EndoEconomics March 2020 Issue

MARCH 2020

A journal dedicated to advancing GI ASCs and practices MA

R

10 Ed Yakacki’s incredible journey CH

COLON CANCER AWARENESS MONTH

8 14 18 1 endoeconomics MARCH 2020

ONBOARDING ADVANCED PRACTICE PROVIDERS ADDRESSING BURNOUT IMPROVING PATIENT RECALL

ASC DEVELOPMENT SERVICES

Building GI Surgery Centers of Excellence!

Feasibility Study Site Selection Facility Design Project Financing Vendor Negotiations Equipment Purchasing Construction Management Staff Recruitment and Training License and Certificate of Occupancy Medicare & Accreditation Surveys

TO LEARN MORE: info@endocenters.com

EDITORIAL STAFF

Carol Stopa Editor in Chief cstopa@endocenters.com

CONTENTS

MARCH 2020

6

8

Publishing services are provided by GLC, 9855 Woods Drive, Skokie, IL 60077, (847) 205.3000, glcdelivers.com.

EndoEconomics™, a free quarterly publication, is published by Physicians Endoscopy, 2500 York Road, Suite 300, Jamison, PA 18929.

The views expressed in this publication are not necessarily those of Physicians Endoscopy, EndoEconomics or the editorial staff.

POSTMASTER: Send address changes to: Physicians Endoscopy, Attn: EndoEconomics, 2500 York Road, Suite 300, Jamison, PA 18929.

While every effort has been made to ensure the accuracy of EndoEconomics contents, neither the editor nor staff can be held responsible for the accuracy of information herein, or any consequences arising from it.

LETTER

NOTEWORTHY

STRATEGIES

2

3

5

Message from the President

The Colon Cancer Coalition, upcoming PE events and more

10

Making connections

6

The recall effect

8

Team building

20

Advertisers assume liability and responsibility for all content (including text, illustrations, and representations) of their advertisements published.

Printed in the U.S.A. Copyright © 2020 by Physicians Endoscopy All rights reserved All copyright for material appearing in EndoEconomics belongs to Physicians Endoscopy, and/or the individual contributor/ clients, and may not be reproduced without the written consent of Physicians Endoscopy.

Reproduction in whole or in part of the contents without expressed permission is prohibited.

To request reprints or the rights to reprint such as copying for general distribution, advertising, promotional purposes: Submit in writing by mail or send via email to info@endocenters.com.

SPOTLIGHT

INSIGHTS

10

14

INSPIRATIONAL STORIES Ed Yakacki’s incredible journey

HR Beating burnout

18 CLINICAL Electronic engagement

ENDO OPPORTUNITIES 24

GI physician opportunities at partnered practices

20

MARKETING Social Media 101

Find out more at endocenters.com or find us on

1 endoeconomics MARCH 2020

letter

{Message from the President}

BE PRESENT Looking ahead is important, but to thrive we need to focus on success today

David Young, President & CEO, Physicians Endoscopy

BECOMING PART OF A LARGER GROUP INCREASES ACCESS TO RESOURCES, SUCH AS A PHYSICIAN LIAISON, WEB DEVELOPMENT TEAM, CALL CENTER AND TECHNOLOGYDRIVEN RECALL PROGRAM.

2 endoeconomics MARCH 2020

THERE IS A TENDENCY IN HEALTHCARE to always look forward. We watch and analyze future trends concerning consolidation, private equity, technology, reimbursement, regulatory changes and more. We keep this close eye on what’s coming down the pipeline because we want to prepare for developments that could reshape the industry, be ready to take advantage of avenues worth pursuing and not get caught off guard by threats. These efforts are important to the long-term viability of the independent practice of medicine.

But if we want to thrive in the GI industry of tomorrow, we must remain highly focused on what’s necessary for success today. That boils down to mastering—as best we can—the fundamentals of our success: focusing on our patients and making sure they have access to exemplary GI care in the practice and ASC. How do we do this? By strengthening our foundation. This begins with ensuring we have strong referral relationships with primary care physicians (PCPs). They are not only a significant source for new referrals, but also provide critical information required to care for these patients.

Improving partnerships with PCPs and keeping them current with organizational developments can enhance volume and allow us to consistently deliver timely, cost-effective treatment.

Helping patients find out how to access us is next. These days, that largely concerns developing a robust web presence.

Our websites must provide everything from information on physicians and services

to procedure preparation education to directions on traveling to our facilities.

Websites must be easily navigable, render properly on mobile devices and be readable in multiple languages. Efforts around building and improving our digital footprint must speak to reputation management. That means monitoring review websites and social media while encouraging satisfied patients to document their positive experiences online.

This objective also requires flexible schedule management. If patients are unable to schedule an appointment that easily fits within their day-to-day activities, they will find a provider who can. Flexible scheduling often requires early, late and weekend visit requests.

Once we bring patients in for their initial visits, we must make it easy for them to return. This boils down to a well-organized and well-executed recall program—one that accommodates patients’ scheduling needs and communicates using their preferred method of communication.

Accomplishing these goals as our businesses grow will require scaling, flexibility and time. Fortunately, these can be made easier by choosing the right partner.

Becoming part of a larger group increases access to resources, such as a physician liaison, web development team, call center and technology-driven recall program.

With the right partner, organizations achieve short-term improvements while setting themselves up to benefit from the many exciting opportunities on the horizon.

noteworthy

{News and events}

Send us your community stories.

Email us at info@endocenters.com.

Example of Excellence

Image: iStock.com/SDI Productions

Colon Cancer Awareness Month The Colon Cancer Coalition was started in 2004 by Kristin Lindquist, who lost her sister Susie Lindquist Mjelde to colon cancer. Today, 16 years later, this national coalition has three solid goals in mind when it comes to colon cancer: raise awareness, increase screenings and keep funds local.

They are dedicated to providing an outlet for those who have been touched by colon cancer. By telling their stories, these participants help raise awareness. The local events organized help raise funds that are granted back into the host community in order to increase screenings and save lives. Their events include “Get Your Rear in Gear,” “Tour De Tush,” and “Caboose Cup.” According to the Colon Cancer Coalition, the chances of surviving colon cancer are around 90% when detected and treated in the early stages. However, only 40% of colon cancers are diagnosed during this window. If patients would overcome their trepidation surrounding the procedure, many unnecessary deaths could be prevented. Events like Philadelphia’s “Get Your Rear in Gear” encourage awareness about colon cancer, and help the community get educated and involved.

Funds raised through events hosted by the Colon Cancer Coalition are granted back into the communities that earned them. Local community programs dedicated to raising screening rates, increasing awareness, and educating the public about signs and symptoms related to colon cancer are awarded funds. Money raised is also used to help support patients and their caregivers.

