North American Society for Pediatric Gastroenterology, Hepatology & Nutrition

table of contents

VOLUME 14, NO. 2N E W S

NASPGHAN Foundation News . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4NASPGHAN Members Attend DDW Reception . . . . . . . . . . . . . . . . . . . . . . . . 5Foundation Grants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6Committee Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7Second–Year Fellows Conference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 American Board of Pediatrics / EPA News . . . . . . . . . . . . . . . . . . . . . . . . . . 9MOC Update / NASPGHAN Washington Day . . . . . . . . . . . . . . . . . . . . . . . 10

AAP Corner / Nutrition University . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Meetings & Important Deadlines / Meetings of Interest . . . . . . . . . . . . . . . . 14

Billing & Coding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Washington Update . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

NASPGHAN Symposium for Dietitians . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Classifieds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

President’s ReportPresident, NASPGHAN: Athos Bousvaros MD, MPH

BUILDING NASPGHAN INTO ABRANDOne of the main efforts of my presidency has been

trying to build NASPGHAN into a “brand”. By this, I mean increasingthe awareness among patients, professional societies, industries, and policymakers that NASPGHAN is a powerful voice advocating for the health of children with digestive and liver disease. There are many obstacles in the way of raising awareness of our society among non-pediatric gastroenterologists. First, we have a relatively small number of members compared to the adult GI societies (AGA, ACG), and the general pediatric societies (AAP). Second, our society’s acronym(NASPGHAN) is hard to spell and hard to remember. It doesn’t roll off the tongue like “Amazon” (what does selling books have to do with a river in South America?) or “ImproveCareNow” (the best nameever, in my opinion). I’ve met with policymakers, and when I tell them I’m from “NASPGHAN”, they say “that’s a mouthful”. Third, I don’tknow how much we have emphasized public outreach and advocacy in the past.

Over the last few years, however, we have made several steps to increaseour national profile. Our terrific advocate, Camille Bonta, works not onlywith NASPGHAN but with other societies such as ASGE. She has hadour society co-sign several important letters drafted by others (includingAGA and AAP), and also made suggestions for NASPGHAN membersto sit on FDA advisory panels. Members of NASPGHAN are also goingto Capitol Hill for the second year in a row to advocate for issues relevantto pediatric digestive health. Our GIkids.org website, edited by RickCaicedo and Tom Sferra, is adding content that will attract interested parents whose children have common digestive problems. We have a Facebook page and a Twitter feed. Lastly, our decisive actions and educational initiatives on magnets and other dangerous foreign bodies have earned us recognition from consumer protection specialists and othersocieties.

We still have a long way to go to build NASPGHAN into a brand, however, and we need your help. Please let your patients, society contacts, and policymakers know about NASPGHAN. Please distributecopies of the NASPGHAN research agenda (see below) to any interestedparties. The more people that are aware of our organization, the more effective we will be.

NASPGHAN NEWSCongratulations to Jeannie Huang and her maintenance of certification(MOC) group. In record time, she and her colleagues have developed aweb-based part 4 (Quality Improvement) MOC module, and gotten itapproved by the American Board of Pediatrics. Jeannie and her team

acted very quickly, after a survey we put out last fall showed that 80% ofrespondents wanted NASPGHAN to develop part 4 MOC in pediatricgastroenterology. This module will be available early this summer, in time for physicians who need part 4 MOC credits for 2013 to fulfill alltheir part 4 recertification requirements. I plan to be one of the first in line to try Jeannie’s module.

Have you seen the NASPGH ANresearch agenda monograph yet? This terrific pamphlet, developed by Sohail Husain and colleagues,neatly summarizes areas of particularimportance in pediatric GI research. We have printed thousands of copies for members to have and distributeto interested parties such as patients, foundations, and pharmaceutical companies. Please look this over, andhave some available in your office.

The professional education committee led by Sandeep Gupta is one of our hardest working groups.They have recently developed CME credits based on Journal of Pediatric GI and Nutrition articles, whichmake it easy to obtain credits. All you have to do is read your journal, thengo to the NASPGHAN website and get the CME credits at no charge.

