The gastroenterology position at Benefis Health System offers a diverse and challenging clinical experience, catering to a high-volume practice with significant patient demand. The role encompasses both inpatient and outpatient care, with the flexibility to focus on either or maintain a mix of both. In the outpatient setting, physicians typically work Monday to Friday from 8:00 AM to 4:00 PM, managing a busy clinic and performing a variety of endoscopic procedures. The practice sees 14-18 cases per day in Great Falls alone, with a substantial backlog of approximately 1,200 scopes waiting to be scheduled. This high volume ensures a rich clinical experience and the opportunity to hone skills across a wide range of gastrointestinal conditions.
2023 (2022) Numbers:
Colonoscopy – 2,775 (2,077)
EGD – 2,074 (2,091)
ERCP – 218 (212)
EUS – 46 (53)
Procedures form a significant part of the clinical responsibilities, including routine endoscopies, colonoscopies, and more complex cases as needed. The newly constructed 24,000 sq ft endoscopy center, set to open in December 2024, will provide state-of-the-art facilities for these procedures. This center will feature 10 procedure rooms, each equipped with dedicated anesthesia equipment, allowing for efficient and high-quality care. ERCP is a key component of the practice, with volumes averaging about one per day. For those interested in advanced endoscopic procedures, there's also the opportunity to perform EUS, with the current volumes ranging from 0-3 per day.
Inpatient responsibilities are equally demanding and rewarding. Hospitalists cover seven days a week, starting early at 6:30-6:45 AM and working until 12-4 PM, depending on the daily volume. The total procedures for inpatient GI, including ERCP, EGD, and others, range from 2-8 per day. A dedicated inpatient procedure room is available starting at 7:30 AM, allowing for efficient management of emergent cases. It's worth noting that ERCP skills are required for those taking on inpatient or hospitalist roles. You'll have access to on-site diagnostic imaging including CT, MRI, and PET-CT, as well as a rapid-turnaround laboratory with genomic and molecular testing capabilities.
The clinical team is well-supported by a robust infrastructure. Three APPs handle most of the clinic and follow-up work (GI will not see patients in clinic), allowing physicians to focus on more complex cases and procedures. A nurse practitioner manages referrals, ensuring a steady flow of patients, while a PA provides support for inpatient work, handling 2-10 consults per day. The dedicated endoscopy nursing team and GI navigators for patient screening and review further enhance the efficiency of the practice.
Call responsibilities are described as manageable, with one physician reporting only one evening call-back in 2.5 weeks. However, it's important to note that while outpatient roles have no call requirements, those in inpatient roles will participate in the call schedule. The exact structure of call can be flexible and is often customized based on the team's needs.
Given the rural setting, gastroenterologists at Benefis Health System should be prepared for a broader scope of practice. This might include managing a wide variety of gastrointestinal conditions that in more urban settings might be referred to subspecialists. The practice also emphasizes collaboration with other specialties, including oncology, hepatology, and radiation oncology, providing opportunities for multidisciplinary care.
Lastly, there's a strong emphasis on quality and efficiency. The goal is to have 5 providers a day in the endoscopy center, plus one provider in the clinic, aiming for 14 - 18 procedures per provider per day. This high-volume, high-efficiency model requires skilled physicians who can maintain quality care while managing a significant patient load. The opportunity to shape one's practice and utilize the available resources makes this an ideal position for a gastroenterologist looking to make a significant impact in a growing and dynamic healthcare system.