The Colon Cancer Coalition cites that over 20,000 participants from over 40 cities nationwide have earned more than $1 million annually for colon cancer. These events are so important, because they use action to inspire the communities in which they are held.

Visit coloncancercoalition.org to find out how you can help today. Donate, participate, inspire those around you or volunteer your time for this worthy cause!

Business news journal Buffalo Business First recently announced its list of honorees for its second annual Excellence in Health Care Awards. Physicians Endoscopy would like to congratulate Christopher Bartolone, MD, Medical Director/ Managing Partner of Gastroenterology Associates LLP and Endoscopy Center of WNY in Buffalo, New York, for being named an honoree.

“These winners are committed to improving care, educating the public or working on the cutting edge of health care technology,” said John Tebeau, publisher of Buffalo Business First. With the Excellence in Health Care Awards, the journal recognizes the top men and women in the Western New York health care industry.

{News and events}

Harvey Guttmann, MD, Named “Leader to Know” Becker’s ASC Review recently published a list of “3 Gastroenterology Leaders to Know,” which included Harvey Guttmann, MD, of Gastrointestinal Associates, Inc. Dr. Guttmann is Chief of Gastroenterology and President of Medical Staff at Abington Memorial Hospital in Abington, Pennsylvania. He also served as President of Gastrointestinal Associates, which is an independent practice based in Rydal and Chalfont, Pennsylvania. Congratulations to Dr. Guttman on this recognition!

See You There!

Come meet the Physicians Endoscopy team at these upcoming conferences: > GI Roundtable Denver, CO April 3–4, 2020 > Digestive Disease Week Chicago, IL May 2–5, 2020 > ACG Eastern Regional Postgraduate Course Washington, D.C. June 5–7, 2020 > GI Outlook Arlington, VA August 1–2, 2020 > California Ambulatory Surgery Association Indian Wells, CA September 9–11, 2020

For more information about our upcoming event attendance, visit endocenters.com.

Image: iStock.com/Boonyachoat

noteworthy

strategies

{Business strategy and the bottom line}

endocenters.com

Making

Image: iStock.com/aapsky

connections On a recent trip home from a meeting in Virginia, I stood on the train platform waiting for my ride back to Philadelphia. It was a beautiful fall morning, and I was looking forward to the four-hour ride, offering me plenty of time to get caught up on emails without interruption.

A young conductor approached me asking where I was headed. He was the inquisitive type, and a one-word answer was not going to suffice. He asked how often I visited the area and what I do. I briefly explained I work for a company that builds surgery centers where gastroenterologists can perform procedures like colonoscopies. For the next 15 minutes, he quizzed me about surgery centers, asking me whether they are safe, and if I would have my procedure done at one of these centers.

While he was not old enough to be considered a screening candidate, he was intelligent enough to understand that there are other reasons people should get screened, like family history or symptoms. I was surprised at how interested he was to know more. Even though it was quite early in the morning, I could see his wheels of curiosity turning. He asked how long I worked at my job and concluded, “So you really help save lives.” I was awestruck by his response, and for the first time, it really hit me hard.

Someone just learning about what I do quickly surmised the end result in a matter of minutes. It made me pause and feel good about my career of over almost two decades.

I always viewed my efforts from a different perspective: how I can help physicians who work so hard for their

patients achieve their goals. But this fellow was spot on.

I felt very proud.

The conversation quickly shifted, and he wondered why he’d never heard of a surgery center before and how people find one. It was a concept that seemed very foreign to him, but he appreciated knowing there was an alternative to going to a hospital. He wondered about patient safety, if centers were inspected for cleanliness, and why a patient would choose such a place rather than the traditional hospital. The questions kept coming, and I was delighted to educate this young man on choice, cost and quality care.

In this moment, it struck me how important education is for our industry. No matter our role, we can take even small interactions like this one as opportunities to educate people, not just patients.

The more we raise awareness, the more lives we save.

It is a responsibility for all of us that touch the medical CAROL STOPA is Senior Vice President field to benefit others. of Business Development and Marketing As for my conversation for Physicians Endoscopy (PE) and with this young man, eventuEditor-in-Chief of EndoEconomics. She ally, our train was announced, has more than 19 years’ experience in and it was time to board. He acquisitions, de novo and hospital/systhanked me and said to have tem joint ventures. She can be reached a nice day. Actually it turned at cstopa@endocenters.com. out to be a great day.

5 endoeconomics MARCH 2020

strategies

{Business strategy and the bottom line}

The recall effect Growing your GI practice by successfully mining your colonoscopy recalls.

By TJ Berdzik

Colorectal cancer is the second leading cause of cancer death in the United States. Approximately 140,000 people are expected to be diagnosed with colorectal cancer in 2019. Regular colonoscopies and timely treatment are keys to catching colorectal cancer early and treating potential problems before they become a serious condition. An active colonoscopy patient recall system is a clinically appropriate and necessary tool for a gastroenterology (GI) practice. Despite the clinical importance of colonoscopy patient recall, studies point to low GI patient recall rates, with significant variation between practices.

Beyond the clinical considerations, a colonoscopy patient recall system can generate significant patient volume at a significant return on investment (ROI). A robust patient recall system can be very expensive in terms of labor, systems and services. Patient recall can take place entirely in-house, entirely outsourced or some combination of the two.

Running the Recall Numbers The first step in analyzing the size of the opportunity is to consider the size of the recall pool. Data that we’ve analyzed from Physicians Endoscopy (PE) partnered centers point to an average colonoscopy recall interval of approximately five years with a range of 1–10 years.

Approximately two-thirds of center procedures are colonoscopy procedures. If we consider a physician with 10 years of stable volume, the average annual size of the colonoscopy recall pool may approximate the physician’s

6 endoeconomics MARCH 2020

average annual volume. When you consider recall for repeat esophagogastroduodenoscopies (EGDs), a physician’s average annual recall pool likely exceeds their annual procedure volume.

The next step in analyzing the size of the opportunity is to calculate how many patients due for a recall come back for a repeat procedure during the active recall process (typically the due date plus 6–12 months). We refer to this calculation as recall conversion rate. In analyzing data from PE partnered centers, we find that recall conversion rates range from 18% to approximately 35% with an average of 28%–30%. Recall conversion rates generally max out around 40%–45%.

From a high level, if the size of a recall pool approximates the annual volume of a long-term physician with stable volume, a 5% increase in recall conversion rate can correspond to a roughly 5% increase in annual volume.

We believe that many practices have an opportunity of 5%–15% volume growth from better recall conversion rates. These estimates have been validated based on the results of enhanced recall efforts implemented by practices at partnered PE centers.

