Taxonomy I Part VI-B (Gastroenterology)

(22 April 2006 20:37)

NATIONAL PROJECT ON THE COMMUNITY BENEFITS

OF FAMILY MEDICINE RESIDENCY PROGRAMS

CUMULATIVE QUESTIONNAIRE RESPONSES

Taxonomy Section I Part VI-B

(Gastroenterology)

SD I.13i(1.0) (L32) Does your residency provide specialty care?

SD I.13i.1 (0) If yes, list these services in approximate order of volume or revenue.

(Is flexible sigmoidoscopy listed?)

Yes:

UCSD

Site-visited profiled residencies:

Harbor

SD I.13i(1.0.1) (L32) Does your residency program provide the following kinds of specialty care?   i(1). Flexible Sigmoidoscopy? Yes __ No __ Additional Info:

If yes, are these services provided during special clinics? What is the number of patients seen? What are the revenues that are generated?

Yes:

UCSD Traditional

Scripps Chula Vista

UCSD St Vincent

UC Irvine                     (5/wk)

White Memorial

Pomona

Durant

OSU Tulsa

USC Univ & SG          (Family medicine centers and community health centers)

Indiana U Methodist

No:

Saints

SD I.13i(1.1) (SD I.13i.1(2) (L32)) Does your residency program provide the following kinds of specialty care?  i. flexible sigmoidoscopy?  Yes__ No __

Yes:

Whittier

Pomona

Arrowhead

Loma Linda

Stockton

Louisville

Glendale

OU Tulsa

OU Oklahoma City

Dayton Community

Miami Valley

Decatur

Mercer

Natividad

Klamath Falls

Lehigh Valley

Kaiser LA

Fresno

Glasgow

Lexington

OHSU Portland

No:

MCE Birmingham

Mercy Toledo

Tyler

Las Vegas

Springfield

SD I.13i(1.2) (SD I.13i.1(3)) If you do provide flexible sigmoidoscopy, are these services provided as normal family medicine center appointments? Yes __ No __

Yes:

Arrowhead

Loma Linda

Louisville

Glendale

OU Tulsa

OU Oklahoma City

Dayton Community

Miami Valley

Decatur

Mercer

Klamath Falls

Lehigh Valley

Lexington                     (can be clustered)

OHSU Portland

No:

Whittier

Pomona

Stockton

Natividad

Kaiser LA                    (it used to be done in the family medicine center; residents now do them in the GI department)

Fresno

SD I.13i(1.3) (SD I.13i.1(4)) If you do provide flexible sigmoidoscopy, are these services provided during special clinics? Yes __ No __

If so, what is the number of patients seen?  What revenues are generated in each specialty service?

Yes:

Whittier                        (scheduled in procedures clinic or by special appointment)

Pomona

Arrowhead                   (40/yr)

Stockton                      (2/clinic)

Louisville                      (2/clinic)

Glendale                       (3-4 per half day; not able to estimate revenues)

OU Oklahoma City      (100/yr)

Dayton Community

Miami Valley

Natividad                     (30/year at $123/each (the FQHC rate))

Klamath Falls               (1/wk @ $100)

Kaiser LA                    (family medicine faculty and residents administer these in GI department)

Fresno                          (2-4/mo at UMC; 2-4/mo at Sequoia; $40/patient revenues)

Glasgow                       (Have not been doing them, because they have fallen out of practice; it is an orphan procedure)

No:

Loma Linda

OU Tulsa

Decatur

Mercer

Lehigh Valley

Lexington

OHSU Portland

SD I.13i(2.1) (SD I.13i.2) (L32) Does your residency program provide the following kinds of specialty care?  i(2). colonoscopy?  Yes__ No __

Yes:

Arrowhead

Stockton

Klamath Falls

No:

Whittier

Pomona

Loma Linda

Louisville

MCE Birmingham

Glendale

OU Tulsa

OU Oklahoma City

Dayton Community

Miami Valley

Decatur

Mercer

Natividad

Lehigh Valley

Mercy Toledo

Kaiser LA

Tyler

Las Vegas

Fresno

Springfield

Glasgow

Lexington

OHSU Portland

SD I.13i(2.2) (SD I.13i.2(3)) If you do provide colonoscopy, are these services provided as normal family medicine center appointments? Yes __ No __

No:

Arrowhead

Stockton

Klamath Falls

SD I.13i(2.3) (SD I.13i.2(4)) If you do provide colonoscopy, are these services provided during special clinics? If so, what is the number of patients seen?  What revenues are generated in each specialty service?

