EndoEconomics Summer 2019 Issue

SUMMER 2019

A journal dedicated to advancing GI ASCs and practices

14 Growing stronger: PE and Capital Digestive Care 1 endoeconomics SUMMER 2019

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REACHING UNDERSERVED PATIENTS

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SUCCESSFUL HOSPITAL STRATEGY

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PLANNING EMPLOYEE EXITS

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

SUMMER 2019

11 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.

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LETTER

NOTEWORTHY

STRATEGIES

2

3

6

Reaching out

8

Game plan

Message from the President

Celebrating top docs, welcoming PE’s new VP of HR and more

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.

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

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Printed in the U.S.A. Copyright © 2019 by Physicians Endoscopy

EXCELLENCE

INSIGHTS

All rights reserved

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Community care

14

Growing stronger

18 MARKETING The right trajectory

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 express permission is prohibited.

22 HR Exit strategy

ENDO OPPORTUNITIES 24 GI physician opportunities at partnered practices

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

Cover photo: Somnuk Krobkum via GettyImages

Find out more at endocenters.com or find us on

1 endoeconomics SUMMER 2019

letter

{Message from the President}

REACHING OUR POTENTIAL Strengthening the business and improving patient access prepares us for healthy growth

David Young, President, Physicians Endoscopy

FOCUS ON THE BUSINESS OF YOUR PRACTICE AND HOW YOU CAN STRENGTHEN IT BY FOLLOWING SOME OF THE SAME PRINCIPLES THAT SUPPORTED THE DEVELOPMENT OF YOUR ASC.

2 endoeconomics SUMMER 2019

I WILL START THIS MESSAGE BY DISCUSSING A TOPIC THAT I FEEL IS OF THE UTMOST IMPORTANCE AND WILL LIKELY RECEIVE AT LEAST A MENTION IN MANY OF MY MESSAGES: PATIENT ACCESS. The ability for patients to access you and the services provided through your practice and ambulatory surgery center (ASC) is instrumental to your financial solvency.

There are many different ways patient access you. They may come to you directly after learning about your practice through research or recommendations. They may come via referral from a primary care physician (PCP) or another provider. Or they may come to you through your ASC. While much of what we discuss in this publication focuses on strengthening ASCs, what is important to understand is that such strength is tied to the relationships between practices, their ASCs and primary care. When such relationships are on solid ground, it enhances access and creates an opportunity for patients to receive cohesive, highquality care management throughout their care experience.

To establish such a foundation requires focus on a few essential areas concerning your practice. These include your reputation of clinical service and your reputation of coordination of care with PCPs. Succeed here and patients and PCPs will want you as their gastroenterologist of choice. Furthermore, overseeing a high-quality business that ensures the

most appropriate care is provided at the right time, at the right place and in the most efficient manner will be viewed favorably by payers as well.

Accomplish all this and you will be in a better position to create a practice that, with a strong ASC, has great potential for growth. Further cementing that potential may require that you examine the structure of your practice and how you can emulate what helped make your ASC successful.

Why do gastroenterologists and other physicians build ASCs together rather than on their own? ASCs require financial strength and capital. A burgeoning practice is really no different.

Many gastroenterologists practice solo or in very small groups. It is often difficult to afford associates in such arrangements.

By bringing together several gastroenterologists and understanding the group dynamic of sharing staff and costs, the practice will be in a better position to afford associates. Once brought on board, they can support the growing practice by capturing more referrals and helping the practice’s partners spend more time in their ASC, which is an enhancement to profitability.

The key takeaway: Try to focus on the business of your practice and how you can strengthen it by following some of the same principles that supported the development of your ASC. Such a mindset can improve patient access and lead to a financially stronger practice and ASC.

noteworthy

{News and events}

endocenters.com

Celebrating Our

Physicians Endoscopy (PE) congratulates more of their GI physician partners who have been named Top Doc for 2018 and/or 2019! These physicians were selected as the most outstanding healthcare providers in the field of gastroenterology from review sources such as Castle Connolly.

George Bolen (DC) Susan Stein (DC) Baaz Mishiev (FL) David Weiss (FL) Jeffrey B. Kaner (FL) John R. Hodges Jr. (GA) Mark Stern (GA) Paul Schwartz (GA) W. David Curtis (GA) Jennifer Dorfmeister (IL) Kenneth Schoenig (IL) Rajesh S. Pillai (IL) Sonia S. Godambe (IL) Wei M. Sun (IL) Eric Libby (MA) Jose Marcal (MA) Robert Muggia (MA) William Vanneman (MA) Bradley H. Bennett (MD) Richard Gelfand (MD) Alan F. Cutler (MI) Amir Damadi (MI) Phillip A. Goldmeier (MI) Ralph Pearlman (MI) Roberto Gamarra (MI) Austin Osemeka (NC) Alan R. Gingold (NJ) Amber M. Khan (NJ) Barry Zingler (NJ) Charles Accurso (NJ) Kenneth Rubin (NJ) Kunal Grover (NJ)

Marc A. Fiorillo (NJ) Mark Greaves (NJ) Mark Sapienza (NJ) Mauricio Zapiach (NJ) Michael Meininger (NJ) Mitchell Spinnell (NJ) Monica Awsare (NJ) Nader N. Youssef (NJ) Patrick G. Tempera (NJ) Rajesh Dhirmalani (NJ) Sandarsh Kancherla (NJ) Vincent Panella (NJ) Brian Putka (OH) Eric J. Shapiro (OH) John Dumot (OH) Michael K. Koehler (OH) Raymond W. Rozman, Jr. (OH) Robert Bruce Cameron (OH) Sapna Thomas (OH) Daniel Blecker (PA) Daniel J. Sher (PA) Daniel Ringold (PA) Eric B. Goosenberg (PA) Gregg Gagliardi (PA) Harvey Guttmann (PA) J. Matthew Bohning (PA) John F. Altomare (PA) Joseph M. Bruno (PA) Kenneth Breslin (PA) Louis La Luna (PA) James Weber (TX) Timothy Ritter (TX) Chetan Pai (VA) Dong Lee (VA) Frank DeTrane (VA) Eric Yap (WA) Georgia Rees-Lui (WA) Kalle Kang (WA) Raj C. Butani (WA) Note: Care has been taken in collecting this information. If any errors or omissions are found, kindly email info@endocenters.com with details.