Making Recall Part of the Repertoire We find that the more effort a practice puts into recall, the higher the conversion rate. On the low end, practice efforts may be limited to a physical letter as the patient approaches their recall due date. On the high end, a practice can implement a very robust system of letters,

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texting, primary care provider communication, multiple rounds of follow-up calls, and tracking and monitoring of results. Depending upon practice, ancillaries and physician ownership, the revenue opportunities from increased procedure volume can include office visit revenue, professional fees, share of center profits (based on any center ownership), and other potential ancillary revenue source such as anesthesia and pathology. Increasing patient recall efforts is an investment that we believe has a significant ROI for both the practices and their centers.

From a practical standpoint, an enhanced recall system can be expensive in terms of cost and practice staff. Simply instructing busy staff to start calling patients for recall when available frequently results in a situation where “free time” becomes “no time.” To increase productivity, practices can use dedicated staff, dedicated blocks of time, and tracking and monitoring of results. If available staff is too limited to properly mine the recall data, components of the patient recall process, such as the follow-up calls, can be outsourced to specialized vendors.

While colonoscopy recall efforts are a clinical necessity, a robust recall process that properly mines the recall pool can generate significant additional volume at a very attractive ROI. It is not only a good financial endeavor but makes for good patient care.

Considering recall? See page 18 for a deeper dive into using texting as a tool to increase patient recall.

TJ BERDZIK is a Senior Financial Analyst at Physicians Endoscopy (PE).

He can be reached at tberdzik@ endocenters.com.

Image: iStock.com/alexsl, sturti

7 endoeconomics MARCH 2020

strategies

{Business strategy and the bottom line}

Team

building Prime your practice for success with a strong onboarding process.

By Joseph Vicari, MD, MBA Advanced practice providers (APPs), whether physician assistants or nurse practitioners, are becoming an indispensable part of the GI healthcare team. In the average GI practice, each patient visit can generate 1.2 to 1.3 endoscopic procedures, and APPs greatly increase a practice’s ability to see patients. Having capable, well-trained APPs enhances the level of service your practice can provide and, ultimately, helps further an important goal: improving the patient experience.

to creating the process. Without a physician champion who both believes in the importance of having an onboarding process and wants to see it through, it is difficult to make any progress.

Ideally, you can create a core team or committee that will be responsible for leading the onboarding process through creation and implementation. I recommend that this group includes your physician champion, a clinical supervisor or nurse clinical leader stakeholder and an administrative stakeholder. Of course, depending on your practice’s culture, you may want to include more voices.

Our practice has seven APPs who provide important insight and knowledge to the process as we update our APP program. However, having one physician champion as the leader has helped ensure our progress is tracked and improvements are implemented.

First Steps: Planning for Success

Establishing a Well-Considered Process

Before determining the details of what to include in your APP onboarding process, your practice needs to commit

Once you have decided developing a successful APP onboarding process is a priority for your office, and

8 endoeconomics MARCH 2020

Image: iStock.com/FatCamera

Invest in Your Team Because of their importance to GI practices, successfully onboarding APPs should be a priority.

However, many practices don’t take the time to properly onboard their APP team members. While it’s understandable that you or your colleagues may feel too busy to take the time to go over general, everyday issues like office workflow, coding and billing, culture, or scheduling with new APP hires, fighting that feeling and investing the time in your APPs up front will pay dividends down the road.

APPs who aren’t properly onboarded to your practice can potentially find themselves on a “treadmill of chaos.” They can be pulled in many different directions and operate without guidance or oversight on your practice’s culture, their role or their daily workflow. I’ve seen this hinder practices when people are thrown into roles and expected to run a race on their own. Then when they burn out, the practice has to go through the often expensive process of finding and onboarding a new hire all over again.

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you’ve identified the stakeholders who will help form the process, the next natural question is: What does a successful process look like?

When answering this question, we take a three-pronged approach. A successful onboarding process needs to address: (1) the clinical role and responsibilities of APPs in your practice, (2) coding and billing, and (3) the culture of your practice.

1. C linical. It is important that APPs understand the fundamentals of a GI consult, as opposed to a history and physical. The consult is like a targeted interview, and a quality consult lays a strong foundation for future patient interactions.

Beyond the consult, there are a number of questions you should address with new APPs that will differ depending on how your office operates. For example: How does an APP’s day flow? Do you use block scheduling or another system? How much time is an APP expected to spend per new patient visit and follow-up visit? What type of electronic medical record system do you use? Are they properly trained in this system? Of course, this list of questions goes on, and your team or committee will want to determine what issues to prioritize. As you learn what works best, you can hone this part of the process.

2. C oding and Billing. Coding and billing understandably trip up many new APPs, so training needs to be part of the onboarding process. APPs should spend time with your coders, particularly in their first months of work.

While more in-depth training up front will pave the way for a smoother experience, coding and billing is an ongoing task. In addition to onboarding, we bring in an

Onboarding Course This April, Dr. Vicari and Jill Olmstead, MSN, ANP-C, CCS-P, FAANP, will present “The Advanced Practice Provider Onboarding for the GI Practice,” a new course offered by the American Society for Gastrointestinal Endoscopy (ASGE) that takes an in-depth look at APP onboarding. The course will include lectures, case studies, Q&As and more, covering a wide variety of subjects including fundamentals of the GI consult, preparing the patient for endoscopy, the APP workday and building a quality team.

The course will take place April 17–18 at the ASGE ITT Center in Downers Grove, Illinois. For more information, and to register for the course, visit bit.ly/2FBgg5Q or email education@asge.org.

outside expert every year to work with the practice on new updates in coding and billing.

3. Culture. Any new employee needs to understand the culture of an organization and its mission before joining it. How you view the practice and delivery of healthcare and what you value as an organization are key concepts that need to be communicated to your new APPs. Making culture part of the employee interview can help you figure out who would be a good fit and communicate your values from the start.

When we discuss culture with our new employees, we always come back to one idea: patients first. When you put patients first, you put quality first, and that philosophy will trickle down from lead physicians and managing partners to APPs and your administrative staff.

The Spirit of Collaboration We have only scratched the surface of best practices and advice for creating a successful APP onboarding process.

In fact, I will be co-directing a 1½ day course for the American Society for Gastrointestinal Endoscopy covering this topic (see “Onboarding Course” for more information).

With so much to cover, it can feel impossible to adequately touch on every topic in your APP onboarding process. To help with the inevitable questions that APPs will have that aren’t covered by onboarding, every new APP in our office is assigned a physician teacher or mentor as a resource for their first three to six months (or longer). This is a policy that I recommend all practices use as part of (and as a complement to) the onboarding process.

Mentorship is extremely helpful in avoiding the “treadmill of chaos.” It provides accountability, but more importantly, it gives the APP a much-needed resource for questions, and helps relieve stress that would otherwise build up if the APP were left alone. However, just as with the task of creating an onboarding process, a mentorship system doesn’t work unless everyone involved embraces it.

