) to meet statespecific licensing requirements.5 Once licensed, they earn the title of Registered Pharmacist (RPh).

After completing pharmacy school, pharmacists can pursue further training through postgraduate residencies or

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// PERSPECTIVES

“...pharmacists play a critical role in medication access, especially with specialty medications, which often pose challenges due to limited distribution and high costs.”

fellowships. Residencies, which last one to two years, focus on direct patient care in areas such as ambulatory care, specialty pharmacy, or general practice, allowing pharmacists to specialize if desired. Fellowships, on the other hand, tend to emphasize research or industry roles. A key advantage of the PharmD degree is the wide array of career paths it offers, spanning community pharmacies, specialty settings, industry roles, outpatient clinics, and hospitals, to name a few. Pharmacists seeking additional expertise may achieve board certification in areas like oncology, emergency medicine, or geriatrics through the Board of Pharmacy Specialties.6 To maintain their license and certifications, pharmacists are required to complete continuing education (CE) credits regularly.

Roles of Clinical Pharmacists Historically, pharmacists were primarily associated with dispensing medications. However, their roles have evolved to encompass active

participation as integral members of multidisciplinary health care teams, contributing to the formulation and monitoring of treatment plans. Today, the foundation of pharmacists’ responsibilities is embedded in Medication Therapy Management (MTM) and Comprehensive Medication Management (CMM).7 MTM is a patient-centered approach to optimizing medication use that involves pharmacists conducting comprehensive medication reconciliations to identify and address medication-related issues, improving adherence in the process. CMM expands on this by incorporating a thorough assessment of the patient’s clinical status and fostering collaboration among health care team members. Pharmacists providing CMM typically operate under a Collaborative Practice Agreement (CPA) or Collaborative Drug Therapy Management (CDTM), which defines their scope of practice under the supervision of a physician. This scope of practice varies across states and is regulated by individual state boards of pharmacy.

Clinical pharmacists are dedicated to improving medication-related outcomes (Figure 1), which include providing education on medications, evaluating the safety and efficacy of treatments, reconciling all types of medications—including prescribed, over-the-counter, and herbal supplements—to identify and address potential drug-therapy issues. Their responsibilities also encompass assessing treatment progress, coordinating care transitions, and ordering and interpreting laboratory results. In addition, pharmacists play a critical role in medication access, especially with specialty medications, which often pose challenges due to limited distribution and high costs.

Pharmacists are skilled at navigating insurance benefits, handling prior authorization processes, resolving denials, and addressing issues related to infusion centers or specialty pharmacy access.

Clinical pharmacists work across diverse settings, including outpatient clinics, specialty pharmacies, infusion centers, or hybrid roles that combine responsibilities across these environments. Regardless of their location, they engage in both direct and indirect patient care and may conduct independent consultations or shared visits with gastroenterologists, ensuring that all patient interactions are documented in medical records.

FIGURE 1. ROLES OF CLINICAL PHARMACISTS

MEDICATION OUTCOMES

MEDICATION ACCESS

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• Medication education (administration, dosing, adverse effect, treatment outcomes/goals) • Lab monitoring (baseline, during, post-treatment) • Medication reconciliation for potential drug interactions, dosing limitations (e.g., hepatic/renal), and adherence assessment • Efficacy assessments • Adverse effect management • Health maintenance/immunizations • Benefits investigation • Insurance education • Prior authorizations (e.g., tracking outcomes, denial/appeal support) • Cost resources (e.g., co-pay assistance, grants/foundations, patient assistance programs) • Medication fulfillment • Other operational tasks (e.g., prescription entry, biosimilar champion)

Benefits and Justification of Integrating Clinical Pharmacists into Practice Clinical pharmacists are now integral to numerous therapeutic areas, including primary care, oncology, cardiology, and infectious diseases, where they have demonstrated significant positive impacts and improved patient outcomes. However, their role in GI care remains relatively underexplored. With the increasing complexity of specialty medications, the rising prevalence of intricate GI conditions, and the anticipated shortage of gastroenterologists compounded by expanding scoping demands, integrating clinical pharmacists into GI practices as key team members can provide substantial benefits. This integration helps optimize medication access and improve patient outcomes.

For instance, an evaluation of pharmacist integration into inflammatory bowel disease (IBD) care revealed several benefits8: • Pharmacist-led monitoring after starting immunomodulators or biologics increased monitoring compliance.

• Pharmacist-provided medication education and adherence counseling improved patient understanding of treatments and adherence rates.

• Pharmacists enhanced vaccine uptake, immunomodulator screening, and smoking cessation rates.

• Pharmacist involvement promoted biosimilar usage.

• Pharmacist-led therapeutic drug monitoring helped optimize biologic regimens.

Another example highlights a pharmacistmanaged Helicobacter pylori treatment service.9 Pharmacists conducted patient consultations, reviewed prior treatment histories, recommended tailored treatment regimens, and monitored patients until confirmation of cure was obtained. Results showed a 100% cure rate for treatmentnaïve patients and a 69% cure rate for those with prior treatment failures.

A common challenge is justifying the clinical pharmacist position within the practice. Both direct and indirect revenue can help support these positions.

Direct revenue sources include capturing specialty medication prescriptions or

“With the increasing complexity of specialty medications, the rising prevalence of intricate GI conditions, and the anticipated shortage of gastroenterologists compounded by expanding scoping demands, integrating clinical pharmacists into GI practices as key team members can provide substantial benefits.” infusion services in house. Depending on state regulations and whether pharmacists are recognized as providers, they may also bill for clinical services such as MTM or transitions of care. Facility fees could apply if patients are seen in the clinic. Indirect revenue stems from pharmacists improving medication adherence and outcomes, such as reduced emergency room visits, hospitalizations, and unnecessary treatments. Clinical pharmacists can also contribute indirectly by helping patients determine appropriate followup schedules with gastroenterologists or advanced practice providers, which can increase clinic visit volumes.

Conclusion Clinical pharmacists are well equipped to collaborate with the GI team in several impactful ways to enhance patient care. Their expertise spans medication management, delivering both direct and indirect support, and elevating the overall patient experience.

References 1. Peery AF, Crockett SD, Murphy CC, et al. Burden and cost of gastrointestinal, liver, and pancreatic diseases in the United States: Update 2021.

Gastroenterology. 2022 Feb;162(2):621-644. doi: 10.1053/j. gastro.2021.10.017.

2. Shah ED, Siegel CA. Systemsbased strategies to consider treatment costs in clinical practice.

Clin Gastroenterol Hepatol.

2020;18(5):1010-1014. doi: 10.1016/j. cgh.2020.02.030.

3. Jordan AA, Bhat S, Ali T, et al.

Healthcare access for patients with inflammatory bowel disease in the United States: A survey by the Crohn's & Colitis Foundation.

Inflamm Bowel Dis. 2024; epub ahead of print.

4. National Association of Boards of Pharmacy (NABP). NAPLEX. Available at nabp.pharmacy/ programs/examinations/naplex.

5. National Association of Boards of Pharmacy (NABP). MPJE. Available at nabp.pharmacy/programs/ examinations/mpje.

6. Board of Pharmacy Specialties (BPS). Available at bpsweb.org.

7. American College of Clinical Pharmacy (ACCP). Comprehensive medication management in teambased care. Available at accp.com/ docs/positions/misc/cmm%20brief. pdf.