Every reasonable effort is made to present accurate information.

It’s a Shore Thing — PE Opens New ASC in Maryland Physicians Endoscopy (PE), in partnership with Peninsula Regional Medical Center (PRMC) in Salisbury, Maryland, recently opened a new GI ambulatory surgery center (ASC) located in Berlin, Maryland, only minutes away from the shore point of Ocean City. Delmarva Endoscopy Center (DEC) received successful licensure in July 2019.

This two-room, state-of-the-art facility is conveniently located to accommodate patients from the Delaware, Maryland and Virginia areas. The center is situated on PRMC’s new medical campus that includes other patient services and facilities. DEC is PE’s first de novo ASC in the state and third partnered ASC in Maryland.

EndoEconomics Recognized Winners of the 36th Annual Healthcare Advertising Awards were recently announced, and Physicians Endoscopy is proud to say that EndoEconomics received a Merit award in the category of Physician Referral publications.

This year’s competition received over 4,000 entries and was judged by a panel of experts who reviewed the creativity, quality, message effectiveness, consumer appeal, graphic design and overall impact of the entries. This is the first year that EndoEconomics has received this type of recognition.

Find past issues of EndoEconomics, including the awardwinning Summer 2018 issue, at endocenters.com.

3 endoeconomics SUMMER 2019

noteworthy

{News and events}

Welcoming a New PE Partner in North Ridgeville, Ohio Physicians Endoscopy (PE), in partnership with University Hospitals Cleveland (UH), received successful licensure on May 2 for a newly developed center in North Ridgeville, Ohio. UH North Ridgeville Endoscopy Center, LLC, is a state-of-the-art, four-room center. UH made the strategic decision to transition their current hospital GI outpatient department and relicense the facility as an ambulatory EE ORegan Ad half page_print.pdf 1 5/24/2019 12:38:15 PM

surgery center (ASC). After months of modifications, construction, and redeployment of equipment and staff, the new center started seeing patients in May and received accreditation by Joint Commission and CMS in early June.

UHNR is PE’s fourth ASC partnership with UH, and plans are to continue a market approach in identifying additional opportunities.

Send us your community stories. Email us at info@endocenters.com

PE-Partnered Center Named Best of the Tristate

PE Welcomes Renae Gary, Vice President, Human Resources

Endoscopy Center at Robinwood in Hagerstown, Maryland, was recently recognized as the Best Outpatient Surgery Center by Verstandig Media’s Best of the Tristate 2019 awards. Physicians Endoscopy congratulates the physicians and the entire team who consistently provide exceptional care and services to their patients and community!

Renae Gary, VP of HR, joined the Physicians Endoscopy (PE) family on May 13. As the organization reaches an inflection point and places more focus on growth, having an HR team to support evolving needs is increasingly important. Renae comes to PE with close to 20 years of experience in multiple industries, including clinical research and insurance. Throughout Renae’s career, she has led organizational change by strengthening the people programs and transforming organizations into profitable, customer-focused global entities.

When asked what she loves about HR, Renae responded: “About a third of our life is spent at work, which speaks to the impact a job can have on a person’s quality of life. So why I love HR is pretty simple ... providing employees opportunities, such as career development and growth and access to quality, affordable health benefits, is not only rewarding, but also provides the opportunity to create and influence the experience that people have when they come to their second homes.”

Renae is excited to be a part of the PE family and looks forward to supporting the company by taking on the future and the opportunities ahead.

strategies

{Business strategy and the bottom line}

Reaching out Providing CRC education, screenings to medically underserved patients.

By Anezi Bakken, MD As all gastroenterologists know, colorectal cancer (CRC) is a leading cause of cancer death in the U.S., and the incidence of CRC is rising in patients under the age of 50. At the same time, participation in CRC screening remains suboptimal, especially among underserved patients. A substantial number of these individuals are uninsured or have access only to Medicaid. Ethnic minorities, including Hispanics, African Americans, Asians and Native Americans, have lower screening rates, as do patients in rural areas, recent immigrants, and people with less education and lower socioeconomic status (SES). Their low participation rates can frequently be linked to poor access to healthcare services, geographic isolation or lack of proficiency in English.

CRC risk is 30% higher in patients with low SES compared to those in the highest SES. There is evidence that African Americans have a 20% higher incidence of CRC, and it usually occurs at a younger age than among whites. There is also a higher mortality rate associated with CRC among African Americans. Less-educated patients, poor patients and those needing public assistance are less frequently screened, are diagnosed at a later stage and are more likely to die from CRC. A recent study has shown that concerted efforts to offer education on CRC improves awareness and demonstrates the value of preventive health screenings among these traditionally underserved populations.1 A 2007 study showed that a physician-directed intervention around recommendation for colonoscopy, patient education and follow-up in a low-income, screening-eligible but non-adherent group of patients produced more than double the screening rate (from 11.5% to 27.9%) as measured after one year.2 These studies demonstrate that medically underserved populations can increase their CRC screening rates—and potentially their survival rates—with active assistance from dedicated professionals.

Gastroenterology practices can help improve screening rates by educating medically underserved individuals about the importance of testing via mail, advertising,

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radio, and at churches, public hospitals and free clinics.

GI practices and ambulatory surgery centers (ASCs) are able to identify and directly reach underserved patients because we can independently offer free services to these patients without having to go through the many layers of red tape and other such administrative hurdles at a hospital or insurance company.

