PSG Rumblings Summer 2019 by TEAM

Summer 2019

www.pasg.org

PSG

INSIDE

President’s Message

Projects Past, Present and Future By Richard E. Moses, DO, JD @MOSESMEDLAW Summer is here and in full swing! The weather is as hot as our Board and great staff. I am approaching the end of my second term as your president. As I look back, I cannot believe how much we have accomplished together. The PSG has done so much in a short time. There is still more to do and a lot of opportunity for us to continue to move our great organization forward. I am sad to inform you that Robbi Cook has left PAMED and is therefore no longer our Executive Director. We wish her all the best in her new endeavors and thank her for her strong commitment and hard work in helping us to reshape the PSG to move forward rapidly. Jason Harbonic is our new Executive Director. He brings with him many years of experience in this role. Jason and I have been in close contact to maintain continuity with our many ongoing projects. We have had a number of conference calls to keep things moving. He is anxious to meet the Board and membership to develop a close working relationship. I continue to maintain an open dialogue with PSG members and non-members to highlight issues affecting the Gastroenterology arena. We appreciate

@THE REALGIDOC

DDNC Update

Staff Introductions

Happenings 7

your phone calls and emails. This open line of communication will continue under Jason’s management so we can meet our membership needs. Jason is supported by a great team including Melissa Harper, the Deputy Executive Director, Jessica Winger, Meeting Manager and Resaica Cannon, the Member Services Specialist. Since my May/June President’s e-Message, the healthcare arena has been “hot” as usual in Pennsylvania and nationally. Governor Wolf signed the Pennsylvania budget for this fiscal year. His proposed provider tax on ambulatory and endoscopy surgical centers as a means to balance his budget was fortunately excluded. Our PSG Action Alerts and membership engagement were clearly heard. Thank you for your time and effort in opposing this tax that would have severely harmed our patients and gastroenterologists across the state. I must also thank Representative Greg Rothman for supporting our efforts. Representative Rothman wrote an editorial that was published in the Central Penn Business Journal detailing the quality of care provided patients, the overall cost savings, and the adverse outcome of the provider tax. We continue to track the prior authorization, venue change, various opioid, and out-of-network billing bills that are circulating in the Pennsylvania legislature. continued on page 2

SLC Update

New Members

FIT Update

PSG By-laws Update 11 PRESIDENT Richard E. Moses, DO, JD, Phila. Gastroenterology Consultants, Ltd. 700 Cottman Ave., Suite 201 Philadelphia, PA 19111 (215) 742-9900 remoses@mosesmedlaw.com PRESIDENT-ELECT Ravi K. Ghanta, MD Digestive Disease Associates 1011 Reed Ave., Suite 300 Wyomissing, PA 19610 (610) 374-4401 rghanta@hotmail.com SECRETARY David L. Diehl, MD Geisinger Medical Center Mc21-11, 100 N. Academy Ave. Danville, PA 17822 (570) 271-6439 dldiehl@geisinger.edu TREASURER Karen Krok, MD Penn State Hershey Gastroenterology 200 Campus Drive, Suite 2400 Hershey, PA 17033 (717) 531-4950 kkrok@pennstatehealth.psu.edu ADMINISTRATIVE OFFICE ASSOCIATION EXECUTIVE Jason Harbonic 777 East Park Drive, P.O. Box 8820 Harrisburg, PA 17105-8820 (717) 558-7750 ext. 1584 info@pasg.org

Rumblings EDITOR Manish Thapar, MD Thomas Jefferson University Hospital 132 S. 10th St. Suite 480 Main Bldg. Philadelphia, PA 19107 (215) 955-8900 manishthapar@yahoo.com

2 President’s Message continued from page 1

On the national front, the Affordable Care Act (ACA) continues to work its way through the courts. Most recently, the Fifth Circuit Court heard oral arguments in a lower court decision (Texas v. United States), finding that no part of the ACA could stand following enactment of legislation zeroing out the individual mandate penalty created under the ACA. It is likely this case will be considered by the Supreme Court for final adjudication. Congress has failed to take any action in preparation for the potentially far-reaching impact of this court case. The House and Senate continue to consider legislation created to protect patients from surprise medical bills. As you are aware, this most often occurs when a patient receives services from an out of network provider in an in network facility. The U.S. District Court for the District of Columbia recently ruled that CMS’s final rule requiring pharmaceutical manufacturers to include a drug’s list price in direct-toconsumer television advertisements could not take effect. The court felt that the Department of Health and Human Services (HHS) overstepped its authority to regulate the marketing of prescription drugs as part of its role in administering the Medicare and Medicaid programs.

