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DIGESTIVE HEALTH HAS NO GREATER CHAMPION THAN GI ASSOCIATES, LLC

When it comes to finding quality care for digestive health and gastrointestinal disorders, all roads lead to Southeast Wisconsin. For decades the gastroenterology specialists of GI Associates, LLC have made an indelible mark on American health care, providing the finest in patient care, digestive health education and research. Along the way, the group has achieved an outstanding reputation for quality and innovation among medical and scientific communities worldwide and attracted patients from across the nation.

Coming Together Has Set Them Apart
GI Associates, the largest single-specialty GI group in the state, was established in 2000. The practice is the result of a merger between Gastroenterology Consultants, Ltd. and Milwaukee GI Specialists. Today, its team of 24 high-caliber gastroenterologists, including a pediatric subspecialist, embraces leading-edge technology and possesses a healthy determination to stay ahead of the curve, serving as a pioneer and leader in the GI field.

The group is distinguished as a national and international referral center for pancreatic-biliary cancer and treatment of other highly specialized GI disorders. GI Associates is well positioned with a broad range of therapeutic services that compliment both its technical capabilities and the strengths of its physicians in the rapidly growing GI market.

“The size of our organization and the fact that we are a single-specialty practice enables us to move quickly when we find something new and important to our patients and referring physicians,” says group founder Joseph E. Geenen, M.D., clinical professor of medicine at the Medical College of Wisconsin. “The health care leaders of today must take their practices in bold new directions. Consumer choice demands it. Much of what we do requires breaking new ground, whether it be our on-site research studies, ongoing physician education, or implementing strategic initiatives that set new benchmarks for the group and for GI care on a national level. Our staff thrives on the challenge of consistently delivering the best in leading-edge, compassionate patient care.”

Digestive Health Services for All Ages
GI Consultants was one of the first private practice groups in the nation to offer pediatric services, and today GI Associates continues to be the only one in Southeast Wisconsin offering care across the life span.

Today the group offers two pediatric gastroenterologists. Maria "Tes" Rivera, M.D. and Alan N. Mayer, M.D., who treat the entire range of digestive disorders – from routine to rare – in infants, children and adolescents. In addition, the pediatric team can assist children who suffer from gastrointestinal problems brought on by food allergies; formula intolerances; and other feeding issues, including poor weight gain and obesity.

The group's goal is to work closely with primary care physicians and families to diagnose and treat digestive diseases early in life, offering treatment options to enable their younger patients to thrive and actively participate in life’s events along with their peers. As they age and approach their twenties, they can seamlessly transition care to the adult gastroenterology team for continued care if needed.

Pioneering Spirit Leads to Medical Firsts
A primary strength of the group is its physicians. Geenen is world renowned for his pancreatic-biliary work and is a member of the Pancreatic-Biliary Services Steering Committee at Aurora St. Luke’s Medical Center in Milwaukee. He was one of the first GI physicians in the country to perform endoscopic retrograde cholangiopancreatography (ERCP) and has pioneered research in the area of therapeutic endoscopy for treatment of ulcers, gallstones and sphincter of Oddi dysfunction.

Marc F. Catalano, M.D., another group physician, was one of the first physicians in the state to utilize endoscopic ultrasound (EUS) as a method of staging cancers not found utilizing normal surgical intervention. Today, many of GI Associates’ physicians use EUS technology for early detection of cancer and staging, enhancing treatment options and patient outcomes.

“Between 10 percent and 15 percent of ERCP and EUS patients seen by GI Associates are referrals from other GI physicians across the country,” says Geenen. “These are tough cases that come to us because of previous treatment failures or because they involve more complex GI issues which require the pioneering expertise found at GI Associates.”

An Emphasis on Education
As a nationally recognized gastroenterology training center, GI Associates provides annual advanced training fellowships for two licensed gastroenterologists interested in enhancing their ability to perform the diagnostic and therapeutic endoscopy procedures of ERCP and EUS. To date, GI Associates has trained more than 60 physicians.