Logistics Offering free screening kits through fecal occult blood tests (FOBTs) is a relatively inexpensive way of providing basic screening. For patients who have a positive test, GI practices can volunteer their services to provide free screening colonoscopies. This will require follow-up calls generated by staff.

If there is interest and/or a funding source in the community, a “lab on wheels” is a great way to take services to designated areas such as community centers and centers of worship. Patients can then receive free FIT kits. Even though the processing is not instantaneous, FIT testing is noninvasive, would reach more patients, is less expensive and more acceptable to patients. Again, follow-up is vital to report on initial FIT results and to schedule colonoscopies for patients with positive results.

Cost Considerations The funds raised from charity events during CRC awareness month and with assistance from the Colon Cancer Alliance can help to defray the cost of FOBT/FIT tests, as well as any costs associated with transporting patients to a center where their colonoscopy can be done.

We can also choose to provide no-cost services for patients who have no insurance. Our practice is providing free procedures on two Saturdays this year for patients who have no health insurance and cannot afford to pay for procedures out-of-pocket. The physicians, anesthesia providers, nurses and technicians are all volunteering their time and services free of charge, and the practice will cover the cost of all necessary drugs.

endocenters.com A 2007 study showed that a physician-directed intervention around recommendation for colonoscopy, patient education and follow-up in a low-income, screeningeligible but non-adherent group of patients produced more than double the screening

from 11.5% to 27.9%

as measured after one year.

Photo by iStock.com

OUR PRACTICE IS PROVIDING FREE PROCEDURES ON TWO SATURDAYS THIS YEAR FOR PATIENTS WHO HAVE NO HEALTH INSURANCE AND CANNOT AFFORD TO PAY FOR PROCEDURES OUT-OF-POCKET.

If other GI practices did this a few times a year, many more underserved patients would be screened and more lives saved. Many of us make other charitable contributions throughout the year; it would be very rewarding to donate one’s skills, time and resources in order to save a life.

FOOTNOTES: 1

2

hristy SM, Sutton SK, Gwede CK, Chavarria EA, Davis SN, Abdulla R, Schultz C I, Roetzheim R, Shibata D, Meade CD. Examining the Durability of Colorectal Cancer Screening Awareness and Health Beliefs Among Medically Underserved Patients: Baseline to 12 months Post-Intervention. J Cancer Educ. 2017 Nov 25. doi: 10.1007/s13187-017-1301-9. [Epub ahead of print] https://www.ncbi.nlm.nih. gov/pubmed/29177920 hankari K1, Eder M, Osborn CY, Makoul G, Clayman M, Skripkauskas S, K Diamond-Shapiro L, Makundan D, Wolf MS. Improving Colorectal Cancer Screening Among the Medically Underserved: A Pilot Study within a Federally Qualified Health Center, J Gen Intern Med. 2007 Oct; 22(10): 1410–1414. https:// www.ncbi.nlm.nih.gov/pubmed/17653808

ANEZI BAKKEN, MD, is board-certified in gastroenterology and internal medicine. In addition to her medical degree, Dr. Bakken has a master of science degree in clinical research.

She has presented papers at several national conferences. She practices at Troy Gastroenterology in Troy, Michigan.

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strategies

{Business strategy and the bottom line}

Game plan Developing a GI strategy that reduces cost and enhances value.

By Carol Stopa Over the past year, we have seen increased activity in de novo joint ventures from hospitals and health systems as they look to develop a more comprehensive GI strategy for their organizations. We are all aware that ambulatory surgery centers (ASCs) provide a lower-cost option for endoscopy procedures and hospitals are seeking this alternative environment to retain and grow their faculty and market share.

Coordinated, efficient, high-quality patient care in the most appropriate setting that achieves healthcare savings across all related services should be the goal for all healthcare organizations. While real value has not been fully realized through conventional hospital methods, a different approach will create an impact within the system.

Value can be achieved through strategic partnerships that bend the curve to improve healthcare outcomes and create real pathways to reduce the total cost of care. Forming new alliances that influence care delivery in a strategic, process-oriented and standardized approach provides building blocks to measure achieved savings over time.

Influencing Cost of Care Impactful savings in the delivery of care is a win for payers, physicians, and, most importantly, patients. The GI physician makes several related decisions once they have taken the first step in the delivery of care—where the patient’s procedure is performed. The cost differential

8 endoeconomics SUMMER 2019

is significant based on the site-of-service setting and various choices that are made in the delivery of that care.

How care is determined, where it is performed and those who are involved in these decisions play a vital role in managing cost. It requires a direct influence on those who have an immediate impact on the cost, reimbursement, and the ability to monitor and measure outcomes.

Influencers not only include the GI specialist but referral sources who should be educated in directing patients to the lowest cost of care setting or specialist.

Coordinating Healthcare Non-traditional alliances are becoming more the norm than the exception. Connecting hospitals and physicians in local markets provide realized benefits toward a more clinically and economically aligned structure. Incorporating a corporate partner into the joint venture can help balance and leverage these relationships. Together we can create new possibilities for savings across the healthcare

endocenters.com

Photo by iStock.com

From the payer’s perspective, the CIN provides the ease of working with a single organization that will provide all the care and services to their members while lowering cost and improving quality. Payers appreciate the administrative straightforwardness that accompanies working with an organization that creates both the infrastructure and provides the services.

Strategic corporate partners have many of the critical components to assist in developing and coordinating a CIN. By collectively aggregating systems, data and expertise, they can elevate market position, help protect physician independence and control the cost of patient care. Some of the key elements include:

spectrum and reset the way we influence how GI healthcare works.