8. Hilley P, Wong D, De Cruz P. How does an integrated pharmacist add value in the management of inflammatory bowel disease in the era of values-based healthcare?.

Inflamm Bowel Dis. 2024; epub ahead of print. doi:10.1093/ibd/ izae196.

9. Bhat S, Nunes D. Pharmacistmanaged helicobacter pylori treatment service within a gastroenterology clinic: workflow and real-world experiences. Ann Pharmacother. 2022;56(2):162-169. doi:10.1177/10600280211021501.

Dr. Shubha Bhat is a Gastroenterology Clinical Pharmacist at the Digestive Disease Institute at Cleveland Clinic. In her clinical practice, she oversees the medication experience, including education, safety monitoring, and adverse effect management of patients with gastrointestinal conditions.

ACG Perspectives | 29

Fostering

HiGh-Performing TEams in the EnDosCopy Suite Cultivating Teamwork and Enhancing Quality David A. Greenwald, MD, FACG

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R // COVER STORY

RECOGNITION OF A JOB WELL DONE IS ALWAYS APPROPRIATE AND UNIVERSALLY APPRECIATED. I suggest doing it often and doing it in all facets of life! I do it frequently in the endoscopy suite, complimenting the various members of the team on what went well during the many phases of each procedure. I include our nurse manager in these reviews, and typically she chimes in with “Teamwork is Dreamwork.” Okay, while some might normally roll their eyes at the cliché, teamwork is part of the fabric of so much of what we do in endoscopy.

Reflecting on what leads to highperforming teams in the endoscopy suite, one can easily come up with a top 10 list of the key factors. So, let’s get to it.

Consistency Think of endoscopic procedures as a mélange of interrelated tasks and the importance of a consistent routine being followed each time. For example, the team has a standardized method for evaluation of a patient before a procedure and may use checklists or an organized “time out” before a procedure to ensure safety.

The specific endoscopic exam has its own characteristic and consistent pattern, interventions are carried out in a similar standardized fashion … you get the idea … establishing and reinforcing consistency allows for greater safety and improved effectiveness.

1. Setting the Tone

Positivity Keeping a positive attitude can be challenging for so many reasons in a busy endoscopy suite, especially during stressful periods, but looking for reasons to accentuate the positives and focusing on those helps keep morale high. Alternatively, focusing on the negatives, such as constant complaining, can be toxic and selfperpetuating. We do so much good in our work in our endoscopy facilities— reinforcing that is great for the team.

From the outset, building a successful team requires recognition of a few key principles: Authenticity Each team member needs to be his or her authentic self. We all have strengths (and weaknesses); recognizing what each team member brings to the group is critical.

Some people will bring organizational skills, others will bring technical expertise, others will bring creativity—it doesn’t matter which, as long as the team is built around everyone’s strengths.

Integrity and Honesty Trust is built within the group based on integrity and honesty. This is uncontestable and remarkably important.

Accountability Teams may be created randomly, but they only thrive when team members take on responsibility and are accountable to the group for their actions. In endoscopy, each team member plays a unique role during a procedure, and we all rely on each other to complete our portion of the overall goal.

Resilience Resilience in the face of adversity makes successful teams even more successful. “Finding a way” when the going gets tough is a huge asset— picking ourselves and each other up when things haven’t gone well and making the subsequent procedures better is a critical building block for a high-performing team.

Communication At its core, the foundation of all high-performing teams is excellent communication.

“Building a successful and highly functioning team requires people to get to know each other; learning about team members helps everyone connect better.”

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2. A supportive team environment among professionals with different training and backgrounds Think of your endoscopy suite or facility. Really think for a minute about all the people who are there—people brought together with different talents, different backgrounds, and different skill sets. We have interventional endoscopists and those who do more standard procedures; we have nurses and technicians who are comfortable doing quasi-surgical procedures, and others who prefer more traditional endoscopy. Our anesthesia colleagues come from all walks of life. The staff surrounding our endoscopy centers are equally diverse—registration personnel, room supply technicians, administrators and supervisors, engineering, housekeeping and linen services, too many to name, but all part of the team, and each critical. Reflect each day on how many people it takes to allow a single endoscopy center or facility to operate—it’s a fabulous web of people with different talents and backgrounds, all brought together to help each and every patient have a safe, effective, and comfortable procedure. I thank as many of those people as I can all the time—you should consider doing that too! Small acts of kindness go a long way in team building.

3. Supporting team members, building morale, and team cohesion Let’s face it: the endoscopy unit can be a tough, grueling place to work.

Multiple fast-paced procedures every day, lots of time on your feet, rapid turnover, and then there’s the fact that the patients may have substantial and consequential problems discovered— think cancer, bleeding, obstruction.

One can see how this could quickly become overwhelming.

So, how to deal with that? Members of successful teams lean on each other all day, talking together about the tasks at hand and supporting each other. Support may come in

TEAMWORK TIPS “A key component to effective teamwork is communication. Open and transparent communication allows team members to share updates, provide feedback, and address any challenges that arise. Regular check-ins and active listening help foster a supportive environment where everyone feels valued and heard.

Strong communication enables teams to work cohesively, overcome obstacles, and achieve their collective goals.”

Sapna V. Thomas, MD, FACG, Associate Professor of Medicine – Gastroenterology, Medical Director, North Ridgeville Endoscopy, LLC, Ridgeville, OH “All team members play a critical role in patient experience.

Having a pleasant experience and feeling better are often the top goals of patients. Taking pride in your role, respecting every teammate, and remaining empathetic to the patient are keys to success.”

Drew Triplett, DO, Dayton Gastroenterology, Beavercreek, OH “Great teamwork thrives when there’s a clear vision and goals that everyone understands and supports.

This shared purpose keeps the team aligned and motivated. Equally important is transparency and open communication. A safe environment where team members share updates, feedback, and concerns honestly is crucial to building trust and preventing misunderstandings. Finally, strong teamwork means effective delegation and valuing collaboration with the whole team, where every voice is heard and each member contributes their strengths. By fostering an inclusive environment and staying aligned through clear goals and strong communication, my team has achieved greater efficiency, creativity, and success together. We have found that clear goals, transparent communication, and effective delegation are keys to great teamwork.”

Pooja Singhal, MD, FACG, President, Oklahoma Gastro Health and Wellness, Oklahoma City, OK “At our center, teamwork means treating each other— and every patient—like family. Guided by SSM Health’s mission to reveal the healing presence of God, we unite across disciplines to provide truly comprehensive care.

Our multidisciplinary team—physician, nurse, dietitian, therapist, and medication coordinator—works in sync to create personalized care plans rooted in empathy and excellence. We meet patients where they are: clinically, emotionally, and culturally. Clear communication, mutual respect, and shared purpose empower our team to improve outcomes and uplift lives. When the entire team feels connected, patients feel it too.”