We need your support to

continue moving the PSG forward.

The academic agenda is set for our upcoming Annual Scientific Meeting at the Kalahari Conference Center in Pocono Manor, Pennsylvania (October 11 through 13). Dr. Harshit Khara has done an excellent job putting together top-notch experts to address many of the topics that were requested at last year’s fabulous meeting. This year’s conference begins Friday evening, the weekend of October 11, 2019, with a flexible cocktail reception to accommodate your traveling plans. The conference is family-friendly with access to the water park. There will be fun activities for children of all ages (including us, the adult children-atheart). Your great PSG staff is putting together a number of non-academic family-friendly activities to engage your children and grandchildren. (You do not have to swim to have plenty have a lot of fun). Jessica Winger, our conference planner and coordinator, has negotiated a discounted conference rate if you plan to stay over Sunday night also as it is Columbus Day weekend. GO, JESSICA!

Membership is extremely important to maintain the health and future of your PSG. Please renew if you have not already done so. If you have, thank you. Please ask your partners and associates if they are members. If not, encourage them to join. We need a strong voice in Pennsylvania to be heard with all of the changes and challenges that are on the horizon. PSG continues to advocate and be involved in legislative and regulatory issues affecting your ability to practice and treat your patients. We need your support to continue moving the PSG forward. Remember, we are the PSG, your organization and professional family. We look forward to hearing from you, connecting with, and working with you in the month ahead. Contact us or me personally as necessary, or just to touch base. I look forward to seeing you and your families at Kalahari! Best regards, Richard

Jenkintown, PA Gastrointestinal Associates, Inc. is seeking a BC/BE gastroenterologist to join our practice. We are especially interested in expanding our advanced therapeutic program and would welcome applicants completing an advanced therapeutic fellowship. You would provide a full range of care to patients, both in hospital and through outpatient procedures. This is a full-time position with shared clinical and administrative responsibilities. Gastrointestinal A ssociates, Inc. was founded in 1972 and has grown to a team of 19 professional health care providers. We serve a wide range of patients over various locations in the Philadelphia, Montgomery and Bucks County areas. We offer a competitive salary package to include benefits along with a partnership track. To apply, please fax or email a CV and cover letter to: Alfreda Rawlings, Executive Director Gastrointestinal Associates, Inc. 215-885-7528, Fax Email: ARawlings@gastropa.com

3 Staff Introductions Jason Harbonic Executive Director

Jessica Winger Meeting Manager

(717) 909-2697 jharbonic@pamedsoc.org

(717) 909-2693 jwinger@pamedsoc.org

Jason’s experience includes over 15 years as a non-profit management professional with an emphasis in membership recruitment and retention. Prior to joining Pennsylvania Medical Society this year, he worked with numerous professional societies. His experience includes serving as Director of Membership and Marketing for the American Society for Bone and Mineral Research, Member Services Manager for the American Medical Informatics Association, and Membership and Chapter Relations Specialist for the Clinical Laboratory Management Association. He is a member of the American Society of Association Executives and actively pursues continuing education opportunities, including completion of the ASAE Advanced Membership Course. Jason is a graduate of Kutztown University in Kutztown, PA where he earned a Bachelor’s Degree in Political Science. He resides in Drexel Hill, PA with his wife.

Melissa Harper Deputy Association Executive (717) 909-2690 mharper@pamedsoc.org Melissa Harper joined the PSG team in May. She will focus on managing special projects, coordinating communications for the association including correspondences, Rumblings newsletter and will assist the Executive Director in coordinating activities for the governing body and committees. Melissa is a graduate of Eastern University where she earned a Bachelor’s Degree in Organizational Management.