Over the past several years, an increasing number of hospitals and health system leaders have looked to establish clinically integrated networks (CIN) as they develop strategies to lower the cost of care and enhance value. These CINs include a network of hospitals, physician organizations and providers within a defined market using established governance, measurements and set incentives to create a virtually integrated delivery system that will enhance patient care and reduce cost. The successful CIN not only improves access to quality care for patients but also improves physicians’ access to insights into the health of populations.

CIN participants must have aligned and coordinated incentives. Physician leadership is necessary for implementing clinical changes in their practices. And a high degree of trust must be developed with physicians for them to participate within the CIN.

>E stablishing a coordination point within the network >D efining a quality measures committee versed in national standards >C reating a set of quality measures that can be communicated back to physicians >B enchmarking across facilities >R eporting claims-based data to assess performance >L everaging technology to track quality outcomes and identify opportunities to improve patient care > Measurable improvement programs > Establishing tools that enable ongoing evaluation and education > Leveraging technology to report performances back to the providers in real-time

Focusing on Providers and Payers Hospitals should focus on key drivers that will influence the specialist’s behavior. It is essential that the GI provider feels valued. In many cases, hospitals have a variety of physician employment models on their faculty staff, from fully independent to quasi-employed to full employment models. Each model needs different incentives to achieve desirable outcomes. For example, a hospital system needs provider coverage in different geographic locations that may be undesirable or inconvenient to the doctor. Physicians want to balance their valuable time in seeing patients while keeping a keen eye on how schedule changes impact their overall income. Preventing any potential roadblocks to an aligned strategy may include: >E nhanced professional fees or bonus structures >R ecruitment assistance and practice expansion >F unding infrastructure technology and systems enhancements In broader conversations with payers in various regions of the country, more resources are being considered for managing GI diagnostics, procedures and treatments.

Emerging concepts for commercial payers include episodic

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strategies

{Business strategy and the bottom line}

payment for treating IBD and Crohn’s Disease and single-price colonoscopy. The majority of payers will begin to explore a payment model redesign that will reward providers that are able to take risk in the next two to five years. They will focus largely on creating episodic pay options.

Physicians will need to collectively position themselves for this more sophisticated payment environment and prepare for challenges to ancillary services.

DEVELOPING A STRATEGIC, COLLABORATIVE PARTNERSHIP BETWEEN HOSPITALS, HEALTH SYSTEMS, PHYSICIAN GROUPS AND A STRATEGIC PARTNER WILL HELP SUSTAIN THE INDEPENDENCE OF THE GI SPECIALIST AND THEIR SURGERY CENTERS.

Building Strategic Alignments GI physicians who have not strategically positioned their practices and surgery centers to maintain financial viability are under pressure to meet requirements imposed on them from regulatory oversight, technology infrastructure, declining reimbursement and increased costs.

They are vulnerable to outside influences.

While many are considering selling their practices or becoming hospital employed, the alternative in sustaining a successful

CAROL STOPA is Senior Vice President of Business Development and Marketing for Physicians Endoscopy. She has more than 18 years’ experience in acquisitions, de novo and hospital/system joint ventures. She can be reached at cstopa@endocenters.com.

and profitable GI practice and ASC takes a physician significant time away from clinical care. Doctors are exhausted from managing the business. They want to practice medicine, spend time with their family and enjoy time away from the headaches of administrative responsibilities. The majority of younger doctors coming out of fellowship seek hospital employment and a better work-life balance, as they have witnessed the struggles of their predecessors.

The independent GI physician needs our collective support. Developing a strategic, collaborative partnership between hospitals, health systems, physician groups and a strategic partner will help sustain the independence of the GI specialist and their surgery centers. The future of the GI specialists needs the attention of a collaborative team that includes an aligned hospital and a business partner hyper-focused on the GI specialty.

How PE Promotes Successful Strategies

Photo by iStock.com

Physicians Endoscopy (PE) is a healthcare organization dedicated to the single specialty of gastroenterology. PE develops and acquires GI surgery centers in partnership with gastroenterologists, hospitals and health systems, and has built a positive reputation and strong relationships within the GI sector over the past 20 years. More than half of our 61 centers include a hospital partner.

As a trusted advisor, PE is intimately involved in the business of the GI specialist, bringing ongoing value and expertise. Our team of over 300 employees provides all the back-end functions needed to operate highly regulated and successful surgery centers. Our relationship with the GI physician gives them a sense of stability and trust.

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{Success stories}

endocenters.com

GASTROENTEROLOGY CONSULTANTS OF SOUTH JERSEY, P.C.

care

Photo by iStock.com

CASE STUDY

excellence

Gastroenterology Consultants of South Jersey, P.C. finds success by building long-term relationships with their patients.

It’s been nearly 30 years since Dr. Jeffrey Kutscher, Dr. Maury Leonard and Dr. William Taub set out to change the way people in South Jersey experience gastroenterology. From their main office in Lumberton, the staff of Gastroenterology Consultants of South Jersey, P.C. (GCSJ) does much more than screen and treat their patients; they’ve built a true community.

“In the late 1980s, the field of GI was really evolving,” says Dr. Kutscher. “There was a lot of very new technology emerging, and the idea of doing procedures in the office seemed exciting to us.”

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excellence

{Success stories}

The three founding doctors wanted to open a practice focused solely on GI, where their patients could receive specialized treatment and develop a longstanding relationship with their doctors.

“We really wanted to be able to bond with our patients over the years and have a long-term relationship with them,” Dr. Leonard says. “In gastroenterology, sometimes you intervene for an emergent problem, but more often you’re seeing patients with problems that are long-term.”

Developing Strong Relationships Many GI-related illnesses, Dr. Leonard continues, have a mental element as well. There’s often an overlap between physical and emotional issues, and having an established relationship with your doctor is one of the best ways to ensure that’s being accounted for.

