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47 GASTROENTEROLOGY The Biggest Problem in Gastroenterology & How to Fix it — Texas Digestive Disease Consultants CEO Dr. James Weber Sheds Insight By Eric Oliver J ames J. Weber, MD, is the president and CEO of Texas Diges- tive Disease Consultants, the largest gastroenterology practice in the U.S. Dr. Weber founded the practice in 1995, with the organization expanding rapidly and touting 150 providers and more than 40 locations throughout Texas today. Featuring 10 infusion centers and affiliated with 20 endoscopy centers in Texas, TDDC provides high level of care to its patients. Dr. Weber additionally serves as the medical director of Lonestar Endoscopy with locations in Keller, Flower Mound and Southlake, all in Texas, coming in late 2017. He earned his medical degree from Dallas-based University of Texas Southwestern. He completed a resi- dency at Dallas-based Parkland Memorial Hospital and a fellowship at Dallas-based Baylor University Medical Center. e Crohn's and Colitis Foundation of North Texas named Dr. Weber it's "Doctor of the Year" in 2015. Question: What's the biggest problem in gastroenterol- ogy and how would you fix it? Dr. James Weber: I believe the biggest issue facing gastroenterology centers is the ability to maintain profitability while providing high quality care in an ever changing healthcare environment. [TDDC] works hard to recruit and retain the best physicians, nurses and staff but this takes a lot of effort and ever increasing expense. We must comply with all government and payer requirements to docu- ment quality and safety measures, which takes a great deal of time and money. We face rising costs of equipment and materials to meet or exceed all the regulatory requirements, the physician's needs and the patient's expectations. We continually deal with patients' frustra- tion with insurance coverage which subsequently leads to frequent rescheduling and cancellation of procedures. With these challenges to meet expectations, compliance, coverage, reimbursement and cost containment, the ability to maintain profit- ability does become our centers biggest issue. To deal with these concerns, I think the following steps are impor- tant for continued success: 1. Keep the staff and physicians educated and engaged 2. Continually review, revise and standardize processes 3. Coordinate efforts between the office, schedulers and the center 4. Work diligently with the payers and vendors 5. Never forget that the patient is your top priority n Staying Relevant — Dr. Larry Kosinski on the Future of GI in ASCs By Eric Oliver T o stay relevant in an ever changing gastroenterology landscape, Larry Kosinski, MD, managing partner of Evanston-based Illinois Gastroenterology Group and president of SonarMD, developed Project Sonar. Project Sonar is an intensive medical home model for patients with inflam- matory bowel diseases. Project Sonar started with IGG in 2014 and has since been opened to other gastro- enterology groups in Illinois. Becker's ASC Review asked Dr. Kosinski about Project Sonar's recent growth and the future of gastroenter- ology in an ASC setting. Question: How does IGG continue to grow Project Sonar? Dr. Larry Kosinski: Our growth in Project Sonar is through increased attribution by Blue Cross Blue Shield. They have recently stepped this up and we have now grown to 700 patients. They have now opened up Project Sonar to other GI Groups in Illinois. We have added three more this year so far. Q: What do you think gastroenter- ology will be like going forward, and how does Project Sonar work into that? LK: Gastroenterologists need to transition themselves from a dependency on procedural income to one that is a hybrid of procedures and care management. We have to diversify or else we will be commoditized. Q: If you had to start a whole new facility and you were tasked with basing it around one of the three aforementioned specialties, which one would you choose and why? LK: I would probably focus on orthopedics since we have an aging population who will need those joints repaired. Gastroenterology is too dependent upon one condition, colon cancer. n

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