Jessica Winger serves as a Meeting Manager in the Specialty Society Management Services Department of the PA Medical Society (PAMED). She has been with PAMED for 20 years. Jessica plans events for multiple state medical associations and has also staffed a national association. Her role involves CME coordination, educational and social event planning, negotiating contracts, and exhibit/sponsorship coordination. She loves spending time with her daughter, volunteering at her school, going to the gym, and traveling.

Resaica Cannon Member Service Specialist (717) 909-2699 rcannon@pamedsoc.org Resaica Cannon joined PSG team in March 2019 as a Member Service Specialist. Resaica will focus on interacting with members, membership application processing, and special projects as they occur. Resaica holds a Associates Degree in Office Management.

4 DDNC Update By Ralph D. McKibbin, MD, FACP, FACG, AGAF—PSG Representative and DDNC Immediate Past President The Digestive Disease National Coalition (DDNC) continues to advocate for gastrointestinal patients in the Federal arena. Updates of interest to Pennsylvanians include:

NIH Updates

NIDDK Central Repositories Sample Access Initiative The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) recently announced it would allow investigators to apply for access to non-renewable samples from one or more of its Central Repositories. The NIDDK Central Repositories house valuable biological samples and data from numerous major clinical studies. Please see more information here. (https://www.niddk.nih. gov/research-funding/current-opportunities/par-19-319)

FDA Updates

Request for Nominations from Industry Organizations for the Vaccines and Related Biological Products Advisory Committee (VRBPAC) The Food and Drug Administration (FDA) is requesting that any industry organizations interested in participating in the selection of a nonvoting industry representative to serve on the Vaccines and Related Biological Products Advisory Committee (VRBPAC) for the Center for Biologics Evaluation and Research (CBER) notify FDA in writing. FDA is also requesting nominations for a nonvoting industry representative(s) to serve on the VRBPAC. Please see the Federal Register notice ( https://www.govinfo.gov/ content/pkg/FR-2019-08-07/pdf/2019-16877.pdf) for more information.

CDC Updates

Solicitation of Nominations for Appointment to the CDC/HRSA Advisory Committee on HIV, Viral Hepatitis and STD Prevention and Treatment (CHACHSPT) The Centers for Disease Control and Prevention (CDC) is seeking nominations for membership on the CHACHSPT. The CHACHSPT consists of 18 experts in fields associated

with public health; epidemiology; laboratory practice; immunology; infectious diseases; drug abuse; behavioral science; health education; healthcare delivery; state health programs; clinical care; preventive health; medical education; health services and clinical research; and healthcare financing, who are selected by the Secretary of the U.S. Department of Health and Human Services (HHS). Please see the Federal Register notice here (https://www. govinfo.gov/content/pkg/FR-2019-08-09/pdf/2019-17064. pdf) for more information.

Help IFFGD & Stanford Medicine Understand Your Chronic Abdominal Pain

IFFGD is conducting a research study to help improve the understanding and treatment of chronic abdominal pain in association with Stanford Medicine. This study will help provide researchers with the information they need in order to conduct research in areas that will help fulfill the needs within the patient community. n IFFGD invites chronic abdominal pain patients to participate in this study by completing a survey regarding their symptoms and prior treatments for their abdominal pain. n Please see the survey link at iffgd.org. Participation is voluntary, confidential, anonymous, and should only take about 15 minutes to complete. n You are eligible to participate if you meet the following criteria: • Have experienced symptoms of abdominal pain for six months or more • Are 18 years of age or older n Please feel free to share this information with anyone who might be interested in participating.

Healthcare Nutrition Council (HNC) Medical Foods Workshop: Science, Regulation and Practical Aspects

The Healthcare Nutrition Council (HNC) is hosting a “Medical Foods Workshop: Science, Regulation and Practical Aspects.” The workshop is being co-sponsored by the American Society for Nutrition and will take place August 13-14 in Washington, DC.

5 Non-Medical Switching Conference

The Workshop will bring together patients, healthcare professionals, academics, regulatory and legal experts, and government agencies to foster a dialogue on the regulatory framework of medical foods in the United States.