Having a team that wants to promote success as much as your new APP JOSEPH VICARI, MD, MBA, FASGE hires want to be successful was the Managing Partner of Rockford Gastroenterology Associates, Ltd., for 13 can mean the difference years and is board-certified in Gastroenbetween discussions terology. He is a Clinical Assistant Protoward a process that fessor of Medicine at the University of withers on the vine, and Illinois College of Medicine at Rockford. creating a strong, growing He also serves as chair of the Practice system that adds enormous Operations Committee of ASGE. value to your practice.

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spotlight

{Inspirational stories}

An

incredible journey

How Ed Yakacki navigated an early colon cancer diagnosis and came out the other side with a new perspective on life.

According to the Colon Cancer Coalition, between 1998 and 2007 colorectal cancer cases have dropped steadily in adults over 50, but they have increased by more than 2% each year in younger adults. This is a startling trend, because most young adults don’t think to get screened for colon cancer. Despite no family history, Ed Yakacki was barely 30 years old when he was diagnosed with stage 4 colorectal cancer that had spread into his liver and three inches into his colon.

Meredith Jayne (MJ): How was the cancer initially detected? Were there any signs that made you go to the doctor?

Ed Yakacki (EY): I was around 29 when I went to my family doctor because I was having symptoms going to the bathroom. I would be in pain and then it would go away, so I would assume it was something I ate, but then it would come back. The doctor’s office ran a bunch of

10 endoeconomics MARCH 2020

tests, and they kept telling me I looked fine. If I had a nickel for every time I’ve heard that, I would be a millionaire. It got to the point where I was asking them for a colonoscopy, because all these tests they were doing weren’t really going anywhere.

My pain was getting worse and worse, and one day I called my father up crying because I was in so much pain. I didn’t know what to do, so my dad took me to the emergency room and the ER doctor

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there could tell by the look on my face that there was something wrong with me.

I had a sigmoidoscopy scheduled for the next day, and the doctor there told me that there were some abnormalities, but he said with my age and health, he suspected it was Crohn’s Disease. I went home, and I was still having discomfort, so I got an ultrasound done. A week later I went back, and when I went in the room the doctor was crying. He said, “It’s worse than we thought. It’s cancer.”

After he said cancer, I didn’t hear a word after that. I just really couldn’t believe it because I was only 30 years old.

MJ: How did you feel when you first received the diagnosis?

EY: I thought my life was over, really. I kept thinking, “I’m only 30 years old, I haven’t even lived my life yet.” I tried to process it, but I didn’t know what to think.

MJ: Tell me a little bit about your treatment process.

EY: I went to the oncologist and they mapped out a treatment plan. In their minds, there was a clear path to how we would handle the cancer. But one thing I’ve learned from all of this is that you need to learn how to handle the psychological part of it, not just the physical part. I’ve been diagnosed with three different types of cancer, and it’s taken up about 10 years of my life; it’s not a job where you clock in, work your eight hours, clock out and go home … this is a 24-hour job, seven days a week. I felt alone, I was scared, I often asked, “Why me?” I didn’t think that I deserved the diagnosis that I got. I struggled with that immensely.

MJ: What did you do to meet and overcome the challenges of your treatment?

EY: The turning point for me was getting involved in one of these colon cancer walks. Before I went to one

of these events, I was very isolated, and I was an emotional wreck.

Then I went to this walk through the Colorectal Cancer Alliance. When I got there, I saw that a lot of the teams were walking or running in honor of someone they lost from the disease, and that really struck a chord with me. It completely changed my life, because here I was kicking stones down a road, and there are people out there who have lost their lives to this. I decided to do something to help.

At that point, I got involved everywhere that I could. I did the next walk, Get Your Rear in Gear, Philadelphia, and raised around $4,500 for them. It gave me a purpose that I was missing in my life at that time.

Why did I survive this? It cost me badly, but I decided that I should be taking my bad circumstances and trying to educate people.

MJ: What has this experience taught you?

EY: It’s really made me grow up and look at life differently.

I wasn’t really in control of my life, and I thought I was.

I learned that. I learned compassion. I learned humility.

I’ve learned to try to help others and to pay it forward.

I try to be there for other people with a new diagnosis, because when I see somebody suffering I see that look on their face, and I see myself in their shoes. The key to beating this is patience; listening to the people that are in charge of whatever your treatment strategy is; and keeping the faith that tough times don’t last, but tough people do. Today might be a bad day, but there are good times within the day.

MJ: Can you describe how sharing your story with others has affected your journey with cancer?

EY: When I’m talking about my story … it’s like going to confession for me. It’s a cleansing of the soul and a way to make sense of my journey. Helping other people helps me.

After Get Your Rear in Gear, I went to Washington, D.C.,

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spotlight

{Inspirational stories}

and spoke there. An online group for colon cancer invited me to speak for the Colon Cancer Alliance, so I went down there and spoke to probably 400 people, and I told them my story; the good, the bad and the ugly. I started getting more involved, and I went and spoke all over the country. That’s what helped me get to the point I’m at.

WHY DID I SURVIVE THIS? IT COST ME BADLY, BUT I DECIDED THAT I SHOULD BE TAKING MY BAD CIRCUMSTANCES AND TRYING TO EDUCATE PEOPLE.

MJ: What would you tell someone who just got their cancer diagnosis today?

EY: The first thing I would say is that it’s definitely not a death sentence; it is manageable and you just have to think about what you’re fighting for. You have to advocate for yourself.

I would also tell them that creating small goals is so important. This last time, on my birthday, I found out in the morning that my wife was pregnant with our first child. That afternoon, I was told that I had cancer for the third time. An aggressive bone cancer called Ewing’s Sarcoma. All I knew was that I wanted to meet my son. My wife would say, “I don’t want you talking like that.” But I told her, “Listen, this isn’t my long-term goal—it’s just a goal.” Small goals are what keep you going.

MJ: What would you want other men and women of screening age, who are hesitant to get a colonoscopy, to know?

EY: I’d tell them that yes, there are small hurdles involved with getting a colonoscopy, but if you want to be with your loved ones, this test is something that could be instrumental in extending your life. Most of the time with colon cancer, by the time you’re having symptoms, it’s a good indicator that it’s an advanced stage of the disease; it’s a silent killer.

I always tell people, “You don’t want to end up like me. You don’t want to end up having these surgeries and treatments. You want to make sure you’re healthy. The prep is the worst part of it. After that, you get put to sleep, you wake up and you don’t even know it happened. It’s important to take it seriously—I went down a rough road and I don’t want to see anybody else go down this road.”