Tauseef Ali, MD, FACG, Medical Executive Director, SSM Health Digestive Care | Crohn's and Colitis Center, Oklahoma City, OK

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// COVER STORY

“High-quality outcomes in endoscopy mandate effective collaboration, and that spirit of working together successfully comes from trust— trust in the science of what is being done, trust in the training and judgment of the others on the team, and trust in each other.” the form of kind words, a meaningful “thank you,” a thoughtful gesture, or sometimes support is the comfort of just being with each other.

Listening carefully fosters team cohesion. Indeed, being a good listener is often more important than knowing what to say. Supportive teams have excellent listening skills and allow time and space for meaningful conversations.

What else can be done to build morale and create cohesion? One is recognition of work well done by the team. In our facility, we have a Star Recognition Award, for which anyone can nominate another. Nurses can nominate technicians and vice versa, physicians can nominate housekeepers … you get the picture.

Taking time to get to know your peers and co-team members pays off in a big way. Building a successful and highly functioning team requires people to get to know each other; learning about team members helps everyone connect better.

Gossip is always bad and wrecks teams. Strive to keep conversations positive and focus on the good.

Finally, I’m a big fan of making available time and space for “out-ofwork bonding.” Gatherings in nonwork settings may not be for all, but for those who choose to partake, they really can help establish a sense of community and provide for shared experiences. We have made a point of having summer barbeques, holiday gatherings, potluck lunches, group attendance at sporting events— striving for “something for everyone” but always focused on ways to get to know other members of the team in a different setting.

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4. Leadership An effective team needs strong leadership; that leader needs all the qualities listed above and an understanding of how the team is functioning at any given time.

Leadership training is a good thing and one that all in a leadership position should consider. Having leadership training suggested to a leader is not a sign that one is doing a bad job, but instead should be viewed as an opportunity to learn what makes a good leader and to improve one’s skills. A good leader is a good listener, is sensitive to the needs of the group, is present, is responsive, is creative, and is flexible. Effective leaders meet with their teams regularly and are available. High-performing endoscopy teams are best when they have effective leaders.

5. Team training in endoscopy One of the most exciting aspects of endoscopy over the past 50 years has been rounds and rounds of innovation. Consider procedures like ERCP and endoscopic ultrasound, and techniques like fine needle aspiration, endoscopic bariatric modalities, EMR, ESD, and POEM. Groundbreaking advances by gastroenterologists were only possible with advances and support by the whole team. Indeed, these procedures cannot be successful without a fully coordinated team, including the endoscopist, nurse, technician, and so often many others.

Hence, the idea of team training. As GI procedures expanded into a more therapeutic realm and the field of interventional endoscopy took shape, the importance of training the whole team became increasingly apparent.

In fact, appropriately, entire courses

GIQuIC is a medical specialty registry designed by gastroenterologists for gastroenterologists to collect, organize, and display digestive health care data for multiple purposes, including the following goals: 1. Improve patient outcomes by allowing users to benchmark quality, identify gaps in care, and develop specific and targeted quality improvement initiatives.

2. Contribute data for research and assist the GI societies in developing guidelines for patient care.

3. Provide quality measures data to third parties, including CMS’ Meritbased Incentive Payment System (MIPS), private payers, accrediting bodies, referring providers, and patients.

The GIQuIC registry was developed in conjunction with the American College of Gastroenterology (ACG) and the American Society for Gastrointestinal Endoscopy (ASGE) when gastroenterologists determined they needed a way to measure the quality of the health care they were providing to their patients. Patients, referring providers, and payers were asking them to demonstrate the quality of their performance and their dedication to continuous improvement.

The GIQuIC registry now contains INFORMATION ON

OVER 22 MILLION COLONOSCOPIES and

OVER 4.5 MILLION UPPER GI ENDOSCOPIES

focus on team training, where not only the gastroenterologist attends to receive instruction but also the whole team. Hands-on courses in complex therapeutics were designed for the full team, emphasizing the critical need for each team member to learn their part of the procedure.

6. Developing and maintaining a culture of safety Our patients demand, as they should, the highest standards of safety and quality. Let’s look at safety first. Safety is enhanced by team participation, as a team can have more “eyes on the procedure” and more perspectives available to ensure a safe procedure.

I am thrilled to have everyone in the room looking for polyps on the monitor during a colonoscopy. The endosonographer who asks their team, “Do you all think my needle is in the pancreas,” and values the responses is often in a safer position than the endoscopist going it alone. When the experienced endoscopy technician says, “Would you consider using a specific tool to remove this foreign body,” their comment is helpful—their prior experience and input should be valued.

“Groundbreaking advances by gastroenterologists were only possible with advances and support by the whole team. Indeed, these procedures cannot be successful without a fully coordinated team, including the endoscopist, nurse, technician, and so often many others.”

A culture where any and all safety concerns can be brought forward is key.

Safety issues should be able to be raised freely, without judgment, and without any concern for backlash or repercussions. In short, all concerns brought forward by the team should be considered and evaluated.

7. Developing and maintaining a culture of quality Let’s focus on quality—developing a culture of quality means knowing what quality benchmarks exist and striving to achieve or exceed those benchmarks.

For example, in gastroenterology, GIQuIC is the national quality registry.

Benchmarks have been established as markers of high-quality exams and high-quality proceduralists. Goals exist in multiple aspects of many procedures;

for colonoscopy, quality benchmarks have been established for cecal intubation rate, adequate withdrawal time from the cecum to the rectum, and adenoma detection rate. The whole team plays a part in achieving these benchmarks; the end result is a reflection of how the entire team is doing. Once the culture is established and the benchmarks set, accountability in the form of report cards and public posting of achievements helps build a community sense of quality and its importance.

Moreover, most endoscopy units employ post-procedure surveys and solicit comments. High-performing units regularly seek out this feedback and use it to drive change where needed. And what better way to

Cover Story | 35

small thing. Our incredible teams in the gastroenterology unit often make achievements like that look commonplace, but they are truly remarkable. It is incumbent on the team to keep focused on the impact their work makes and celebrate those achievements.

The Core…

celebrate successful teamwork than by posting these comments prominently in a place where team members can see and then share in the positive remarks?

8. Elements of effective collaboration and communication High-quality outcomes in endoscopy mandate effective collaboration, and that spirit of working together successfully comes from trust—trust in the science of what is being done, trust in the training and judgment of the others on the team, and trust in each other. Most important for effective collaboration is realizing and remembering that the team collectively is better than each of the individual parts. We all rely on each other all the time—choosing to compliment each other frequently, providing accolades for a “job well done,” and similarly picking each other up when things don’t go well are all communication tools that are critical for effective collaboration.

9. Keys to facing challenges together So, not everything goes well all the time. Complications occur; outcomes may not always match the intended goals. How does a high-performing

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team meet these challenges? Head on! Understanding the difficulties in a procedure or an unplanned outcome and debriefing an event that didn’t go the way it was expected is important. The focus should be on why the outcome was different than anticipated and what could be done differently the next time. This approach helps to stabilize the situation, including the emotional reaction to a bad outcome. It refocuses the team on the usual good outcome and reminds everyone that the team can always learn and improve.

Discussions of challenging situations need to happen in a timely way, in an open forum where everyone can participate freely. The facilitator of the debrief must be fair and respectful of all opinions. As usual, effective communication principles are central.