On Wednesday, July 17, 2019 Janssen Pharmaceuticals hosted a conference entitled, “Non-Medical Switching: Implications for Patients and Healthcare Providers.” The event, held in Washington DC, was the first-ever national conference on non-medical switching. The conference featured new research on the national prevalence of non-medical switching and included presentations from two DDNC member organizations. Dr. Ralph McKibbin, DDNC Immediate past President and representative from the Pennsylvania Society of Gastroenterology, presented on his experience with non-medical switching from the clinical perspective. Suzanna Masartis, Executive Director of Pennsylvania’s Community Liver Alliance and DDNC board member, discussed her leadership on legislation that seeks to establish protections for patients from nonmedical switching in Pennsylvania.

Takeda and Sosei Heptares Sign R&D Pact

Takeda and Sosei Heptares have entered a deal that involves research, development and commercialization of novel molecules, focusing initially on multiple gastrointestinal diseases. Please see more information here (http://www.pharmatimes.com/news/ sosei_heptares,_takeda_embark_on_strategic_r_and_d_ partnership_1296291).

NCCRT News

The National Colorectal Cancer Roundtable (NCCRT) shared a new guidebook with findings and recommendations gathered from their 2018 joint study with the American Cancer Society regarding screening disparities in colorectal cancer screening. It is designed to help in the education, empowerment, and mobilization of those who are not getting screened for colorectal cancer. The guidebook can be downloaded from their webpage. https://nccrt.org/resource/2019messagingguidebook/ 9375 9376 PFZ I&I Congress Half Ad CMYK 04 PRINT.pdf

12/04/2019

14:50

Inflammation & Immunology

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The DDNC will continue to advocate for the digestive disease patients. The complete legislative agenda can be accessed on the website, www.ddnc.org.

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7 Happenings Private Equity Investment in GI - a New Frontier By Ravi K. Ghanta, MD, PSG President-Elect @RAVIGHANTA5 The general trend for gastroenterology practices is changing very rapidly as we see more movement away from private practice and a trend toward hospital ownership. Although most gastroenterologists prefer to remain independent, many factors are making this very difficult to sustain. A new player has entered the arena possibly giving more options to private practice gastroenterologists. Although private equity (PE) investment is not new to the medical field, it is relatively new to the specialty of gastroenterology. Recently, gastroenterology and endoscopy has emerged as an area of interest for private equity investors focused on U.S. healthcare services since it is viewed as a growth market and lower investment risk for these firms. The concept of private equity investment into the field has had very limited exposure and understanding by gastroenterologists. While gastroenterology has seen just a handful of mergers over the past few years, the field still remains a highly fragmented specialty. Due to the fragmentation of the field with multiple small groups and a limited number of large groups, these GI practices are often unable to achieve any meaningful leverage with payers at a local or national level. These groups, large and small, are constantly under threat from their local hospitals and healthcare systems. Because of this, PE firms see opportunity for large practices that could benefit from local consolidation, while smaller independent practices could benefit from a centralized administrative infrastructure that lowers cost. Given the growth potential of the specialty through increased ancillary service offerings, increasing outpatient surgical volumes, and the fact that consolidation could lead to cost savings, PE investment firms see potential for tremendous financial growth. Since many private practice

doctors may balk at â&#x20AC;&#x153;selling outâ&#x20AC;? to a hospital system, the opportunity to work with a PE firm to maintain a degree of physician control has become more appealing. The first notable private equity investment in GI occurred relatively recently in March 2016 as a partnership between Miami-based Gastro Health and Audax Private Equity. A few others have been in the process but have not yet finalized. In Pennsylvania, the first and only private equity based investment in the field of gastroenterology just occurred in June 2019. Amulet Capital has facilitated the merger of three large gastroenterology groups (Digestive Disease Associates, Regional GI, and Mainline GI) in Southeast, PA creating the seventh largest GI practice in the U.S. and is now named US Digestive Health.

These groups, large and small, are constantly under threat from their local hospitals and healthcare systems. As a gastroenterologist, who has been with Digestive Disease Associates since 2006, I have seen first hand the Herculean efforts taken by the management teams of each of the groups to make this merger take place. This was a work in progress for more than 2 years, but was very exciting when it was completed. The vision is to continue to expand by merging with other GI groups in Pennsylvania and beyond with goals of providing premiere GI and Hepatology care. Although this seems to be an excellent opportunity for our field and is an exciting time, GI groups should become aware of the enormous opportunities as well as the potential risks of private equity-led investment and consolidation.