James A. Cunningham, M.D., a GI Associates physician actively involved in the fellowship training program through the Medical College of Wisconsin, states, “Education will always be an important part of the way we approach GI care – for both our peers and patients.” In addition to the fellowships, the group also hosts annual conferences for primary care physicians from Wisconsin and nurses across the country. These conferences provide the opportunity to share information on the latest GI advances and interventions.

Every week members of the group lead a GI case conference at Aurora St. Luke’s Medical Center, bringing together multi-specialty physicians, including radiologists, oncologists, surgeons, anesthesiologists and cardiologists, to conduct case reviews and discuss treatment plans. These informative sessions may cover the digestive issues of a heart transplant patient one week followed by discussion of women’s GI health initiatives the next.

“Medical breakthroughs and innovative technologies continue to place new demands on health care professionals. It remains imperative that we help keep physicians and other medical professionals informed and up-to-date,” says David A. Carron, M.D., a GI Associates physician and clinical assistant professor of medicine at the Medical College of Wisconsin.

Thousands of health care professionals have been touched by the group’s expertise because many of GI Associates’ physicians speak at symposiums across the country and around the world. Speaking engagements represent part of the group’s emphasis on medical education and training. Its commitment to the field is second to none and further exemplifies GI Associates’ intent to provide patients with the highest-quality care, not only today but also for years to come.

Research Leads to Evidence-based Care
While unusual for a private practice group to be at the forefront of innovation in the GI field, GI Associates is also taking the lead when it comes to research. The group has long maintained a close and productive relationship with pharmaceutical partners, sharing critical ideas, insights and information in their joint quest for effective therapies and the best possible outcomes.

“Our expertise and understanding of the field has resulted in an unparalleled relationship with the GI research community,” says Michael J. Schmalz, M.D., a GI Associates physician, American College of Gastroenterology governor for the State of Wisconsin and member of the Centers for Medicare & Medicaid Services advisory committee. “Wisconsin Center for Advanced Research is the investigative arm of our practice and is generally involved in 10 to 12 clinical trials at any given time. Because of our involvement in these trials, patients who have not found resolution with traditional treatments are referred to us and can gain access to the next generation of pharmaceutical interventions and the latest technology not yet available to the general public.”

The group is currently involved with studies for Crohn’s disease, irritable bowel syndrome, stent development for pancreatic cancer, and the Stretta and Barrx procedures for intervention in patients with severe GERD. Whenever something new is going on in the digestive health arena, you know the physicians of GI Associates are involved.

The group’s research efforts have produced a wealth of valuable information that is shared with GI physicians around the world. For the past decade an average of 18 studies have been accepted for abstract at the National GI Conference each year. An additional 400 research-related articles have appeared in national and international clinical journals and countless chapters have been submitted for inclusion in medical school textbooks.

Setting the Standard for Quality Care
GI Associates is a founding member of the Gastroenterology Practice Management Group, LLC, a national organization comprised of 11 prominent, large gastroenterology practices. Participating in several national consortia, GI Associates plays an active role in establishing best practice guidelines and clinical benchmarking for GI specialists in the United States. The group has also been instrumental in developing and implementing clinical protocols for various diagnostic and treatment algorithms designed to reduce length of stay and improve long-term patient outcomes.

One of the group’s strategic initiatives over the past few years has been evaluation of the rate at which its physicians reach the cecum during colonoscopy.

“If you don’t reach the cecum, you haven’t achieved a full colonoscopy,” says Carron. “There is the likelihood you have missed polyps farther up in the canal. Our physicians reach the cecum during colonoscopy 99 percent of time compared to the national average, which is between 60 percent and 80 percent.”

Other quality initiatives include efforts to standardize practice patterns, reducing preoperative and recovery times for patients. The group has been involved in recent studies investigating new approaches for prepping patients in need of colonscopy and continues working to decrease the total procedure time for patients while improving the quality of outcomes.