10. Remembering, recognizing, and celebrating the value of what we do High-performing teams may actually forget that they’re doing amazing things every day. Endoscopy teams get used to remarkable achievements and may lose focus on the substantial impact they make on people’s lives each and every day. Successfully removing an impacted common bile stone or placing a stent to relieve someone’s potentially life-threatening cholangitis and to allow them to return to their previous good health and to their loved ones is not a

I recently was called late one evening to urgently remove a fish bone that had been inadvertently swallowed.

We activated “our team” and several hours later, the sharp foreign body had been identified and removed safely and effectively. As we completed the procedure, we spoke for a few moments about how well the procedure had gone; the comments quickly moved to how it was truly a team effort, start to finish. We all agreed—everyone had played an important part in the success, and we could not have succeeded without each other’s contributions.

Bottom line…it is certainly gratifying to do well, and even more gratifying to work as part of a high-functioning team. Endoscopy is truly a teambased activity!

About Dr. David Greenwald is Director of Clinical Gastroenterology and Endoscopy at Mount Sinai Hospital. He is a past ACG president, past chair of the ACG Board of Governors, and served on and chaired many ACG committees.

TRAINEE HUB

Interviewing

for GI Fellowship –

Tips and Tricks for Applicants Clive Miranda, DO, MSc

SECURING A GASTROENTEROLOGY FELLOWSHIP POSITION is a competitive and high-stakes process, and the interview plays a pivotal role in determining a candidate’s success. Beyond clinical expertise and academic achievements, interviewers assess qualities such as preparedness, professionalism, and personality fit. With virtual interviews becoming more common, mastering both technical and interpersonal aspects of the process is essential. This guide compiles expert insights and practical strategies to help candidates present their best selves—from setting up an optimal interview environment to crafting compelling responses and leaving a lasting impression.

Whether you’re aiming to stand out with thoughtful preparation or seeking ways to navigate common pitfalls, these tips will help you approach your fellowship interview with confidence and authenticity.

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// TRAINEE HUB

TIPS Tip #1 – Set the Stage First impressions matter, and in a virtual interview setting, your background, lighting, and overall setup play a crucial role in shaping how you are perceived. A clean, professional, and distraction-free environment ensures the interviewers’ focus remains on you, not on a cluttered room or an unmade bed. Opt for a plain background or a neatly arranged space—adding a small plant or bookshelf can add warmth without being distracting.

Lighting is equally important.

Natural light from a window in front of you is ideal, but if that’s not possible, a ring light can help create even, well-balanced illumination.

Avoid overhead lighting that casts unflattering shadows or bottom-up lighting that can make you look eerie.

Additionally, ensure your camera is positioned at eye level to create natural engagement—stacking books under your laptop can be a quick fix.

Tip #2 – Test Run Triumph A seamless interview experience begins with ensuring your technology is reliable and ready to go. Nothing disrupts an interview faster than choppy audio, a frozen screen, or a weak internet connection. To avoid these pitfalls, test your setup well in advance. Check your internet speed and have a backup plan ready, such as a mobile hotspot, in case of connectivity issues.

Familiarize yourself with the platform being used, whether it’s Zoom, Microsoft Teams, or another program. Download necessary updates, adjust audio and video settings, and practice navigating features like screen sharing or muting/unmuting. Investing in noisecanceling headphones and an external

microphone can enhance sound quality and minimize background distractions.

On interview day, log in at least 10–15 minutes early to troubleshoot any lastminute issues. Having a fully charged laptop, an extra pair of headphones, and an external webcam, if needed, ensures you’re prepared for any unexpected hiccups, allowing you to focus on showcasing your best self.

Tip #3 – Dress to Impress Even in a virtual setting, your appearance speaks volumes about your professionalism and attention to detail. Dressing as if you were attending an in-person interview sets the right tone and conveys respect for the process. Opt for business attire—men should consider a well-fitted suit or dress shirt with a tie, while women may choose a blazer, blouse, or professional dress. Avoid overly bright colors or distracting patterns that may not translate well on camera.

Beyond clothing, grooming matters.

Ensure your hair is neat, facial hair is welltrimmed, and you look well-rested and polished. Subtle accessories, like a watch or tie clip, can add a touch of sophistication, but avoid anything overly flashy.

Even if your interview is virtual, wear proper pants—you never know when you might need to stand up unexpectedly!

Dressing professionally not only leaves a positive impression but also boosts your confidence, helping you feel more composed and interview-ready.

Tip #4 – Engage with Energy Your demeanor during an interview can leave a lasting impression, often just as much as your answers. A warm smile, engaged posture, and steady eye contact with the camera demonstrate confidence and enthusiasm. Interviewers are drawn to candidates who show genuine excitement about the program, so let your passion for gastroenterology and your future training shine through.

Active listening is key. Nod occasionally,

“Thoughtful, well-structured responses not only highlight your competence but also demonstrate professionalism, self-awareness, and an ability to think on your feet—qualities that make for a standout fellowship candidate.”

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react naturally, and avoid interrupting. Balance enthusiasm with professionalism—be animated, but not overly casual. Remember, faculty want to mentor someone they enjoy interacting with, and your energy can set you apart from other applicants.

An engaging presence makes you memorable and signals that you’re both interested and invested in the opportunity.

Tip #5 – Frame Your Thoughts Strong communication is essential in a fellowship interview, as it reflects your ability to articulate complex ideas clearly—an invaluable skill in both patient care and academic discussions.

When responding to questions, aim for concise yet comprehensive answers.

Rambling or providing excessive detail can dilute your key points, while overly brief responses may come across as disengaged. The key is balance: structure your thoughts logically, stay on topic, and deliver your message with confidence.

A helpful strategy is the STAR method (Situation, Task, Action, Result), which allows you to present experiences in a structured and compelling manner. When discussing challenges you’ve overcome, research projects, or patient interactions, this method keeps your answers focused and impactful. Similarly, incorporating specific details, such as a faculty member’s research that aligns with your interests, shows that you’ve done your homework and reinforces your genuine enthusiasm for the program.

Tactfulness also plays a role in how you frame your answers. If you’re uncertain about a particular career path, acknowledge your openness to exploration rather than giving a vague or noncommittal response. Likewise, when discussing past experiences, emphasize lessons learned and growth rather than dwelling on setbacks.

Thoughtful, well-structured responses not only highlight your competence but also demonstrate professionalism, self-awareness, and an ability to think on your feet—qualities that make for a standout fellowship candidate.

Tip #6 – Follow Up with Finesse A well-crafted thank you email is a small gesture that can make a big impact.

Within 24 hours of your interview, send a personalized message to each interviewer, expressing gratitude for their time and reinforcing your interest in the program.

Mention specific points from your conversation, whether it was a shared research interest, a unique aspect of the fellowship, or an insightful piece of advice they offered. This personal touch not only shows appreciation but also helps you stand out in their memory.

Don’t forget to acknowledge program coordinators and administrative staff, as they play a crucial role in the process. Keep your message concise, professional, and genuine—overly generic or excessively long emails can lose their effect. While responses aren’t always guaranteed, a thoughtful follow-up demonstrates professionalism, attention to detail, and a sincere enthusiasm for the opportunity, all of which contribute to a strong and lasting impression.