8 SLC Update by Jason Harbonic, PSG Executive Director

The Specialty Leadership Cabinet (SLC) met Tuesday, August 13th at the Pennsylvania Medical Society (PAMED). Dr. Jackson, Chair of the SLC, started the meeting by noting the passing of Drs. Jasvir and Divya Khurana and their daughter, Kiran, in a small plane crash in Upper Moreland, PA. Dr. Jasvir Khurana was a bone pathologist at the Lewis Katz School of Medicine at Temple University and his wife, Dr. Divya Khurana, was a neurologist at St. Christopher’s Hospital. Medical Nutrition Therapy—The first item on the agenda was a presentation from Meg Rowe with the Pennsylvania Academy of Nutrition and Dietetics (PAND). Ms. Rowe requested that the SLC consider supporting legislation providing title protection, reciprocity, and scope of practice for medical nutrition therapy. Ms. Rowe explained that medical nutrition therapy differs significantly from wellness nutrition. She further explained the need for title protection to differentiate nutritionists from dieticians. In addition, nutritionists want to participate as part of a physician-led health care team with the ability to make nutritional diagnoses. She feels these changes could increase reimbursements for care. She stressed that this legislation is not intended to restrict or impact other health care providers who may offer nutritional care. SLC Election Schedule—The next item on the agenda was a presentation from Angela Boateng, PAMED General Counsel, on the issue of the misaligned SLC specialty board schedule due to early board member departures. Ms. Boateng summarized the issue as a specialty being unable to succeed itself on the SLC after two terms. Two recommendations were offered: one either that this restriction apply to the entire board or that the restriction only apply to the individual seat. Ms. Boateng then discussed the issue of re-aligning the seats. One option is to allow for the misaligned seats to

remain unchanged, while the second option is having one seat serve an initial three-year term which would then be eligible for reelection to a four-year term to fix the misaligned terms. Third, there is the issue of the misaligned at-large seat. This seat could also be realigned using the initial three-year term followed by a four-year reelection option as noted above. Corporate Practice of Medicine—The next presentation was a discussion of the corporate practice of medicine study. This was a study proposed to determine the extent of corporate ownership of physician practices. The SLC discussed the various uses for this study and the pros and cons of each.

Legislative Update David Thompson, PAMED Director of Government Affairs, and John Tommasini, PAMED Government Affairs Associate, provided the following update: Scope of Practice—Although not much is happening, some changes are being proposed to the Department of Health. Informed Consent—Two bills are coming. PAMED was approached by trial lawyers to work on this legislation to increase auto insurance limits. Out-of-Network Billing—There is hope to address this issue at the state level rather than the federal level. Emergency Medicine has led the efforts on this issue. It is expected that a bill will be introduced in the fall regarding the fee schedule for out-of-network billing. Prior Authorization—The bill is ready to go. It is waiting for insurer comments before the bill is introduced to address concerns of a house staffer. Act 112—SLC recommended this should be prioritized. Cardiologists have retained a lobbyist to focus on their concerns. The board will consider prioritizing.

9 Welcome New Members Active – Full Members

State Board of Medicine Complaint—Legislation was introduced that if there is no action on a complaint, then physicians do not have to answer “Yes” if they are asked about complaints. Superior Court Election—There are two open seats. PAMPAC board will interview candidates and decide whether to endorse. Opioids—Legislative activity is slowing down a bit. SB 675 is problematic when trying to prescribe medications for substance abuse disorder. Extreme Risk Protection Bill—PAMED supports this, noted the federal court ruling on mental health commitment. Joint Underwriters Association (JUA)—Legislation now puts JUA under state jurisdiction. Business of Medicine—Anita Brazill, Vice President of the Pennsylvania Clinical Network, provided a summary of the clinically integrated network (CIN) for private practices. This network allows practices to aggregate to meet the challenges of value-based payments and value-based contracts. It is not the same as an IPA, PHO, or ACO. The network includes a medical professional liability saving program which can save 15-40% on insurance. The CIN is supported by PAMED. SLC Updated Nomination Process—We discussed the updated specialty society nomination process for the SLC. HR 286—PAMED agrees to oppose this bill that is supposed to avoid coercion regarding vaccinations using informed consent, and provides for penalties for complaints of coercion.