These days, Ed is two years cancer free, and will be marking three years in April 2020. He has a 2½-year-old son, and a 9-month old daughter. He worries about the fact that the grass needs to be cut, and that his kids have a doctor appointment in the afternoon. “I’m just thankful to be on this side of it … it’s weird to be normal again,” he

12 endoeconomics MARCH 2020

says. “I’m trying to mold my kids into good people and teach them the value of everything that I’ve been through.”

Ed is a three-time cancer survivor. He’s had both hips replaced, three blood clots in the lungs, seven blood transfusions, 23 surgeries, 32 rounds of chemo, 61 radiation treatments, and is one hell of a fighter.

“I’m a grinder,” Yakacki MEREDITH JAYNE is the Marketing says simply. “It’s been Manager at Physicians Endoscopy a crazy journey, but it’s (PE). She can be reached at mjayne@ molded me into who endocenters.com.

I am today.”

insights

{Human resources and personnel issues}

Beating burnout 7 steps for preventing and managing physician burnout.

By Suzette Sison

14 endoeconomics MARCH 2020

cians practicing in more than 29 specialties about their degree of burnout, how they cope with it and if they had thoughts of suicide. Feelings of burnout were reported by 44% of respondents.

The Toll of Burnout Left unaddressed, physician burnout can result in poor clinical care, increased mistakes, patient dissatisfaction, and dysfunctional interactions with patients, nurses, and other physicians. Physician burnout can even lead to doctors leaving

Image: iStock.com/xavierarnau

Many physicians under pressure to provide better outcomes faster and at lower costs, are getting burned out. Physician burnout is a significant health problem because it affects quality of care, results in high turnover rates and reduces productivity. More importantly, burnout can also destroy lives and increase the risk of suicide.

Unfortunately, physician burnout is widespread. In the Medscape National Physician Burnout, Depression & Suicide Report 2019, researchers surveyed 15,069 physi-

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the profession. For 1 in 10 of the Medscape respondents, they said their burnout was so severe that they were considering quitting medicine.

Burnout is expensive too. A June 2019 study published in the Annals of Internal Medicine found that physician burnout costs approximately $4.6 billion each year due to physician turnover and reduced clinical hours. This works out to about $7,600 per employed physician each year.

Perhaps worst of all, burnout can lead to depression and even suicide. Physicians in the United States have the highest suicide rate of any profession. In fact, the suicide rate among doctors is more than double that of the general population. Of the Medscape respondents, 14% said they have had thoughts of suicide but not attempted it; 1% said they have attempted suicide. Clearly, preventing and managing physician burnout is of the utmost importance.

Burnout is devastating and costly, but fortunately it is not an inevitable part of being a doctor. These are seven steps physicians can take to recognize, prevent and manage burnout before it ruins their careers.

1

Recognize the Symptoms of Burnout

Physician burnout can cause physical, emotional, and behavioral signs and symptoms. Recognizing these signs and symptoms in oneself or in others can prompt an individual or organization to address burnout. Physical signs of burnout include feeling tired often, fatigue, frequent headaches, back or muscle pain, change in sleep habits or loss of libido.

In addition to the physical effects of burnout, it impacts mental and emotional health as well. Emotional signs and symptoms of burnout to look for include self doubt or feelings of failure, detachment, loss of motivation, loneliness, increasing negative outlook, decreased job satisfaction or loss of interest in favored activities.

Finally, burnout symptoms can also involve the physician’s everyday behavior, including avoiding responsibilities, isolation, procrastination, use of food, drugs

or alcohol as coping mechanisms, cynical or negative attitude, out-of-character aggression in driving or family, friend and co-worker interactions, and coming in to work late, leaving early or skipping work altogether.

2

Evaluate the Level of Burnout

The Maslach Burnout Inventory™ is a standardized assessment of physician burnout, in use since the 1970s. It uses three scales to evaluate physician burnout: > Emotional exhaustion – Feeling drained at the end of the day and being unable to recover after time off; energy levels spiral downward. > Depersonalization – Also known as compassion fatigue, depersonalization is characterized by a negative, callous, uncaring or detached attitude. > Personal accomplishment – Measures feelings about the success and accomplishments of one’s work.

These scales offer a good starting point for assessing your own burnout. Many issues like burnout don’t present themselves obviously when you’re experiencing them, and the Maslach Inventory can help you make a more objective analysis of your own burnout.

3

Address the Cause of Burnout

Several factors contribute to physician burnout. The Agency for Healthcare Research and Quality (AHRQ) lists five causes of burnout: > Time pressure > Chaotic environment > Low control over pace > Electronic health records > Family responsibilities

4

Shorten Hours or Change Work Settings

The Medscape survey asked what physicians did to alleviate burnout. Reducing work hours was the option for 31% of respondents, and 24% said they changed work settings. About 1 in 5 said they made changes to office workflow or staffing.

15 endoeconomics MARCH 2020

insights

{Human resources and personnel issues}

The Risk Is Real

> Half of all female

physicians expressed burnout, while 39% of male doctors said they felt burned out.

> 48%–52% of

doctors working in neurology, physical medicine and rehabilitation, emergency medicine, and family medicine also reported burnout.

> Physicians

practicing in urology were most at risk for burnout, with 54% of respondents reporting symptoms.

Reducing work hours can leave physicians more time to spend with their families or engage in favorite activities. A change in work settings, such as switching from working as a clinician in an office to teaching or research, can provide a new outlook.

5

Practice Mindfulness

Research suggests that mindfulness may be helpful in reducing physician burnout. In one study, PCPs who underwent a short training in mindfulness enjoyed significant reductions in burnout, depression, stress and anxiety. The benefits continued throughout the nine-month trial.

6

Reduce Paperwork

The Medscape survey asked physicians about the factors that contribute most to burnout. An overwhelming 59% named bureaucratic tasks, such as paperwork, as the main source of their burnout.

Spending too many hours working and increasing computerization/EHRs came in second and third at 34% and 32%, respec-

16 endoeconomics MARCH 2020

> Gastroenter-

ologists were the 10th most burned out.

> Plastic surgeons and physicians practicing in public health and preventative medicine were the happiest at work, as were those in ophthalmology, dermatology, pathology and pediatrics.

tively. One family physician said, “All that paperwork sucks all of the enjoyment out of being a doctor.�

7

Consider a Partnership with a Management Company

Most physicians get into medicine because they want to help people, not because they want to spend their time worrying about billing or payer contracting. A management company can take over office and management tasks, which gives physicians more time to practice medicine and provide the best patient care possible. A management company can also provide more hints and tips for preventing and addressing physician burnout.

Recognizing the signs of physician burnout and addressing its underlying causes can help more SUZETTE SISON is the Senior Director physicians find satisfaction of Marketing at Physicians Endoscopy in their work, stay at their (PE). She can be reached at ssison@ jobs longer, and provide endocenters.com. exceptional care.