Yes:

Arrowhead                   (120)

Stockton                      (4 per clinic; revenues are generated)

Klamath Falls               (3/wk, generating $1000/wk)

SD I.13k(3.1) (new) Does your residency provide the following kinds of specialty care:  k(3.1) gastroenterology? Yes __ No __

Yes:

Natividad

Klamath Falls

Lehigh Valley

Mercy Toledo

Kaiser LA

Tyler

Las Vegas

Fresno

Springfield

Glasgow

Lexington

OSHU Portland

SD I.13k(3.2) If you do provide gastroenterology, are these services provided as normal family medicine center appointments? Yes __ No __

Yes:

Natividad

Klamath Falls

Lehigh Valley

Mercy Toledo

Kaiser LA

Tyler

Las Vegas

Fresno

Springfield

Glasgow

Lexington                     (clustered appointments for flexible sigmoidoscopy)

OSHU Portland

SD I.13k(3.3)  If you do provide gastroenterology, are these services provided during special clinics? Yes __ No __

If the answer to I.13k(3.3) is yes, what is the number of patients seen?  What revenues are generated in each specialty service?

Yes:

Klamath Falls               (3 week at hospital for gastro-scopy)

Fresno                          (Hepatitis C clinic is offered for 4-6 patients/wk.  Revenues of $30/patient)

No:

Natividad

Lehigh Valley

Mercy Toledo

Kaiser LA

Tyler

Las Vegas

Springfield

Glasgow

Lexington

OSHU Portland

NPCB P2 I.132k(30) (SD I.13k(3.4)) Describe the kinds of gastroenterology that typically takes place within the family medicine center (whether as normal appointments or during special clinics):

Natividad                     (hepatitis C; peptic ulcer disease; gastritis; GERD; infectious diarrhea; inflammatory bowel disease; Crohn’s disease)

Klamath Falls               (assessment of malabsorbtive GERD; peptic ulcer disease; liver disease; irritable, inflammatory bowel disease; infectious diarrhea)

Lehigh Valley                (GERD; hepatitis B and C; cancer screening, diagnosis and treatment)

Mercy Toledo              (infectious etiology; motility disorders; infectious gastro diarrhea; constipation; IBS; post-cancer surgery; cancer screening; no invasive procedures)

Kaiser LA                    (GI bleeding; ulcers; liver disease)

Tyler                            (occult blood; nasal gastric tube insertion; GERD management; enoscopies; I and D of lombosed external hemorrhoids)

Las Vegas                    (peptic ulcer; liver disease; esophagitis; IBS; enoscopy; hemorrhoids; rectal bleeding; constipation)

Fresno                          (non-interventional gastro and paracentesis)

Springfield                    (ulcers; reflux; diarrhea; constipation; Crohn’s; hemorrhoids)

Glasgow                       (GERD; Crohn’s disease; ulcerative colitis; peptic ulcer disease; gall bladder disease; colon cancer screening; diverticulosis; hepatitis C; NASH)

Lexington                     (ulcer disease; GERD: colitis; IBS; GI bleeding; hemorrhoids; post-operative colo-rectal cancer care; infectious diarrhea; acute gastroenteritis; malabortive sydsomas; gall bladder disease; pancreatitis)

OHSU Portland            (treatment of ulcers; esophagitis; IBS; hemorrhoids; constipation; diarrhea)

Phase 2 Responses:

Sparrow                       (Reflux; irritable bowel management; acute diarrhea; nausea; vomiting; rectal bleeding; abdominal pain; Crohn’s disease; other inflammatory bowel diseases; scopes – endoscope, flex sig)

Huntsville                      (GERD; diabetic gastroporesis; peptic ulcer disease; various types of hernias; liver failure; cirrhosis; hepatitis)

Ventura                        (paitents with peptic disease; chronic liver disease; IBS; inflammatory bowel disease; chronic pancreatis; GERD; typical county patient problems)

Long Beach                  (IBS; gastritis; H-pylori testing; flex-sigs; evaluation of diarrhea; constipation; abdominal pain; nausea; vomiting)

U Penn                         (Normal appointments)

Crozer-Keystone          (GERD; IBS; hepatitis B and C; alcoholic liver disease)

Jefferson                       (Reflux; ulcers; gastroparesis; hiatal hernias; chronic diarrhea; constipation; celiac spew; cirrhosis, hepatitis)

McKeesport                 (Evaluation of GI problems; stool exams and cultures; testing for blood; no procedures)

Oahu                            (Regular evaluation and managements of abdominal pain, bowel-related complaints; flex-sig; we manage cirrhosis patients)

NPCB P2 I.13.2k(31) For what conditions would your residency program refer patients to gastroenterologists?  What is the expected wait time before the patient in seen?