Raman Battish, MD Matthew D Coates, MD, PhD Marcus R Happe, DO Sarina Kapoor, MD Jennifer L Maranki, MD Stephanie M Moleski, MD Ann Ouyang, MD Sanam Razeghi, MD Guoxiang Shi, MD

Affiliate Member Marcus Shin, PhD

Associate Members Neeraj Mangla, MD Aaron P Martin, MD Shannon L Tosounian, DO Nabeel M Akhtar, MD Yousif Al-Saiegh, MD Gurneet Bedi, MD Jessica Dahmus, MD Ishita Dhawan, MD Jeffrey M Dueker, MD Lori-Ann Glasgow, BA Erkanda P Ikonomi, MD Raymond A Janowski, MD Navneet Kaur, MD Keerthana Kesavarapu, DO Neal M Patel, MD Sahil R Patel, MD Vishal Patel, MD Stephanie L Romutis, MD Jennifer Schwartz, DO Ruchit N Shah, DO Ajay Singhvi, MD Kashif Tufail, MD

Non-Physician Clinician Members Michaela Breski, PA-C Dana C Campetti Jacqueline Edwards, PA-C Christine Hanna, PA Melissa S Jamison, PA-C Nicole McAndrew Tara L Meyer, PA-C Ashley N Miller, PA-C Kathryn N Semans, PA-C Sarah Yadlosky

10 FIT Update By Allison Baragona, MD, Fellow-in Training, 3rd Year @ALLISONBARAGONA It is that time of year again, when medical trainees are beginning the newest phases of their careers, whether it be residency, fellowship, or onto life as an independently practicing physician. There is a palpable buzz of excitement in the air of the halls of teaching hospitals everywhere, as young physicians assume their new roles. New gastroenterology fellows are anxiously embarking on the final chapter in their training journey, while more senior fellows begin to contemplate what will come next in their career after the long road of training has reached its end. Though all training programs are different, the nature of a gastroenterology fellowship leans quite heavily to the academic side of medicine, and often can leave trainees in the dark about what life in the “real world” of a gastroenterologist may be like. Thankfully, the PSG acts as a support as we look to plan our future careers. I have had the privilege of serving as a fellow in-training (FIT) member on the PSG board for the past year and a half. During that time, I’ve gotten to know board members, had the opportunity to network with physicians in private practice, and learn what practice outside of academic medicine could look like. The business of medicine is not something that we

spend a lot of time on in medical education, and is an area that I have been admittedly been underexposed to. My experience on the PSG board has been an excellent introduction to this. Participating in board meetings sheds light on business and logistical concerns that arise in everyday gastroenterology practice, and how these issues are handled by groups of physicians. As a native Pennsylvanian, who plans to spend my professional practice in Pennsylvania, it is heartening to know that an organization like the PSG exists. I know that I can continue to count on the PSG to support my interests, not only as a trainee, but also throughout my professional career in independent practice. Now that my third year of fellowship is in full swing, my pursuit of employment takes center stage. This is an exciting opportunity, and figuring out where my career will take me is an experience I have long awaited. With new freedom to find employment outside of a match system for the first time in my adult life comes some apprehension of the unknown. I count myself lucky that I have been able to spend time as a FIT member on the PSG board, learning about gastroenterology practice of all different flavors, from the various full board members in a range of different practice types. I enter this experience with hope, excitement, and an open mind for the opportunities the future may have to offer, and take comfort in knowing I will continue to have the PSG as a support system throughout my career.