“Knowing the families and knowing more about their lives helps with diagnosis and treatment,” he says. “It’s not just an ulcer; it’s not just colitis; it’s something that impacts people, impacts their ability to go to work or school, their day-to-day lives. We want to give them the best quality of life. Here, it’s not just prescribing a pill and saying goodbye. That’s not the practice.”

Thanks to the relationships the doctors at GCSJ develop with their patients, Dr. Leonard says many of the families he sees are now second and sometimes third generation.

“We get to know them not as symptoms or problems, but as family,” he says. “They come in and it’s like, ‘Hey, I know you’re here for your ulcer, but how’s your wife?’

Where we are here in Lumberton, we see patients old and young from communities all around us, and even some from the military base. Now that it’s become busier

and computerized, we still try to find that human side of things to stay connected to people.”

Dr. Taub says one of the things he and his partners set out to create is a practice that treats patients like family.

“It comes down to treating patients the way you’d want your family treated—the way you’d want to be treated,” he says. “I think we certainly were successful at that, and we’ve continued to build upon that for the past 30 years.”

The doctors of GCSJ, Dr. Taub says, have also worked to keep themselves abreast of the latest technologies and techniques to ensure their patients are receiving the highest standard of care.

“Along with that is a commitment to hiring physicians who can add to that and bring their own expertise to the practice,” he says.

Meeting the Community’s Needs As the communities around the Lumberton practice have grown, so has the need for specialized gastroenterology.

“Although we didn’t create the practice, we were all individually chosen as people who really wanted to grow an independently owned practice in a community we believe in,” says Dr. Monica Awsare. She, along with Drs. Lee deLacy, Nidhir Sheth, Jitha Rai-Patel and Mayank Lahoti, make sure that every patient seen at GCSJ is comfortable with their doctor.

Having two female doctors on the staff, Dr. Awsare says, has proven to be an asset to the community.

“I think it certainly helps us bring in more female patients, and especially younger female patients,” she says. “Many women feel a bit more comfortable talking to another woman about sensitive issues. There are also some unique GI concerns in women, in terms of incontinence and the GI issues that can accompany pregnancy, and I think some women just prefer to be treated by a woman.”

Today, GCSJ has eight doctors, and the practice remains personal.

Gastroenterology Consultants of South Jersey, P.C. are (starting at left): Nidhir Sheth, MD; Monica Awsare, MD; William Taub, MD; Jeffrey Kutscher, MD; Maurice Leonard, MD; Mayank Lahoti, DO; Lee deLacy, MD; and Jitha Rai-Patel, MD. Find them online at gcsj.org.

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endocenters.com

“We’re giving patients the best treatment that’s available, but we’re still getting to know them and building relationships.”

And while the doctors at GCSJ work in concert with many of the area’s top general practitioners, Awsare says there’s another type of referral that’s even more important.

“A lot of what we do here is word-of-mouth,” she says.

“Patients come to me not necessarily because their family doctor said, ‘Go see her,’ but because their neighbor did.

It’s just a wonderful area to live and practice in.”

“One of the special things about our practice is we spend a lot of time with people,” Dr. Kutscher says. “All of our doctors are at the top of their field, and they’re providing the best care possible and still developing those relationships. It’s a lot nicer when you’ve gotten to know your doctor, and you can depend on them to answer your questions. Once you’re my patient, I’m the doctor you see every time.”

Personalized Service As the field of gastroenterology has evolved, GCSJ has done more than keep up with the times. In 2008, the practice opened the Burlington County Endoscopy Center, a non-hospital-based outpatient center, just minutes from the main office.

“We’re able to do almost all of our procedures there,” Dr. Kutscher says. “It’s been recognized by the American Society for Gastrointestinal Endoscopy as a quality unit— it deserved recognition, and we’re very proud of it.”

The center allows the doctors of GCSJ to provide a more personalized, reassuring experience to their patients than a traditional hospital setting.

“Going from being seen in our office to having a procedure at the center is a seamless process,” Dr. Kutscher says. “It also means that we can make our own schedules— we’re not competing with other doctors for time—so we can spend as much time with patients as they need.”

The most common issues the doctors of GCSJ see in their patients are acid reflux disease, Crohn’s Disease, ulcerative colitis, inflammatory or irritable bowel disease,

Celiac disease, and liver diseases like Hepatitis C and fatty liver.

At the Burlington County Endoscopy Center, the GCSJ doctors can perform an endoscopy to examine the upper digestive tract in order to diagnose and treat reflux issues and screen for a rare type of cancer called Barrett’s esophagus. The primary procedure they perform—and by far the most important—is colon cancer screening, Dr. Kutscher says.

“It’s still a very common disease,” he says. “About 150,000 people in the U.S. get colon cancer every year, and about 50,000 still die from it. It’s such a tragedy, because in the majority of cases, colonoscopy can prevent people from getting colon cancer.”

Colonoscopy is different from procedures like a mammogram or Pap smear, he says, because while those are screening tests, a colonoscopy is truly preventative.

“It not only tells the patient they don’t have colon cancer, but it can actually prevent it,” he says. “We look at the entire bowel, find those small polyps years before they turn into colon cancer and remove them.”

Being able to see patients in their own procedure center streamlines the process, and the added convenience, Dr. Kutscher says, makes patients more likely to keep up with their annual colon cancer screening.

“We really have room to take care of our patients without any significant delay,” he says.

The doctors of GCSJ know they’re part of an ever-evolving field, and they’ve been able to find a balance between keeping up with the latest technology and computerdriven medicine, and the personal touch.

“Gastroenterology is a technical field,” Dr. Leonard says.

“Having the center has allowed us to stay state-of-the-art.

We use all HD equipment and technologies that allow us to see better and treat better. It’s important that you stay on top of technology, but not let it overwhelm you. We’re giving patients the best treatment that’s available, but we’re still getting to know them and building relationships.”

After all, Dr. Kutscher says, Gastroenterology Consultants of South Jersey is still a small-town practice at heart.