Image: iStock.com/gpointstudio

The first step to addressing physician burnout is acknowledging the risk.

The Medscape National Physician Burnout, Depression & Suicide Report 2019 evaluated over 15,000 physicians regarding the topic of burnout, and it found that the risk is high in many physician specialties. The report found:

insights

{Clinical updates}

Electronic engagement

By Brandon Daniell

Communication with patients is directly linked to However, these options are time-consuming, expensive top-line revenue growth at GI practices and surgery and often ineffective. Time spent making multiple centers. Consider how an answer of “no” to any of the calls, leaving a voicemail or printing and mailing a following questions would impact revenue: Did the letter is time staff could have spent doing something patient show up for a scheduled appointelse. Letters, in particular, are sent with ment or procedure? Did the patient notify the hope that patients receive and then about their intent to cancel far enough in actually open, read and respond to them. advance to permit scheduling of another While some organizations have turned to patient? If the patient showed up for an email to help with engagement, it also has appointment as scheduled, did they comply its shortcomings. One study shows that with prep instructions? Now, consider how the average U.S. worker’s inbox has nearly revenue would be increasingly impacted as 200 unread or unopened emails at any more patients come up short concerning given time.1 THE AVERAGE U.S. these questions.

WORKER’S INBOX For decades, phone calls and letters Making the Case for Two-Way Texting HAS NEARLY have served as the major form of Fortunately, as a growing number of communication in the GI space. If patient providers are discovering, there is a means engagement levels were less than desired, of communication that addresses many OR UNOPENED EMAILS AT the solution has typically been to make of the shortcomings associated with more ANY GIVEN TIME. more phone calls and send more letters. traditional forms. Texting—and more

200 UNREAD

18 endoeconomics MARCH 2020

Image: iStock.com/Iamstocker, masterzphotois

GI centers should leverage technology to improve patient recall.

endocenters.com

specifically two-way, HIPAA-compliant texting— Tactical Texting presents a communication What makes text messaging such an to provide their mobile number and opportunity for GI practices effective communication platform for know how to open, read and, if necesand surgery centers to GI? Consider the following: sary, respond to the texts they receive. bolster their patient communication efforts and >T he majority of patients have mobile > Many adults prefer to receive and bottom line in the process. phones2 and use texting in their daily send a text instead of receiving or Two-way texting enables lives. American adults opt in to receive making a phone call.4 information to be pushed text messages from airlines, dentists, > Research indicates that 95% of text to and pulled from hair salons, credit card companies and messages are read within three minpatients, caregivers and many other businesses. By embracing utes of being sent5 and 98% of all text healthcare facility staff. It two-way texting, GI practices and surmessages sent in the United States is a proven method for not gery centers are leveraging a channel are read.6 only engaging patients, already adopted and embraced by a > Given that nearly all mobile phones but also enhancing majority of their patients.3 have access to the internet, texting is an outcomes, improving > Two-way texting does not require easy way to notify, educate and provide staff productivity and any special hardware, just existing support to patients. If a link is included strengthening workflow. computers in the facility and patients’ in the text message, it is an easy way to Looking back at the mobile phones. steer patients to directions to a facility, questions we posed > T

wo-way texting requires no behavior instructions, educational resources, concerning top-line change from patients.

They simply need frequently asked questions and more. revenue in the GI space, texting has been demonstrated to reduce cancellations and no-shows, increase the likelihood of effective pre-procedure filling an open slot in the schedule and increase the recall texting, we’ve seen canof patients for screenings. cellations in the last 24–48 hours decline by as much A Crisp Reception as 5%, with an average of Since 2017, some Physicians Endoscopy (PE) facilities have about 1%–2%. Net, this can BRANDON DANIELL is President and used two-way texting as a patient communication tool. contribute to higher room Co-Founder of Dialog Health. He has Patients seen at these facilities have been very receptive utilization, center revenue more than 15 years of business and program development experience in to receiving text communications. As of January 2020, and profitability.” healthcare; working with some of the nearly 80% of these patients have provided a mobile Two-way texting is a leading employers, physicians, payors, number and were being reached via text messages, says communication resource and hospital systems including GTE TJ Berdzik, CFA, Senior Financial Analyst and Manager of that can be an immediate (now Verizon), BCBS of TN, and Hospital Financial Analytics at PE. asset to any GI facility. By Corporation of America.

“From a volume standpoint, the benefits from such embracing the convenience, effective pre-procedure communication are twofold,” speed and ubiquity of twoBerdzik says. “First, patients sometimes forget their way texting, GI practices appointments. If a nudge via text reminds a patient to and surgery centers can increase patient engagement, show up, the center has avoided a no-show cancellation. which is a benefit to patients, staff, gastroenterologists The second benefit is in cancellation timing. If a patient and the healthcare system as a whole. would have canceled anyway due to a conflict, an early nudge, such as one sent several days before their appointREFERENCES ment, may motivate the patient to cancel.” www.theladders.com/career-advice/average-inbox-199-unread-emails By using texting to improve earlier cancellation timwww.pewresearch.org/internet/fact-sheet/mobile/ ing, there is an opportunity to backfill the now vacant www.dialoghealth.com/post/dispelling-a-myth-age-is-a-barrier-to-texting appointment slot with a new patient. In PE’s experience, www.chicagotribune.com/business/ct-americans-texting-00327-biz-20150326-story.html Berdzik adds, “We found that the data indicates both www.forbes.com/sites/marketshare/2013/03/04/pulling-back-the-curtain-on-text-message-mobile-marketing/#d0d221a10d9b lower last-minute cancellations as well as an increase mobilemarketingwatch.com/sms-marketing-wallops-email-with-98-open-rate-and-only-1in earlier cancellations. Overall, through the use of spam-43866 1

2

3

4

5

6

19 endoeconomics MARCH 2020

insights

{Marketing strategies and tips}

Social Media

101 Basic social media tips for GI practices and centers.

Image: iStock.com/Opla, Supersmario

By Deven Stopa

20 endoeconomics MARCH 2020

endocenters.com

Facebook, Twitter, Instagram and other social media are changing the way consumers find products and services, including medical care. The days when doctors were the sole gatekeepers of medical information are gone—about half of all Americans look for health information online before seeing a physician. This may be especially true for those with gastroenterology problems, as many people feel embarrassment when discussing digestive issues.

The Power of Social Research shows that about 80% of physicians are now online and use social media for personal interactions, research and professional communications. About 90% of those online are social media consumers, which means they use Facebook and other social media sites to find information. Another 9% engage with others by commenting on posts and participating in community discussions.