Sparrow                       (Significant GI bleeding workup; difficult abdominal pain patients; scope needs and screening; EGDs; colonoscopies)

Huntsville                      (Colonoscopy and GI Bleeding; H-pylori testing; biopsies for liver; colon cancers; some hepatitis; a week or two turnaround)

Ventura                        (endoscopy; colonoscopy with polypectomy; hepatitis C initial referral, although we may do the ongoing management; any transplant candidates)

Long Beach                  (failed medical management; or if there is a need for EGD or colonoscopy; diagnostic dilemmas)

U Penn                         (Physician specific – 1 week to 1 month turnaround)

Crozer-Keystone          (hepatitis C treatment; screening and evaluation; cancers; 1 month time)

Jefferson                       (Hepatitis C; some cirrhosis; chronic Hepatitis B; rectal bleeding; 1-4 months)

McKeesport                 (Scoping for GI bleeding; colonoscopy for patients over 50; less than a week to be seen, depending on insurance)

Oahu                            (Referrals fro EGDs, colonoscopies; suspected stomach cancer; ERCP (usually identified in hospital); severe cirrhoses; liver biopsies; referrals to hepatologists for Hepatitis C or B patients needing treatment; huge shortage of GI specialists in Hawai’i– 4 months wait, otherwise we refer to general surgeons that do those procedures)

*NPCB P2 I.6b(1) Does your residency program manage the following GI disorders

for your family medicine center patients either in the inpatient or outpatient settings or both?

a)      irritable bowel syndrome? Yes __ No __

Yes:

Shadyside

Johnstown

Altoona

St Margaret

Fairfax

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

*NPCB P2 I.6b(1) Does your residency program manage the following GI disorders

for your family medicine center patients either in the inpatient or outpatient settings or both?

b)      peptic disease? Yes __ No __

Yes:

Shadyside

Johnstown

Altoona

St Margaret

Fairfax

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

*NPCB P2 I.6b(1) Does your residency program manage the following GI disorders

for your family medicine center patients either in the inpatient or outpatient settings or both?

c)      GI bleeding? Yes __ No __

Yes:

Shadyside

Johnstown

Altoona

St Margaret

Fairfax

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

*NPCB P2 I.6b(1) Does your residency program manage the following GI disorders

for your family medicine center patients either in the inpatient or outpatient settings or both?

d)      GERD? Yes __ No __

Yes:

Shadyside

Johnstown

Altoona

St Margaret

Fairfax

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

*NPCB P2 I.6b(2) Does your residency program participate in colorectal screening and surveillance programs consistent with professional guidelines? Yes __ No __

Yes:

Shadyside                     (We have flex sig available and a health maintenance module)

Johnstown

Altoona

St Margaret

Fairfax

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

*NPCB P2 I.6b(3) Does your residency program participate in the identification, management, referral and follow-up care of patients requiring the following tertiary care services:

a.      end stage liver disease? Yes  __ No __

Yes:

Shadyside

Johnstown

Altoona

St Margaret

Fairfax

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

*NPCB P2 I.6b(3) Does your residency program participate in the identification, management, referral and follow-up care of patients requiring the following tertiary care services:

b.      colon cancer? Yes __ No __

Yes:

Shadyside

Johnstown

Altoona

St Margaret

Fairfax

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

*NPCB P2 I.6b(3) Does your residency program participate in the identification, management, referral and follow-up care of patients requiring the following tertiary care services:

c.       pancreatitis? Yes __ No __

Yes:

Shadyside                     (we would refer advanced pancreatitis)

Johnstown

Altoona

St Margaret

Fairfax

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

*NPCB P2 I.VII.4 Are you able to assure that your family medicine patients have access to the following diagnostic tests, either within your family medicine center or through a process of referral or consultation?

a.      endoscopy? Yes __ No __

Yes:

Shadyside                     (through consults)

Johnstown

Altoona

St Margaret

Fairfax

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

*NPCB P2 I.VII.4 Are you able to assure that your family medicine patients have access to the following diagnostic tests, either within your family medicine center or through a process of referral or consultation?

b.      liver biopsy? Yes __ No __

Yes:

Shadyside                     (through consults)

Johnstown

Altoona

St Margaret

Fairfax

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

*NPCB P2 I.VII.4 Are you able to assure that your family medicine patients have access to the following diagnostic tests, either within your family medicine center or through a process of referral or consultation?

c.  imaging studies? Yes __ No __

Yes:

Shadyside

Johnstown

Altoona

St Margaret

Fairfax

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

*NPCB P2 I.VII.4 Are you able to assure that your family medicine patients have access to the following diagnostic tests, either within your family medicine center or through a process of referral or consultation?

d. stool/occult blood tests? Yes __ No __

Yes:

Shadyside

Johnstown

Altoona

St Margaret

Fairfax

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

Last Updated (04 September 2006 17:50)