This article is republished with permission from SJ Magazine.

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excellence

{Success stories}

Photo by Somnuk Krobkum /Getty Images

Growing stronger 14 endoeconomics SUMMER 2019

endocenters.com

Physicians Endoscopy partners with Capital Digestive Care, building a stronger future for gastroenterologists.

Through a joint venture partnership with Capital Digestive Care (CDC), Physicians Endoscopy (PE) is launching a new management services organization (MSO). CDC is the largest independent GI group in the Mid-Atlantic and Northeast and one of the largest GI groups in the country. In addition, CDC operates an MSO that provides its affiliated practices with a wide range of services, including financial management, revenue cycle management, information technology and human resources.

Under the terms of the partnership, PE will become the majority owner of CDC’s MSO, with CDC and its roughly 65 physicians maintaining a significant stake. PE will subsequently roll out the platform on a national level.

“We are excited to bring this MSO to GI practices and ambulatory surgery centers (ASCs) throughout the country,” says David Young, President of PE. “This is in response to the needs of the market. It will help position gastroenterologists for the future of healthcare and protect the independent practice of medicine. Furthermore, this model will help practices achieve the size and scale that many have needed. Finally, it is a platform that is highly aligned with physicians because it is intended to support growth for the long term.”

15 endoeconomics SUMMER 2019

excellence

{Success stories}

Understanding the Model

WHILE WE ARE While these may sound like lofty goals, BUYING 15% Young believes they are achievable OF A DOCTOR’S INCOME, because of the approach PE and CDC are WE ARE ESSENTIALLY taking to their partnership and the new ONLY TAKING MSO platform. In addition to acquiring a majority of the MSO, PE is also purchasing AS A MULTIPLE IN CASH 15% of CDC’s practice net income. Of that OFF THE TABLE. 15%, half will be rolled into equity ownership in the MSO. These figures are important when you consider the terms of other GI practice deals occurring in today’s marketplace, a doctor’s income, we are essentially only says Young. “Private equity companies taking 7.5% as a multiple in cash off the table. are buying north of 30%—all the way up Why is that important? It is not such a large to 100%—of a physician’s income. The check that will entice a doctor to retire early doctors receive a large check, but then or incentivize them to lower their productivity. you have issues concerning how to keep a Since the doctors maintain control of 85% of doctor incentivized to remain highly protheir income, they remain incentivized to be ductive when he or she just sold a large productive, grow the practice, and build value. percentage of income. Once they receive Furthermore, they are incentivized to help that check, some may choose to retire grow the MSO as they are earning income early, so now the buyer has lost the asset from it as well.” that is the doctor.”

The purchase of a smaller piece of income Further complicating matters is the keeps the practice attractive to future phypotential trickle-down effects of such large sicians. Older physicians maintain more of payments. If a practice’s physicians agree their equity to sell to younger physicians. The to sell a significant portion of their income, younger physicians can buy into the equity every current member receives the consid- in the MSO and only need to give up a small eration. But what about future physicians percentage of income. recruited to the practice?

Another important component is the way “If you are a young doctor, you will proba- in which the income is acquired, says Young. bly be strongly discouraged from joining “The corporate practice of medicine presuch a practice,” says Young. “As soon as vents us from legally owning a piece of the you join, you are immediately giving away practice. The way we acquire the income is much of your income with no considerthrough a management fee. It is effectively ation because you were not part of the like buying an ownership stake, but we original deal. Not only are many of these do not own the practice. This is important deals selling at a higher piece of income because not only does it address legal disincentivizing current doctors to mainconcerns; more importantly, we are not tain their productivity, it is a real blockage involved in the actual running of the to young doctors when they see all of the practice. The physicians maintain full older doctors receiving the value.” control and continue to make all He continues, “The only way those modclinical decisions.” els tend to perform well over time is by The MSO platform is also designed to continuously acquiring more practices to address the needs of a practice’s affiliated roll into the organization rather than grow ASC(s). Private equity deals typically through recruiting, which tends to be a lot involve the acquisition of a practice that easier and cheaper.” may have a small ASC attached to it, Young The new MSO platform helps avoid notes. “There are management and develsuch scenarios, says Young. “Our approach opment companies acquiring ASCs, but creates a strategic alignment between they will often avoid investing in or organizations. While we are buying 15% of supporting practices.”

16 endoeconomics SUMMER 2019

Photo by iStock.com

7.5%

endocenters.com

We believe this model and its vision will allow us to be strategically aligned with and effectively support the growth of independent physicians, which we view as critical for ensuring patients continue to receive the higher quality of GI care.

“There were no GI companies bringing ASCs and practices together into a vertical solution until now,” says Young. “We will have a solution that gives doctors a practice management solution and an ASC solution. There will be two MSOs delivering services to each of the different solutions provided under one business offering. That means one partner for all the needs within the GI space.”

The Right Solution for Today’s Market On top of providing gastroenterologists with cash and an investment in an MSO, the new platform offers numerous benefits to gastroenterologists. One of the most significant is removing the burden of setting up and managing the multitude of services provided by the MSO. “There are many gastroenterologists who have spent a lot of time focusing on the more significant components of their practices — their ASCs, anesthesia services, referrals — who are now realizing that their practices require greater care and attention,” says Young. “We give them a platform that meets all of their service needs.”

Small practices can take advantage of this platform if they want the headaches of managing these numerous services taken off their plates. But Young explains that for many practices, there is a more significant reason why they will want to leverage the model: the path to partnering with other practices should prove much simpler.

“Most of these 1-3 physician groups, which are the majority of today’s practices, need to come together if they want to afford the cost associated with succession

planning, specifically recruiting physicians and paying their salaries,” he says.