11 PSG By-laws Update by Zubair Malik, MD, PSG Bylaws Chair The PSG updated the By-laws of the organization. The By-laws had not been significantly updated for decades. The current rewrite and updates to the By-laws will help keep the organization vibrant, running smoothly and efficiently, and function in a manner that benefits its members in a way that is needed with our changing healthcare system. There were several reasons we felt this was necessary to be accomplished. One of the major goals is to increase engagement and participation in the PSG for all GI-associated professionals. The new By-laws expand membership and engagement beyond just Gastroenterologists. As we are all aware, the practice of gastroenterology is not just between a physician and a patient. As our specialty and medicine have evolved in complexity, there are many different roles necessary for gastroenterology to be practiced effectively and safely in order to provide high quality care to our patients. This includes GI nurses, medical assistants, GI technicians, as well as other service lines that support gastroenterology - dieticians, genetic counselors, and pharmacologists, amongst many other groups including practice administrators. We believe that the Pennsylvania Society of Gastroenterology is an organization that can help educate, support, and advocate for gastroenterology within Pennsylvania. With the inclusion of Advanced Practice Providers (Physician Assistants and Nurse Practitioners), we will be able to expand our membership and reach in gastroenterology. This will also improve education so the PSG will better understand what needs to be done to support members and patients.

The increased GI network will better create a sense of unity and strength with GI professionals across the state. It will also potentially help influence necessary and future legislation pertaining to gastroenterology in Pennsylvania by broadening our voice. These additions will ultimately help to maintain the best patient care and highest standard of practice in gastroenterology throughout Pennsylvania. This will also allow each of us a better chance to meet and interact with other GI professionals throughout the state. The By-laws will better define the roles and responsibilities of the committees as well as the committee chairs. Committees are an important part of the PSG that help govern and run the activities and events of the organization. Better definition of committee roles will make our goals easier to accomplish. The committees within the PSG are a great way to get involved. Committee membership helps build and guide the organization in a way that helps membership of the society. Another major update to the By-laws creates a process to allow a President to stay on for an extra term if requested by Board and agreed upon by the then presiding President. If this should occur, the current officers would also maintain their role for that additional term. This change allows for a group of officers to stay together if valuable work is being done that needs to be continued. We do not believe that this will be the norm, but rather used in special instances where it would be in the best interest of the Society to maintain leadership for very specific needs. Other changes were made in language to update the By-laws for 2019 and beyond. We encourage you to get involved and participate in the PSG and look forward to seeing everyone at our next annual meeting.

PSG

PRSRT STD U.S. POSTAGE PAID HARRISBURG PA PERMIT NO. 922

777 East Park Drive PO Box 8820 Harrisburg, PA 17105-8820

Annual Scientific Meeting October 11-13, 2019

Kalahari Convention Center, Pocono Manor, PA

Richard E. Moses, DO, JD, FACG, President Harshit Khara, MD, Program Chair

Educational Topics Guts n Butts (Luminal GI)

• The “Burning” Debate – Is Endoscopic Treatment of GERD Ready to Replace Surgery • The Role of Capsule Endoscopy in the Management of Small Bowel Disorders • Teaching an Old Dog New Tricks – New Techniques to Improve my ADR • Pelvic Floor Dysfunction: Workup and Management

IBD/Hepatology

• New and Emerging Therapies in IBD • Baby and Me: The Pregnant IBD Patient • Till Death Do Us Part – Evaluation of Acute Kidney Injury in a Cirrhotic Patient: HRS and Beyond • Reactivation of Hepatitis B in Immunosuppressed Patients

Selected Topics

• FIT Lecture: GI Physician Burnout • FIT Lecture: Celiac Disease and Nutrition in GI • A Stitch in Time Saves Nine - Endobariatrics: Where do we stand? • GI Psych: Management of Pain in GI Disorders

The Road Less Travelled (New Frontiers in Gastroenterology) • Too Hot Too Cold Too Wet – New Frontiers in Barrett’s Ablation • Why Wait for the Surgeon? The Role of Interventional EUS for Luminal Access • Say No to the Knife – New Frontiers in Colon Polyp Management

Registration Fees

PSG Active Member PSG Affiliate Member PSG Associate Member (Residents/Fellows) PSG Non-Physician Clinician Member Non-Member Physician Non-Member Resident/Fellow Non-Member Physician Assistant Nurse Practitioner, Registered Nurse, LPN Non-Member Other (office staff)

No Charge No Charge No Charge No Charge $200 No Charge $125 $125 $50

GI Jeopardy Tournament PSG Video Editing Course (Non-CME)

QUESTIONS?

Jessica Winger, Meeting Manager 717-558-7750 ext. 1584 info@pasg.org For detailed meeting information, visit www.pasg.org

2019 postcard PSG FINAL indicia.indd 1