Enhancing Access, Meeting Needs
One of the group’s most important achievements in recent years has been making leading-edge GI care convenient and readily accessible to patients in more ways than ever before. In Southeast Wisconsin, patients are never more than 30 minutes from a GI Associates office equipped to handle consults, procedures and infusion therapy.

Location and accessibility are major strengths of the group. Members of the group are on the medical staffs at 12 area hospitals from Kenosha to Milwaukee and west to Oconomowoc. There are 12 GI Associates clinics, and they manage three freestanding endoscopy centers and have access to a fourth multi-specialty surgery center as needed. Its endoscopy center in the Physician Office Building at Aurora St. Luke’s Medical Center was established in the mid-1990s before such centers were in vogue. It was the first of its kind in Wisconsin.

Endoscopy Centers: Greater Efficiency, Less Cost
Efficiency continues to be a key strategic initiative for the practice despite its exemplary degree of success. The group is ranked in the top 1 percent nationally from a performance standpoint by the Medical Group Management Association and continues to work to enhance patient flow and staff efficiency.

“The utilization of the surgery centers is very important to our practice as they offer a number of benefits for patients,” says Carron. “They are in easy-to-access locations and offer a friendly, comfortable environment. Registered nurses who are hospital-trained and committed to providing patient-centered care staff the centers. Because we offer access to single-specialty centers used primarily for routine screenings such as colonoscopy and esophagogastroduodenoscopy (EGD), we can focus on making the experience easier and quicker for the patient, resulting in enhanced comfort and decreased anxiety.”

“An added benefit is affordability. Performing a colonoscopy in a surgery center is less costly than one performed in a hospital setting. A highly qualified, specially trained physician is still doing the procedure with state-of-the-art Olympus equipment but there is less overhead. We will continue to meet patient demand for choice when it comes to location of services and are dedicated to doing our part to deliver care in the most cost-efficient manner. That’s important in today’s world of consumer choice.”

Dedication to Service Excellence
As a team, the 185 employees of GI Associates intently channel their energies and resources into making a positive and meaningful difference in the lives of each of their patients. Adherence to best practices and evidence-based models of care ensures that no matter which office patients visit or which physician they see, they receive the same standard of care. A mix of midlevel providers, which includes nurse practitioners and physician assistants, and nurses and medical assistants, works directly with patients and supports the physician team. An administrative support staff, which includes a scheduling department for patient appointments and procedures; a fully staffed triage department; and pre-certification and insurance verification personnel all work together to provide patients with a consistent quality experience.

“Referring physicians want to know their patients can be seen on a timely basis. Because our organization utilizes a team approach and most of our physicians work five days a week as opposed to the typical four, we are able to see patients in a timely manner from a scheduling standpoint,” says Bob Kwech, executive director for GI Associates.

More than 90 percent of GI Associates’ patients are seen for consult within one week of a phone call. Any patient can be seen within 48 hours, and of course, they can be seen the same day if it’s an emergent situation. If a patient requires admission to the hospital by their primary care physician, a GI Associates physician will be able to see them in the hospital within 2 hours for the initial consult, benefiting both the referring physician and patient. The goal of the practice is to always work in tandem with the primary care physician, keeping lines of communication open and delivering reports within 24 hours.

Smart Solutions for the Future
GI Associates continually looks to redefine internal process and work flow by adding innovative capabilities to better serve the needs of referring physicians and patients. Currently it is the largest single-specialty practice in Wisconsin with electronic medical records (EMR), a technology implemented more than two years ago to give employees the reliability, speed and mobility required to do their jobs efficiently and accurately from all sites.
As an early adapter of EMR technology, GI Associates serves as a national host site for practices looking to go paperless in the future. To date, more than a dozen practices have spent time with members of GI Associates learning more about EMR functionality, ease of use and the implementation process.