“But partnership efforts often struggle because practices must agree on so many back-office components, which are most of the decisions that must be made for a partnership to proceed. Our platform takes care of those components. This leaves physicians to focus on more critical partnership issues, such as how they will build their practice together and achieve greater revenue over time.”

The platform is also designed to help practices expand their revenue streams by including a pathology component. “That is something many doctors have wanted to pursue but never had an effective means of tapping into the opportunity,” Young says. “We are excited to bring this to our gastroenterologist partners. This is one more way our deal is strategically aligned for doctors of all ages as well as for real practice growth and not just acquisition growth.”

The MSO established through the joint venture partnership between PE and CDC will grow in the Mid-Atlantic region.

While tax and payer restrictions prevent this MSO from working with practices outside of that area, the platform is set up to serve gastroenterologists throughout the country.

“We can go to different states and areas of the country, establish the single tax identification needed for the MSO, and then service practices in those locations,” says Young. “We believe this model and its vision will allow us to be strategically aligned with and effectively support the growth of independent physicians, which we view as critical for ensuring patients continue to receive the highest quality of GI care.”

DAVID YOUNG is the President of Physicians Endoscopy. He can be reached at dyoung@endocenters.com.

17 endoeconomics SUMMER 2019

insights

{Marketing strategies and tips}

The right

traject

Understanding the basics of connecting with patients online.

By Jason Grey

Understanding the basics of connecting with patients online.

By Jason Grey

18 endoeconomics SUMMER 2019

endocenters.com

ory

The internet has fundamentally changed the way many people go about finding a healthcare provider. While years ago most people relied on word-ofmouth referrals from family, friends or primary care physicians, or took a chance with a provider covered by their health plan, today more and more people are looking to the web to find a provider.

A 2016 study by digital marketing agency MD Connect found that 73% of healthcare consumers will start their search for treat-

ment using a search engine. In addition, 83% of patients who end up booking an appointment perform research on the provider’s website before making that appointment, and 61% will visit at least two sites.

In the Spring 2019 issue of EndoEconomics, you can find tips for enhancing your digital presence and managing online reviews.

However, having a solid online presence— including a website with engaging content and positive online reviews—will only take you so far if you don’t leverage it for visibility. Here are some steps you can take to make sure your website is one that people find before they make a decision.

Paid Versus Organic Traffic Before you begin tailoring your website and content to be more search engine optimization (SEO) friendly, it’s important to recognize there are two main types of traffic you can receive online: organic and paid.

Whether it’s from social media sites such as Facebook, Instagram or LinkedIn, or directly through a search engine such as Google or Bing, traffic that comes to your website naturally, without any advertising involved, is called “organic.”

In contrast, paid traffic is just that: traffic that would not have arrived at your site if not for an ad that you paid for.

While it may seem like organic traffic is the way to go—it’s essentially free after all—there are advantages to paying to get more traffic to your site. No matter how good the content on your site is, if it is new, it could take months for it to be properly indexed and rise in search engine rankings. If you have local competitors who are also vying for impressions, you may not want to wait to find out where your site stacks up.

73%

of healthcare consumers will start their search for treatment using a search engine.

83%

of patients that end up booking an appointment perform research on the provider’s website before making that appointment.

61%

will visit at least two sites.

Photo by iStock.com

The Key to Keywords Whether you’re going the route of paid advertising through systems like Google Ads, or aiming for organic traffic (or, as is the case with many providers, doing both), you’ll want to create content that is SEO-friendly. This can include a number of different strategies, most of which can be

19 endoeconomics SUMMER 2019

insights

{Marketing strategies and tips}

Photo by iStock.com

One extremely important aspect of creating content that is SEO-friendly is using proper keywords.

done as you create content and prepare to post it on your website.

One extremely important aspect of this is using proper keywords. This is particularly important for Google Ads, because the system is based on keywords. Depending on your practice specialties, you may want to start with keywords like “Philadelphia colonoscopy” or “Philadelphia GI,” and you’ll want to mix and match with different versions like “Colonoscopy in Philadelphia” or “GI surgeon Philadelphia.”

When you target Google Ads to specific keywords, the company’s algorithm is actually using two factors to determine your “ad rank” and, ultimately, where your ad appears when someone searches one of your keywords.

One factor is the money spent, of course, but Google also factors in the quality of your ad, which is influenced by a number of elements including the relevance of your ad text and keyword, the quality of the page people are being sent to and how often people are clicking on your ads, among others.

content that has value on its own and speaks to your keywords.

For example, if there is a procedure or aspect of your business that is unique to you, post about it. Getting more specific can help because people with more specific searches are generally more aware of what they’re looking for and more likely to click on your site if you offer it. And don’t forget to review your keywords and content regularly. Find out what has worked, what hasn’t and make changes. Trends on the internet are always shifting, and to get the most out of your online marketing, you need to as well.

The strategies discussed here will give you a great start, but they also just scratch the surface of what you can accomplish with good content and good SEO. As you get more familiar, the more success you’ll see and the better you can stand out from your competitors.

Content Ideas

Having compelling content is key to getting people to visit your site. Here are a few types of content you might not have considered that can help make your website more engaging: >P atient stories – In particular, stories with a

strong family or community connection compel people to click. >B log posts – This can include posts from physicians, staff and even guest blog posts from other practices. >Y ouTube videos – Videos such as patient testimonials, behind-the-scenes of the office and providers discussing their passions help personalize your practice. >N ews posts – Explanations or opinions on local or national GI news, such as updated guidelines or recently released study results, provide a good opportunity to capture people’s attention.

Stay on Target To drive the most traffic to your site, focus on your keywords. In addition to identifying and using them to target ads, you should also be using them in your content.

Not only will this increase your ad rank, but it will also improve your organic traffic rankings.