Only about 1% of online docs are content producers who create blogs, forms and other original content.1 While most physicians and patients are online, the statistics suggest practitioners are not quite sure how to reach out and connect with patients. In many cases, they leave it up to administrators to post content on social media. A growing number of practitioners may be interested in taking control of their social media presence but are not sure how.

Fortunately, it is easier than ever for gastroenterologists and clinics to promote their services and attract new clients on social media. Although posting on social media can be tricky, especially for medical professionals who spend more time with patients than on the internet, developing a presence on social media is not as difficult as it seems.

Be Prepared Before you start developing content for your site, consider what your content is targeting and where you want to send people who are interested in your content. You should: > Develop a keyword list. Google and other search engines use keywords to help people find the information they are looking for. Internet users type keywords and keyword phrases into the search bar, and the search engines look for web pages that closely match those keywords. Don’t forget to add in locally-based keywords that help patients in your community find you.

For example, patients in Georgia may type in “Atlanta gastroenterologist,” or “stomach doctor in Atlanta.” > Link the post to your website. When you make posts live, be sure to provide a link to your website at the end of each one. Link short posts to longer blogs, for example, or link social media posts to the contact page.

Practice/practitioner information. Some of the posts should focus on the practice, the gastroenterologists and the staff. These posts can highlight health fairs or PRO TIP: events in which the practice USE LOCALLY-BASED or staff participates, awards, KEYWORDS THAT DRAW continuing education ATTENTION TO YOUR achievements, facility PRACTICE. upgrades, holiday hours or general news.

GI diseases and disorders. Social media posts can discuss general information about GI diseases and disorders. Most of these posts can cover the common digestive problems PRO TIP: USE EASY-TOpatients may encounter, UNDERSTAND WORDS WHEN such as colorectal cancer, DESCRIBING COMPLEX Crohn’s disease, celiac MEDICAL CONCEPTS. disease, gastroenteritis, gastroesophageal reflux disease, and appendicitis.

A few posts should discuss rarer conditions, such as achalasia, a cyclic vomiting syndrome. Posts can describe common symptoms, little-known symptoms, diagnosis, and treatment. Discuss any risk factors, such as gender or ethnicity, which readers may not know about.

Gastroenterology procedures and treatments. Some posts can cover information about gastroenterology procedures and treatments, such as colonoscopies, and the use of PRO TIP: various medications, to help ADDRESS ANY CONCERNS patients know what to expect.

OR QUESTIONS THAT A Centers that offer an easPATIENT MIGHT BE TOO ier, more desirable prep for EMBARRASSED TO ASK colonoscopies can promote ABOUT DURING AN OFFICE VISIT. their services in these posts to draw in more patients.

Interesting information about the digestive system.

People love learning interesting health facts, and they love sharing that information to social PRO TIP: ENCOURAGE media. For example, create READERS TO SHARE THESE posts that describe the POSTS ON THEIR SOCIAL immense surface area of MEDIA ACCOUNTS. the small intestine, or the similarities between the enzymes in laundry soap and enzymes in the digestive tract.

What to Post There are myriad interesting topics for GI practices to post about. Here are some ideas for your next potential post:

New research. Technology and research change the face of medicine nearly every day. Patients love to learn about

21 endoeconomics MARCH 2020

insights

{Marketing strategies and tips}

new medical research, particularly as it relates to conditions that they may have or that a family member may have. Gastroenterologists can present themselves as “thought leaders” by discussing new research on social media.

PRO TIP: KEEP THE RESEARCH INFORMATION SIMPLE. WRAP UP THE SOCIAL MEDIA POST WITH AN ACTIONABLE STATEMENT, SUCH AS “FOR MORE INFORMATION, CONTACT OUR GASTROENTEROLOGIST.”

Hot topics. Talk about current hot topics, such as the microbiome of the gut, “detox,” colon cancer awareness, and fecal microbiota transplantation.

PRO TIP: PROVIDE READERS WITH HELPFUL, SCIENCEBASED FACTS, ALONG WITH LINKS TO RESOURCES.

FAQs. Talking about digestive difficulties can be embarrassing for many patients, so many are reluctant to have face-to-face conversations about their digestive PRO TIP: KEEP QUESTIONS troubles – even with their AND ANSWERS SHORT AND gastroenterologists. Posting TO THE POINT. frequently asked questions (FAQs) and their answers can help shy patients find the answers they need from the privacy of their own homes. Information presented in question-and-answer formats is also attractive to Alexa, Google Assistant, Siri, and other voice assistants, which work by finding snippets of information that best answer users’ spoken questions.

Take polls. Create surveys and polls to determine how often patients undergo screening and to learn why some are afraid of PRO TIP: REASSURE PATIENTS THAT THEIR screening. These polls SURVEY ANSWERS also tell patients that their ARE CONFIDENTIAL. opinions and perspectives are important.

The Social Stats 69% of adults in the U.S. use Facebook, according

to Pew Research Center, and about 74 Facebook users visit the site each day.2

73% of American adults watch videos on YouTube, and 37% use Instagram.3 Google receives more than 1

questions every day.

billion health

4

media pre-scheduling tool, crunched the numbers from 10 data-driven studies. Their research suggests posting to Facebook once a day, “tweeting” 15 times on Twitter daily, and uploading one LinkedIn post daily.

Schedule posts to reflect gastroenterology health observances. National health observances help raise awareness about important health topics. The month PRO TIP: WRITE THESE of March is Colorectal SOCIAL MEDIA POSTS IN Cancer Awareness Month, ADVANCE. for example, and April is both IBS Awareness Month and Esophageal Cancer Awareness Month. Clinics and clinicians can use the observances to promote screenings.

Posting on social media is getting easier—and more powerful—every day. Gastroenterologists and gastroenterology clinics can develop a social media presence quickly, present themselves as leaders in the medical industry, and reach more patients with just a few social media posts.

When to Post Once you have the content created, it’s time to put it to work. Create a plan for posting your content with these guidelines in mind: Frequency. There is considerable debate in the marketing industry when it comes to the frequency of social media posts. Co-schedule, a social

22 endoeconomics MARCH 2020

PRO TIP: LEARN HOW TO SCHEDULE POSTS TO MAINTAIN A HIGH PROFILE WHILE KEEPING POSTING TIME TO A MINIMUM.

REFERENCES www.pm360online.com/examining-physician-use-of-social-media-in-2017

1

www.pewresearch.org/fact-tank/2019/04/10/ share-of-u-s-adults-using-social-mediaincluding-facebook-is-mostly-unchangedsince-2018

2

3

Ibid.

4 www.beckershospitalreview.com/ healthcare-information-technology/google-receives-more-than-1-billion-healthquestions-every-day.html

DEVEN STOPA is Director of Digital Marketing at Physicians Endoscopy (PE). She can be reached at dstopa@ endocenters.com.