TESTIMONIALS Joseph Sleiman, MD Inflammatory Bowel Disease Advanced Fellow – Cleveland Clinic Foundation “Faculty want to know they are going to have fun mentoring you, and that you will mesh well with the others. This is where verbal and nonverbal communication (although tough virtually) will come in handy. English proficiency is truly important here and might go against some IMG candidates. But feeling free to navigate an academic question while using pop culture references (age-appropriate to your faculty, perhaps, or that relate to their kids), all while sprinkling in a few personal stories (which might shine light on your character), would make the most ‘memorable’ interview on the faculty side.

This will only get better the more you put yourself out there during conferences and meeting new people in your life. Practice with friends and faculty in your institution.”

“Whether you’re aiming to stand out with thoughtful preparation or seeking ways to navigate common pitfalls, these tips will help you approach your fellowship interview with confidence and authenticity.”

Timothy Zaki, MD Gastroenterology Fellow – University of California, Los Angeles “Many interviews are long, but you want to stay alert and attentive. Jot some notes down, make eye contact with faculty when they’re talking to the interviewee group as a whole.

Interviewers can easily notice when someone is not paying attention, and it gives off the impression you’re not that interested in the program to begin with.”

Devika Gandhi, MD Advanced Endoscopy Fellow – Emory University “Matching into GI fellowship is tough; there are many incredibly qualified candidates, so being prepared can help you stand out. Have your ‘elevator pitch’ about yourself ready. The first question is nearly always some form of ‘So tell me about yourself,’ and many questions are usually very similar, so practice what you want to say in advance and run it by loved ones/mentors. Clearly articulate your strengths and interests. When you’re prepared for your interview, it gives a good indication that you’re more likely to be prepared in the workplace. As a bonus, it can also improve confidence and help with interview jitters!

Don’t tell everyone what you think they want to hear. Be genuine and consistent. Don’t tell one person you’re interested in IBD because that is their niche when you’re not, or that you want to be a researcher in a niche field when you really don’t because you think that’s what they want to hear.

People will talk at rank meetings or socially (you never know who knows each other!) and it can come off as unfocused or, worse, it can come off as dishonest.”

Saurabh Chandan, MD Advanced Endoscopy Fellow – Center for Interventional Endoscopy, Advent Health “It always helps when applicants have experiences outside of medicine that they can elaborate upon. Remember that each applicant is a unique person with a unique story … so why not highlight some of the things that make you special? Things such as another degree, experiences in mission work, and working in underserved areas are all exciting stories for interviewers and can make your application stand out.”

Hanna Blaney, MD, MPH Transplant Hepatology Fellow – Georgetown University “Do your research on programs, especially if programs offer different tracks. For example, if you are interested in research, ask questions about how the program will support your goals. If you want to be a clinical educator, ask about teaching opportunities.”

Dr. Clive Miranda is a GI fellow at Creighton University Medical Center in Omaha, NE. He currently serves on ACG’s Diversity, Equity, and Inclusion Committee, and as a Social Media Ambassador for Evidence-Based GI.

Trainee Hub | 39

ACG ANNOUNCES

a New Book Series NOW AVAILABLE! Each chapter of the Guide to the Guidelines series includes carefully selected vignettes designed to illustrate key concepts from the guidelines, followed by a conversation-style discussion written to keep you awake and alert.

The authors highlight noteworthy points and provide multiple-choice questions to test your knowledge of the material.

Brennan Spiegel, MD, MSHS, FACG

Hetal A. Karsan, MD, FACG

Visit gi.org to purchase your copy!

40 | GI.ORG/ACG-MAGAZINE

GETTING IT

Recruitment Toolbox:

10 Cardinal Rules Andy Tau, MD; Lanre Jimoh, MD, MBA; Syed Hussain, MD

HUMAN CAPITAL IS THE CORNERSTONE OF SUCCESS in any healthcare enterprise. In gastroenterology, the challenge of finding the right people has never been greater due to a significant mismatch between workforce demand and supply.

This toolkit offers a comprehensive guide to help gastroenterology divisions and practices recruit top candidates and build successful teams.

Getting It Right | 41

// GETTING IT RIGHT

“Begin by defining your organization’s culture, reputation, market competition, population growth, and location desirability with honesty. Avoid assuming that your organization is the best in every aspect.”

RULE #1: This is a Candidate’s Market In today’s market, there are approximately three job opportunities for each graduating gastroenterology (GI) fellow in the U.S. In 2022 alone, 588 GI fellows completed their training, yet over 1,630 full-time gastroenterologist positions remain unfilled, according to the National Center for Health Workforce Analysis.1 Several factors contribute to this shortage: • Supply Constraints: An aging gastroenterologist population, post-pandemic burnout, retirements, and stagnant fellowship positions • Increasing Demand: An aging American population, increasing prevalence of GI diseases, and a lowering in the recommended age for colon cancer screenings Given this landscape, employers must recognize that candidates hold a more advantageous position in the job market.

RULE #2: Know Thyself Begin by defining your organization’s culture, reputation, market competition, population growth, and location desirability with honesty.

Avoid assuming that your organization is the best in every aspect. Categorize these elements into positive and negative aspects and ensure that all partners and associates are aligned on key talking points before interviewing candidates. Transparency is crucial, especially on potentially negative topics, such as why some associates may not have advanced to partnership. Mixed messages can create uncertainty and raise red flags.

42 | GI.ORG/ACG-MAGAZINE

RULE #3: Recruit Early and Actively by Casting Wide and Narrow Nets Recruitment efforts should start during the candidates’ second year of fellowship, with many practices offering sign-on bonuses or monthly stipends during training.

By the middle of their third year, most fellows have typically secured positions.

Anticipated retirements should prompt recruitment efforts two years in advance.

Lateral hires—experienced physicians looking to switch practices—should also be seriously considered, as they often present rare and flexible opportunities.

• Wide Net: Target candidates beyond local geography through word-ofmouth, national recruiting firms, GI journal ads, national conferences, social media, and a prominent "Careers" link on your website.

• Narrow Net: Focus on local talent by building relationships with local GI fellowship programs, hosting educational dinners, volunteering as adjunct faculty, and maintaining a strong presence in local GI societies.

For candidates seeking to return home after training or local physicians looking for a change, your group’s involvement at both local and national levels increases the likelihood of connecting through overlapping networks.

RULE #4: Diversity/Inclusion is Gold The importance of diversity/inclusion in your team cannot be overstated. Since this article focuses on practice management, as opposed to clinical outcomes, we will discuss the diversity/inclusion benefits to the GI practice.

A diverse group of physicians not only enhances financial outcomes by attracting patients who look like their physicians but also improves recruitment in a selffulfilling manner. Similarly, a candidate gravitates toward a partner who looks

like the candidate, or shares the same experiences, culture, and background.

The partner becomes the “hook” that lands a successful signing.

Highlighting your explicit commitment to diversity and inclusion can be a powerful recruitment tool if you don’t have such a “hook.” This strategy may also help with retention efforts, if your current partner sees that the practice values diversity/inclusion as part of its recruitment strategy.

RULE #5: Be Transparent about the 3 C’s – Compensation, Call, and Culture Be upfront about compensation structures, benefits, and call schedules. Any lack of transparency is a red flag for candidates. Share average earnings of de-identified physicians at various career stages and current buy-ins for ancillary services, with appropriate disclaimers about potential changes by the time the candidate reaches partnership.