Let the keywords guide the topics you cover. Use your important keywords in headlines and subheadings, as well as the permalink URL, if possible. However, be careful not to overstuff your content with one keyword—it can begin to look like spam. Ideally, you should be creating

20 endoeconomics SUMMER 2019

JASON GREY is Director of Digital at GLC, a marketing communications agency. He can be reached at jgrey@ glcdelivers.com.

Experience Experience World World Class Class Hospital Hospital JVs JVs Strategic planning is at the forefront for many hospitals with an emphasis on Strategic planning at the forefront formovement many hospitals with antoward emphasis on improving quality and is lowering costs. The of hospitals licensed improving quality and lowering costs.

The movement of hospitals toward licensed ambulatory surgery centers has accelerated based on a shift to value-based care, ambulatory surgery centers has accelerated on a shift to value-based care, population health, andbased transparency. population health, and transparency.

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

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(866) (866) 240-9496 240-9496 www.endocenters.com www.endocenters.com

insights

{Human resources and personnel issues}

Exit strategy Best practices for responding to an employee resignation.

By Renae Gary Employee turnover is a reality for any business. And, unfortunately, in healthcare it’s a much more common occurrence. As a report published by Compdata (a Salary.com company) notes, the healthcare industry had one of the highest turnover rates in 2018, only trailing the hospitality industry.

It is imperative that ambulatory surgery centers (ASCs) and practices have a process in place for properly responding to and handling an employee resignation.

Such a process must be comprehensive to ensure nothing is overlooked during the employee’s remaining time with the organization and customizable to address potential challenges and opportunities. These are some of the key areas ASCs should focus on when an employee terminates.

Replace the Employee … or Not? ASCs and practices often operate with a lean staff, which can make an employee departure stress-inducing. One may be inclined to race to get a job opening published or reach out to a recruiter.

However, before you begin an external search for a replacement, assess the opening and the responsibilities of the departing team member to determine the importance of the position for your current operations. If your organization has changed in recent years, you may find that the position is no longer necessary, or that the departing team member’s responsibilities can be assigned to other employees without overloading them. Employers should also consider future needs of the company. As organizations grow and place more focus on technology, the skill sets required for what may have once been an administrative role will likely evolve.

If the position remains essential, look internally to see if any current employee possesses the skills required to effectively fulfill the open position’s responsibilities.

Promoting an individual is an effective way to address an opening and can help build loyalty. Furthermore, doing so may also mean that you will now only need to find a replacement. This can make the transition have less of an impact on operations.

22 endoeconomics SUMMER 2019

If your facility does not have an existing team member capable of stepping up, see if the departing employee’s core responsibilities can at least be temporarily assigned to other team members (even if it requires paying some overtime), handed off to a temporary employee or possibly outsourced. This will give your facility more time to perform a proper job search and not rush hiring and training.

Plan the Departure One of the first questions you will need to answer once an employee has submitted his or her resignation is: What is the plan for this individual’s remaining time with your facility? If the individual is leaving under unpleasant circumstances (e.g., frustration with management, taking a position with a competitor), you may want to waive any time period typically associated with departing staff and ask the individual to leave the facility immediately. This can help avoid awkwardness or the creation of an uncomfortable work environment.

If the departure is amicable and the employee will remain, develop a detailed plan outlining what is expected of the team member during his or her final days with your facility. Some of the time may be allocated to continuing routine job responsibilities. You may want to set aside time for the individual to train other team members on job responsibilities, especially if you have already determined who will replace the employee. You should also ask this individual to complete a “knowledge transfer” document to detail matters such as job responsibilities and outstanding projects. Finally, build time for an exit interview.

Once you have assembled an exit plan, review it with the departing employee. During that conversation, emphasize the importance of appropriate behavior and professionalism. If you see that the individual is coming up short in these regards, including slacking off, failing to properly complete work, gossiping or bad-mouthing leadership, consider ending the employee’s time with the facility early.

Address Security Matters Whether the employee exits your facility two weeks or two hours after submitting his or her resignation, ensure you have the means to effectively restrict access to your facility—physically and electronically. From a physical perspective, this may include collecting a keycard, identification badge and parking pass. Inform any building security about the employee’s resignation.

From an electronic standpoint, this should include shutting down the employee’s email account and removing his or her access to your computer network and software. Collect facilityowned electronics, such as laptops and tablets, that may have their own built-in means of accessing your network. If employees share a password for the facility’s Wi-Fi, change it. If you provided this individual with access to company accounts, such as e-commerce, social media or email marketing, remove his or her account.

It is imperative that ambulatory surgery centers and practices have a process in place for properly responding to and handling an employee resignation.

endocenters.com

Be Meticulous

Photo by iStock.com

ASCs and practices thrive on consistency and predictability. An employee resignation can greatly disrupt both. When flustered, it’s easy to make hasty decisions or forget about critical tasks that can lead to shortand long-term problems.

Since you know employees are inevitably going to leave your facility, take the time to craft a checklist you can use to help ensure you tackle all the steps required for a smooth transition. Effective preparation can make what may be a difficult time for your facility and staff much easier.

RENAE GARY is Vice President of Human Resources at Physicians Endoscopy. She can be reached at rgary@endocenters.com.

23 endoeconomics SUMMER 2019

endo opportunities

Midwest Bloomington-Normal, IL Digestive Disease Consultants Reputed 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.

Portage, MI Bronson Gastroenterology Practice

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 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.

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.

24 endoeconomics SUMMER 2019

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 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.

Rochester, MI Troy Gastroenterology 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.

South Gastonia, NC Carolina Digestive Diseases Seeking a BE/BC gastroenterologist to expand coverage in community of Gastonia, NC. 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 is performed at a two-room ASC.

Northeast 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.

Submit your CV online at endocenters.com/recruiting

North Bergen, NJ Advanced Center for Endoscopy 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.

Lumberton, NJ 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 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 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.

PRSRT STD US POSTAGE

2500 York Road, Suite 300 Jamison, PA 18929

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