“EMR has allowed us to formalize our clinical protocols,” says Geenen. “Depending upon the diagnosis and state of disease we’re treating, protocols can be implemented within the EMR as guidelines to assist our clinicians in moving patients through appointments in a timely manner. Efficiencies are enhanced because we allow our staff to focus on what they are trained to do. Medical assistants room the patients and take and chart vital signs, freeing up the midlevel providers and the physicians to focus on the presenting problem, proper diagnosis and implementation of the appropriate plan of care for a particular patient.”

“It all comes down to improving the patient’s experience,” he adds. “We continue to challenge our employees. At the end of the day we want every member of our team to feel confident patients were treated the same way they would want to be treated if on the receiving end of care. We also want our physicians to maximize face-to-face time with patients, taking time to answer questions and ensure patients follow through with treatment plans as recommended. We know that if we can educate and motivate patients, we can get them to play an active role in their care and can enhance outcomes.”

“Health care professionals perform best when they’re well informed,” says Carron. “By integrating medical and information technologies as we have, our physicians have instant access to critical information allowing them to make the right decisions right away. EMR has certainly affected our service standards in a very positive way – from medication management and networked imaging and laboratory systems to improved work flow, cost reduction and our ability to make cutting-edge care available to everyone everywhere in Southeast Wisconsin.”

To a great degree, the sterling reputation of the group can be attributed to its collaborative relationships with referring physicians. A GI Associates physician is never more than a phone call away. EMR affords physicians access to patient information from any location, whether they are in an office, at home, or another part of the country lecturing or sharing study results.

“Our interconnectivity improves our communication with referring physicians, not only in terms of timeliness but also relative to the depth of information we can share,” says Schmalz. “With patient information in hand we can provide test results, an accurate diagnosis and recommendations for treatment. Ultimately, the primary care physician is the manager of the patient’s care; however, as a consultant in that process, we’re willing to be involved at the level the referring physician prefers.”

Screening Initiatives Key to Health
As many as 95 million people are affected by gastrointestinal disorders caused largely by hectic lifestyles, poor eating habits and an aging population. Colon cancer is the second most common cause of cancer death in the United States, yet it is also one of the most preventable and treatable forms of cancer when detected early. These statistics have led the group to focus on the importance of patient education and community outreach.

“Part of our mission is to educate patients so they fully understand their digestive health and know how to maintain it throughout their lifetime,” says Cunningham. “Every patient we see is able to leave the office with a series of educational handouts pertinent to their diagnosis. We also make videos and other materials available to them. We have learned over time that patients who learn as much as they can about their condition and treatment are more successful in following through on their plan of care.”

Education is a responsibility GI Associates takes out into its communities as well. Physicians participate in an average of 200 health seminars, speaking engagements, TV and radio interviews, and other community-based activities each year. A hot topic is the importance of colon screening.

“Only one-third of the eligible population is getting colon screenings as they should,” says Carron. “Our group is aggressively involved with consumer education and is working to make the importance of screening known. Colorectal cancer is the third most common cancer in both men and women, and more than 148,000 new cases will be diagnosed in 2006. At age 50 individuals should begin screening. Colon screening is one of the best investments a person can make in their continuing good health, as detection in the earliest stages leads to the best long-term results.”

Leading the Way in Digestive Health
GI Associates’ leadership remains committed to educational initiatives and executing long-range strategies that capitalize on the group’s strengths and keep it positioned on the leading edge of the field of digestive health. Medical breakthroughs such as capsule endoscopy and evolving technology will continue to change the way physicians interact with patients. GI Associates will be setting the standards and leading the way.

“Our objective is to have GI Associates build an even stronger leadership position in key segments of the industry, including pharmaceuticals, diagnostics and consumer health care,” says Geenen. “As science makes diseases increasingly treatable, GI Associates will be at the forefront with solutions that make quality health care accessible and affordable for all patients.”