Equally important is the distribution of call responsibilities. A practice where call burdens are shared equally among all members, regardless of seniority, is more attractive to candidates. Additionally, discuss the organization’s culture, focusing on camaraderie, support, and collegiality among partners.

RULE #6: Roll Out the Red Carpet When it’s time for the interview, make candidates feel valued from the moment they arrive. Consider offering a personal driver from the airport and minimize travel costs for the candidate. Some employers conduct an initial virtual interview followed by an in-person interview, which ideally includes an adjoining weekend for candidates to explore the city.

During the in-person interview, invite the candidate’s family, arrange for a real estate agent, and create a bespoke experience based on the candidate’s interests. Personal touches, such as a guided city tour or a special dinner, can leave a lasting impression. As they say, people may forget what you say or what you do, but they do not forget how you made them feel.

RULE #7: Avoid Putting a Square Peg in a Round Hole Retention is as important as recruitment. Physicians who completed training within the last six years often stay in their first jobs for only two years. Transparency during recruitment, especially regarding key job features like compensation and call responsibilities, reduces the risk of early departures.

Matching a candidate to the right organizational culture is crucial. Some candidates may be uninterested in the business side of medicine, while others may have entrepreneurial aspirations.

Compensation models must also align with the candidate’s expectations and values. For instance, some practices evenly split revenue, while others operate on a purely RVU or other compensation model.

Candidates with advanced endoscopy training should be provided with clear projections of the procedures they will perform annually.

This transparency is essential, as these candidates have invested significant time and income in acquiring these additional skills.

RULE #8: Work-Life Balance is the Rule, Not the Exception Quality of life is increasingly important to today’s candidates, often outweighing the pursuit of higher income. Resist any temptation to dismiss these concerns as indicative of laziness or a lack of commitment.

Instead, highlight your organization’s efforts to promote work-life balance, such as providing advanced practice providers (APPs) for weekend or call support, AI scribes, or options to pay others for taking on-call duties.

RULE #9: Market Opportunities for Growth (Career and Personal) Clearly define the sources of new patients and explain why your group is hiring, whether due to upcoming retirements, long patient waitlists, or expansion projects. Show candidates the financial trajectory for new partners and ask if they have unique skills or interests they wish to develop.

For candidates who are not interested

“Quality of life is increasingly important to today’s candidates, often outweighing the pursuit of higher income. Resist any temptation to dismiss these concerns as indicative of laziness or lack of commitment.”

in extracurricular activities, emphasize that there is no pressure to engage in these.

Pair candidates with partners who share similar backgrounds or interests, and introduce them to local religious, ethnic, or sports communities to support their personal growth.

RULE #10: Follow Up with Clear Next Steps At the end of the interview, clearly communicate the selection process timeline and when candidates can expect feedback. If a candidate stands out, consider expressing this or even extending an early offer. In a candidate’s market, waiting too long can be costly.

Be cautious with “exploding offers,” which impose a hard time limit for acceptance. These offers can backfire, especially in today’s competitive market, and may damage your reputation if you later need to renegotiate with a candidate.

ABOUT Dr. Andy Tau is an alumnus of the ACG Institute’s 2022 Early Career Leadership Program and practices at Austin Gastroenterology. He has been a member of the ACG Practice Management Committee since 2023.

Dr. Lanre Jimoh practices at Carolina Digestive Health Associates in Charlotte, NC.

Dr. Syed M. Hussain practices at GI Associates in Kenosha, WI. He was a member of the ACG Practice Management Committee from 2018 to 2024.

By adhering to these “10 Cardinal Rules,” employers can optimize their recruitment strategies and attract ideal candidates.

Remember, the goal is not just to sign candidates, but to ensure they feel confident that your practice aligns with their long-term aspirations, encouraging them to stay and thrive within your organization.

REFERENCE 1. Health Resources & Services Administration. National and regional projections of supply and demand for internal medicine subspecialty practitioners: 2013-2025.

Getting It Right | 43

EVIDENCE-BASED GI Clinical take-aways and evidence-based summaries of articles in GI, Hepatology & Endoscopy.

EVIDENCE-BASED GI (EBGI) evaluates new research articles published across leading general medicine, GI and Hepatology journals.

ACG Editors identify the highest quality studies published on important topics and create structured abstracts summarizing the study for quick reference and provide commentary on how the data is applicable to clinical practice.

Editors record audio summaries for easy listening on the go.

Follow EBGI on Twitter for weekly tweetorials @ACG_EBGI

Member benefit!

Watch for the eTOC delivered in your inbox monthly!

EBGI has Podcasts Too! Read. Listen. Learn.

Stay up to date on notable studies in major medical journals with ACG’s latest publication, Evidence-Based GI edited by Philip S. Schoenfeld, MD, MSEd, MScEpi, FACG.

Full issue download available as PDF: gi.org/ebgi

44 | GI.ORG/ACG-MAGAZINE

Inside the

JOURNALS

G

AC RTS EPO E CAS RO J URN L G OM I.OR TS.C TS.G POR POR ERE ERE CAS CAS ACG ACG

VOLUME 6

orts edited by Case Rep rnal of orts edited by ine Jou Case Rep An Onl logy Fellows rnal of ine Jou gy & Hepato An Onl logy Fellows nterolo Gastroe gy & Hepato rolo nte troe Gas

RED JOURNAL HIGHLIGHTS INCLUDE new recommendations on optimizing colonoscopy bowel prep from the U.S. Multi-Society Task Force on Colorectal Cancer and two ACG Clinical Guidelines: Diagnosis and Management of Gastric Premalignant Conditions by Morgan, et al., and Malnutrition and Nutritional Recommendations in Liver Disease by McClain, et al.

A study in Clinical & Translational Gastroenterology found that SARS-CoV-2 infection was associated with an increased risk of developing subsequent respiratory syncytial virus (RSV) infection, particularly within 30–60 days after infection and among those receiving immune-modifying therapies.

ACG Case Reports Journal shares an instance of esophageal perforation due to atrial fibrillation radiofrequency ablation that was resolved using endoscopic vacuum therapy after two separate stents failed to resolve the leak. Two of the authors shared insights in a Behind the Case podcast.

Inside the Journals | 45

// INSIDE THE JOURNALS [THE AMERICAN JOURNAL OF GASTROENTEROLOGY]

[CLINICAL & TRANSLATIONAL GASTROENTEROLOGY]

Optimizing Bowel Preparation Quality for Colonoscopy: Consensus Recommendations by the U.S. Multi-Society Task Force on Colorectal Cancer

Patients With Inflammatory Bowel Disease Are at Increased Risk of Respiratory Syncytial Virus Infections After Severe Acute Respiratory Syndrome Coronavirus 2 Infection: A Propensity-Matched Cohort Analysis

Jacobson & Anderson, et al.