Experience World Class Hospital JVs Strategic planning is at the forefront for many hospitals with an emphasis on improving quality and lowering costs. The movement of hospitals toward licensed ambulatory surgery centers has accelerated based on a shift to value-based care, population health, and transparency.

Combining Physician Endoscopy’s expertise with a progressive hospital will ensure the most successful joint venture!

Let’s Work Together to Develop World Class: Patient Care ● ∙ Physician Engagement ● ∙ Market Position

(866) 240-9496 www.endocenters.com

endo opportunities

West Mesa, AZ Central Arizona Medical Associates Seeking a full-time gastroenterologist. Physician can expect to step into a busy practice while replacing a retiring partner. Anticipate a short track to practice partnership and ASC ownership. Practice operates out of a single office and covers one hospital. Outpatient endoscopy performed at a physician-owned, two-room ASC. Enjoy sunshine and a great lifestyle in the metro Phoenix area.

Scottsdale, AZ Digestive Health Specialists Arizona Full-time gastroenterologist with partnership potential needed for small practice of four MDs, NP and PA. Outpatient-based with low inpatient volume and only one hospital round. No ERCP or EUS training needed. Physician office includes an infusion center, pathology lab and state-of-the-art endoscopy center, all within the same building.

Bellingham, WA

Northern & Central, CA SecureMD Board-certified gastroenterologists needed for mobile endoscopy practice in Northern CA (Sacramento/Stockton/Tracy) and Central CA (Fresno/Tulare/San Luis Obispo). Flexible schedules allow you to work as many as 2–3 days per week or as few as 1–2 days per month.

Midwest Bloomington-Normal, IL Digestive Disease Consultants Reputable single-specialty practice for more than 30 years seeks physician. Multiple revenue sources including endoscopy center, strong support from local hospital and guaranteed salary for two years. Low turnover and high retention rate.

NW Gastroenterology & Endoscopy Physician needed to join a nine-person single-specialty practice.

Freestanding AEC and pathology lab, EUS optional, ERCP optional.

Outstanding benefits package offered. Progressive coastal community offers ocean and lake recreation, skiing, and miles of hiking and biking trails. Small college town atmosphere with proximity to Seattle and Vancouver, Canada, and a great place to raise a family.

24 endoeconomics MARCH 2020

Portage, MI Bronson Gastroenterology Practice Seeking a BC/BE gastroenterologist to join a well-established and respected group of outpatient and hospitalist gastroenterologists, and mid-levels. Employed position includes competitive salary, paid malpractice and full benefits. Kalamazoo, located midway between

Submit your CV online at endocenters.com/recruiting.

Detroit and Chicago, offers highly rated public schools, affordable real estate, and many activities for the whole family. Lake Michigan is less than an hour’s drive away.

Compensation package includes an option for partnership in practice and ownership in affiliated Ambulatory Surgery Center.

North Bergen, NJ Rochester, MI Troy Gastroenterology

Advanced Center for Endoscopy

Two gastroenterologists skilled in general endoscopy and ERCP needed for private practice with two state-of-the-art, AAAHCaccredited ASCs. Competitive base salary with productivity incentive, retirement plan, discretionary allowance, insurance, and eligibility for member status after two years.

GI physician needed to join a single-specialty, nine-physician GI center. The center can help the physician drive patient volume through the ASC, allowing the physician to increase procedure volume in an environment that is more convenient. Ideally located in North Bergen, the “gold coast” of Northern New Jersey, with a spectacular view of the NYC skyline.

Lima, OH

Lumberton, NJ

Gastro-Intestinal Associates, Inc. BE/BC gastroenterologist needed for six-physician, four-CNP single-specialty practice. Practice is physician-owned and includes an 18,000-square-foot combined office and three-room endoscopy center. Opportunity offers 1:7 call rotation, first-year salary guarantee and outstanding earning potential.

Northeast

Gastroenterology Consultants of South Jersey Seeking full- or part-time gastroenterologist to join a privately owned, seven-physician practice. Well-established practice of 25 years, located among several growing communities in Southern New Jersey.

We offer a 1:7 call schedule and an opportunity to perform ERCP/EUS (not required). Affiliated with Burlington County Endoscopy Center, a three-room ASC that is physician-owned and operated.

Central, NJ Garden State Digestive Disease Specialists, LLC

Stoneham, MA Digestive Health Associates, PC Seeking full-time gastroenterologist to join well-established, sevenphysician, single specialty practice group with an ASC in the Boston area. 1:9 call schedule. Competitive salary and benefits. Full partner track at two years.

Seeking full-time BC/BE gastroenterologist to join threephysician practice. The job offers an excellent salary, competitive benefits package, reasonable call schedule (which includes other gastroenterology colleagues in the rotation), and an opportunity for full partnership track in 2–3 years. EUS/ERCP training preferred.

Hillsborough, NJ Hagerstown, MD Gastroenterology Associates Immediate opening for a gastroenterologist to join a well-established, practice. Weekend call 1:8. One-year partnership track for ownership in practice and endoscopy center. Offer includes competitive salary, attractive bonus, comprehensive benefit package and income from endoscopy center and ancillary services. Hagerstown merges the best of small-town friendliness with easy access to metropolitan areas like Washington DC and Baltimore.

New York, NY Gastroenterology on Gramercy Park Seeking a gastroenterologist to join two-physician private group.

Expect to step into a busy practice while replacing a retiring partner. Opportunity offers a primarily outpatient experience with a reasonable call burden. Candidate will have ownership opportunity in affiliated endoscopic ambulatory surgery center.

Uniondale, NY Gastroenterology Associates PC Seeking a full-time/part-time, board-certified/board-eligible GI physician to join large single-specialty gastroenterology group.

Digestive Healthcare Center PA Seeking a BE/BC gastroenterologist skilled in general endoscopy and ECRP to join busy, seven-person, single-specialty, 30-year established practice located in Central New Jersey. Excellent salary, competitive benefits package.

Jenkintown, PA Gastrointestinal Associates, Inc. Seventeen-physician practice is seeking a board-certified gastroenterologist preferably with an investment in IBD or advanced therapeutic training. Full-time position with shared clinical and administrative responsibilities. The job offers a competitive salary and benefits that include bonus potential and partnership track.

Limerick, PA Endoscopy Associates of Valley Forge Board Certified. US Gastroenterology Fellowship. ERCP- or EUStrained preferred. Full-time, rotating call dispersed evenly with three other physicians. One hospital with endo suite, hospital is within 15 minutes driving distance of center. GI center has three procedure rooms. GI practice is in the same building as the GI center. Located one hour outside of Philadelphia.

25 endoeconomics MARCH 2020

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