Updated consensus recommendations by the U.S. Multi-Society Task Force on Colorectal Cancer (MSTFCRC) present clinical strategies to improve bowel preparation. Evidence-based recommendations and key concepts cover patient education and navigation, dietary restrictions, choice of preparation agent, the timing and volume of doses, routine use of irrigation pumps to assist with bowel cleansing during colonoscopy, and same-day salvage maneuvers for inadequate preps. In recognizing bowel preparation adequacy rate as a quality measure, the authors recommend a “reasonable benchmark” of greater than or equal to 90% at both the level of individual endoscopists and at the level of the endoscopy unit.

The MSTFCRC includes representatives from ACG, the American Gastroenterological Association, and the American Society for Gastrointestinal Endoscopy.

Alsakarneh & Ramirez Ramirez, et al.

In a retrospective cohort study, the authors examined the risk of RSV infection in patients with IBD diagnosed with a recent SARS-CoV-2 infection compared to those without infection. They found that more than twice as many IBD patients developed RSV after SARS-CoV-2 infection compared to the control group. Of note, there was no significant difference in the risk of RSV infection within 0–29 days after diagnosis between the two cohorts. However, the risk was higher in the 30–90-day and 81–190-day intervals and among those receiving immune-modifying therapies.  READ: bit.ly/ctg-ibd-cov2-rsv

 READ: bit.ly/mstfcrc-bowel-prep-2025

ACG CLINICAL GUIDELINE: Diagnosis and Management of Gastric Premalignant Conditions Morgan, et al.

The new guideline includes recommendations on endoscopic surveillance for high-risk patients with gastric premalignant conditions (GPMC). Key areas of emphasis are the performance of high-quality endoscopy and image-enhanced endoscopy for diagnosis and surveillance, GPMC histology criteria and reporting, endoscopic treatment of dysplasia, the role of Helicobacter pylori eradication, general risk reduction measures, and the management of autoimmune gastritis and gastric epithelial polyps.  READ: bit.ly/acg-gpmc-2025  LISTEN: bit.ly/acg-gpmc-podcast  SUMMARY: bit.ly/acg-gpmc-highlights See also on page 47

ACG CLINICAL GUIDELINE: Malnutrition and Nutritional Recommendations in Liver Disease

McClain, et al.

Nine recommendations for the diagnosis and treatment of malnutrition (both undernutrition and overnutrition) in liver disease were identified using GRADE methodology. Strong recommendations include the use of branched chain amino acids with standard-of-care treatment in patients with cirrhosis and hepatic encephalopathy (HE) and incorporating late evening snacks in patients with cirrhosis to improve body mass index, lean muscle tissue, and reduce the risk of ascites and HE.  READ: bit.ly/acg-guideline-liver-nutrition  LISTEN: bit.ly/acg-liver-nutrition-podcast

46 | GI.ORG/ACG-MAGAZINE

[ACG CASE REPORTS JOURNAL]

Endoscopic Vacuum Therapy for the Treatment of Atrial Fibrillation Ablation-Induced Esophageal Perforation Lushniak, et al.

A 52-year-old patient presented with esophageal perforation due to atrial fibrillation radiofrequency ablation. Full-thickness perforation is often treated with surgical revision, stent placement, or medical management; however, endoscopic vacuum therapy (EVT) is an emerging minimally invasive technique that can be used to repair transmural gastrointestinal defects. After placement of a stent twice failed to resolve the leak, the authors discovered a 2 cm esophageal cavity with a fistulous tract exuding purulence and treated the injury using a surgical black suction sponge which was exchanged approximately once per week for three weeks. A one-month follow-up showed resolution of the esophageal leak, demonstrating EVT’s utility as a minimally invasive endoscopic treatment modality when alternative therapies fail.  READ: bit.ly/crj-afib-evt  LISTEN: bit.ly/crj-afib-evt-podcast

ACG GUIDELINE Highlights ACG GUIDELINE Highlights Treatment of Helicobacter Diagnosis andpylori Management Infectionof Gastric Premalignant Conditions (GPMC)

William D. Chey, MD, FACG; Colin W. Howden, MD, FACG; Steven F. Moss, MD, FACG; Douglas R. Morgan, MD, MPH, FACG; Katarina B. Greer, MD, MSEpi; Shilpa Grover, MD, MPH; Shailja C. Shah, MD, MPH

Concept and Content: Erica Duh, MD | Reviewers: William D. Chey, MD, FACG and Shailja C. Shah, MD, MPH Concept and Content: Carl Kay, MD | Reviewer: Douglas Morgan, MD, MPH, FACG

Epidemiology Endoscopic & Histologic Assessment When to Test for H. pylori

#1

#2

Treatment for H. pylori

Gastric Premalignant Conditions Management

• H. pylori prevalence in North America is 30%-40% • Typically acquired in childhood Correa Cascade PEARLS OF ENDOSCOPY & HISTOLOGY • More prevalent among non-White races or ethnicities, those living in crowdedEndoscopy or poor sanitary conditions, for patients with known or suspected GPMC: and early generation immigrants from endemic regions.

• Distend gastric folds Benign Conditions • Dyspepsia if <60 years without alarm features (GI bleeding, vomiting, unexplained weight loss, iron deficiency) • Dyspepsia if <50 years with high risk for gastric cancer • Endoscopy with biopsies if dyspepsia and alarm features, NSAID use, family history of gastric cancer, immigration from high incidence region

• Adult household members of H. pylori positive individuals • ITP • Unexplained IDA • Current or prior history of PUD • Chronically taking NSAID or starting daily aspirin therapies

Regimens for H. pylori Treatment

• Clean mucosa with water & defoaming agent +/-mucolytic Premalignant and Malignant Conditions • Perform detailed gastric exam with photodocumentation • Use enhanced endoscopy •(NBI, BLI)lymphoma • High riskimage gastric premalignant MALT • Endoscopically identify mucosal changes along the Correa condition • Gastric epithelial polyps Cascade: 1) AG, 2) GIM, 3) Dysplasia - Atrophy, intestinal Sydney protocol biopsies • Obtain systematic recognizes metaplasia, dysplasia • Place Sydney protocol biopsies into 2WHO jars (antrum/incisura & H. pylori asjar(s), a group I corpus) and targeted if obtained - Autoimmune gastritisbiopsies in additional (definite) carcinogen - Family history of gastric Pathology assessment and risk stratification: cancer • Report the presence or absence of H. pylori organisms • Reportborn GIM with histologic subtype: incomplete or complete; mixed - Foreign immigration GIMhigh histology is considered from incidence region incomplete • Assess extent of GIM: limited - High risk race or ethnicity is confined to antrum/incisura; extensive also involves the corpus Rxproportion of involvement of AG • Classify histologic severity: Rx Experienced (Salvage) or GIM within each gastric region (antrum/incisura vs corpus).

Naïve Severe when ≥2/3rds of glands are involved

• PPI b.i.d.

Non-Dysplastic GPMC Management • Bismuth subcitrate (120-300 mg) or subsalicylate (300 -524 mg) q.i.d.

Optimized bismuth • Tetracycline 500 mg q.i.d.

Gastric Intestinal Metaplasia quadruple • Metronidazole 500 mg t.i.d. or q.i.d.

Doxycycline is not a recommended substitute for tetracycline High-risk

Low-risk*

Empiric

Empiric

Proven Rx Sensitivity

Non-Metaplastic Atrophic Gastritis High-risk

Low-risk*

• Rifabutin 50 mg t.i.d. in mg b.i.d.)

Surveillance in 3 years No further Surveillance Repeat in 3 years substituteSurveillance No further Surveillance (if doseexam unavailable, rifabutin 150 Rifabutin Triple 3 years; shorter to reasses1000 risk* mg t.i.d.

• Amoxicillin interval if multiple *In patients with low-risk AG/GIM who • Omeprazole 40 mg t.i.d.

Individuals at higher risk for GPMC progression & gastric cancer did not have systematic biopsies at risk factors Low-risk index EGD, consider repeat exam at 3 High-risk GIM histology: • Vonoprazan 20 mg b.i.d. years with shared decision making PCAB Dual • Incomplete GIM histological subtype No further Surveillance • Amoxicillin 1000 mg t.i.d.

• Corpus-extension (e.g., antral GIM extending into corpus) • Vonoprazan 20 mg b.i.d.

Any GIM histology with 1+ of following risk factors for GC: PCAB Triple • Clarithromycin 500 mg b.i.d.

• Family history of GC in 1st degree relative H. pylori eradication in those with GPMC (AG, GIM, • Amoxicillin 1000 mgdysplasia) b.i.d.

• Foreign-born/emigration from high incidence nation and resected early gastric cancer reduces the risk of gastric • High risk race or ethnicity (East Asian, Latino/a, Black & AIAN) • PPI b.i.d. cancer & metachronous gastric cancer Severe GIM or AG in biopsies of the antrum/incisura or corpus Levofloxacin Triple • Amoxicillin 1000 mg b.i.d.

• Levofloxacin 500 mg b.i.d.

Dysplastic GPMC Management Recommended

Suggested Low-grade Dysplasia (LGD)

May be considered when no other options High-grade Dysplasia (HGD)

Confirmed by Treatment 2nd pathologistPearls with GI expertise

to an experienced endoscopist at• To a high-volume • All patients found to be infected withReferral H. pylori should be treated avoid falsecenter negatives in test of cure – hold PPI x 2 weeks; • Complete therapy with either: bismuthVisible and antibiotics x 4 weeks Non-visible Non-visible Visible test of cure at least four weeks after • Urea breath test • Avoid clarithromycin and levofloxacin-containing Rx • Fecal resection antigen test unless demonstrated susceptibility Surveillance by an expert every 6-12 Surveillance by an expert every 3 Endoscopic ESD or surgical resection months with systematic biopsies months with systematic • Biopsy-based test • PCN allergy – consider referral for formal PCN biopsies allergy testing and/or desensitization

Complete Resection, R0

Incomplete Resection

Complete Resection, R0

Incomplete Resection

Abx = antibiotic ITP = immune thrombocytopenic purpura PCN = penicillin q.i.d. = four times a day b.i.d. = twice a day Surveillance <12 months then IDA = iron deficiency anemia PCAB = potassiumSurveillance competitive acid blocker Rx = treatment every Repeat EGD <6 months; if 2nd incomplete Repeat EGD <3 months; if every 3-6 months GIM = gastric intestinal metaplasia mg = milligrams PPI = proton pump inhibitor t.i.d. = three times a day 3 yrs if AG/GIM in remaining mucosa resection, consider repeatdrugs endoscopic resection 2nd incomplete resection, 1-2 yrs then every 3 yrs if H. pylori = Helicobacter pylori NSAIDS = non-steroidal anti-inflammatory PUD = peptic ulcer for disease

vs. surveillance vs. surgery in refractory cases

AG/GIM in remaining mucosa

William D. Chey, MD, FACG; Colin W. Howden, MD, FACG; Steven F. Moss, MD, FACG; Douglas R. Morgan, MD, MPH, FACG; Katarina B. Greer, MD, MSEpi; Shilpa Grover, MD, MPH; Shailja C. Shah, MD, MPH The American Journal of Gastroenterology 119(9):p 1730-1753, September 2024. | DOI: 10.14309/ AG: Atrophic gastritis BLI: blue laser imaging ESD: Endoscopic submucosal dissection GIM: Gastric intestinal metaplasia ajg.0000000000002968 AIAN: American Indian or Alaska Native EGD: Esophagogastroduodenoscopy GC: Gastric cancer HGD: High-grade dysplasia  READ THE GUIDELINE: bit.ly/acg-h-pylori-guideline

consider surgical resection

LGD: Low-grade dysplasia NBI: narrow band imaging

Douglas R. Morgan, MD, MPH, FACG; Juan E. Corral, MD, MPH; Dan Li, MD; Elizabeth A. Montgomery, MD; Arnoldo Riquelme, MD; John J. Kim, MD, FACG; Bryan Sauer, MD, MSc, FACG; Shailja C. Shah, MD, MPH The American Journal of Gastroenterology 10.14309/ajg.0000000000003350 | DOI: 10.14309/ajg.0000000000003350  READ THE GUIDELINE: bit.ly/acg-gpmc-2025

Inside the Journals | 47

About

LIFESTYLE AND MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease)

Information for Patients and Caregivers from the American College of Gastroenterology You have been diagnosed with MASLD, also called fatty liver, now what?

Good news! You can decrease the amount of fat in your liver. You can do this by decreasing the total calories (eating less) and increasing physical activity (exercise more).

DIET

EXERCISE

While no one diet is recommended for all people with fatty liver, in general, these are all important steps:

Research shows that exercise has many benefits for people with MASLD including decreased body fat and liver fat, lower cardiovascular risk, plus increased fitness, larger muscle mass, and better quality of life.

• Consume less high fructose corn syrup and sugar

Even brief amounts of exercise can help: 10-minute exercise “snacks” are a great strategy if you don’t have a lot of time.1

• Add more fruits and vegetables to each meal

Pick one or both of these exercise regimens:

• Fill half of your plate with vegetables, one quarter with grains and one quarter with protein

Moderate cardio • Brisk walking for 150 minutes (2.5 hours) each week

• Use olive oil or canola oil to cook • Avoid heavy fat like butter, lard, palm oil, white bread, trans fats, French fries

• Try to be active at least three days per week

• Bake, broil, steam instead of frying food

High intensity activity

• Choose white meat such as chicken or turkey

• Running for 75 minutes each week

• Completely avoid alcohol, there is no SAFE amount of drinking

• Try at least three days per week

• Try to be active at least 10 minutes at a time

• Try to be active at least 10 minutes at a time Reference: 1. Jonathan G. Stine, MD; Zachary H. Henry, MD. How to Write an Exercise Prescription to Treat Metabolic Dysfunction-Associated Steatotic Liver Disease for the Busy Clinician.

The American Journal of Gastroenterology 119(6):p 1007-1010, June 2024. | DOI: 10.14309/ ajg.0000000000002805

LEARN MORE

ACG Patient Info on MASLD – MetabolicDysfunction Associated Steatotic Liver Disease gi.org/topics/steatotic-liver-disease-masld

Find a gastroenterologist near you: gi.org/findagi

Author: Atoosa Rabiee, MD, FACG | Reviewers: Scott L. Gabbard, MD, FACG and Alisa Likhitsup, MD American College of Gastroenterology | gi.org 48 | GI.ORG/ACG-MAGAZINE