A tremendous thanks to Ernie Seidman and his Montreal host organizingcommittee, which is hard at work already ensuring the 2016 World Congress will be one of the best ever.

Thanks also to Praveen Goday, who is developing a symposium for pediatric registered dietitians at this year’s NASPGHAN symposium. We hope this will become an annual event. (See related story, page 18 ).

Lastly, thanks to our fantastic staff at NASPGHAN central (Margaret,Kim, and Heidi), our past presidents (John Barnard, B Li, and KathySchwarz), the current executive council (Kathy Schwarz, Carlo DiLorenzo, James Heubi and our councilors), and to all of you. It truly ismy privilege to serve. As always, I can be reached through 617–355–2962,or by email at (athos.bousvaros@childrens.harvard.edu).

Athos Bousvaros MD, MPH

Associate Director, IBD Center, Children's Hospital Boston President, NASPGHAN

SUMMER 2013

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Dear Friends:

The program for the 27th NASPGHAN Annual Meeting has been finalized. And what a phenomenal program it is! All the speakers haveaccepted our invitations and the current program has a great mix of clinical and laboratory science, presentations geared to practitioners and training directors, and concurrent sessions for nurses and registered dieticians. Topics related to professional development, advocacy and billingwill also continue to be part of the meeting. The very successful Teaching and Tomorrow program will continue and we will have again Hands-on Endoscopy and Manometric sessions. Bottom line: no excuse for not attending this year meeting as there is value for every provider involvedin the clinical practice or research endeavors related to pediatric gastroenterology.

The structure of the meeting will be similar to last year’s. The differences include no single-topic conference on the Wednesday preceding the meeting, more presentations during the Postgraduate Course, one more abstract-based scientific session, and having the first parallel Nutrition Symposium aimed at Registered Dietitians. This course, organized by Dr. Praveen Goday, represents a unique opportunity for our Society to engage our partner dietitians who are so valuable to all of us in our practices but who rarely attend the NASPGHAN meetings. Please advertisethis symposium and encourage the Registered Dietitians in your practice to participate. (Please see related story page 18). The 2012 NASPGHANmeeting will close on Saturday night with the usual social event as there will be no Sunday morning sessions.

One of the unique features of this year meeting is having speakers give “Research Lessons Learned” as state of the art research lectures integratedwith the abstract sessions. We have recruited several of the most accomplished researchers in our field to give these lectures, which will providean historical perspective on different research topics such as neonatal liver disease, intestinal stem cells, gut development, functional GI disordersand IBD.

There will be 20 breakfast sessions (two in Spanish) that will facilitate more intimate interaction between speakers and society members. GI Jeopardy for Fellows and Faculty on Saturday evening will give an opportunity to the Faculty to fare a bit better than they had in the past!Hope to see you all in Chicago!

Carlo Di Lorenzo, MDNASPGHAN President ElectProgram Committee Chair

NASPGHAN Clinical Research Registry Under Way

The NASPGHAN Clinical Research Registry was developed by NASPGHAN in collaboration with the Medical College of Wisconsin. The main aim of the registry is to facilitate clinical research in pediatric gastroenterology by NASPGHAN membersin general and, in particular, to expedite the planning phase of multi-center research studies and clinical trials.

If you registered for the NASPGHAN Clinical Research Registry in fall 2012, you should have received an email with the subject“REDCap access granted”. This email will contain your username and password. If you did not receive a username and password,please contact Christina Gorges. She can be reached at 414-266-6131 or email: (cgorges@mcw.edu).

◆ Link to access Registry: (https://chwredcap.chw.org/redcap)◆ Please log on and double check that all of your information is accurate and up to date.◆ After logging in, click on the My Projects tab. You will see a link called NASPGHAN Database.

Click on the NASPGHAN Database link. Click the Data Entry link in the left sidebar, and then select your organization name fromthe dropdown. You will see an event grid with green and red buttons. A RED circle indicates that information is missing. A GREENcircle indicates there is no missing information.

Please click on the RED circle and enter information into the blank fields. Please double check all existing information in all formsfor accuracy. You may change or update any information within the database at this time.

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I recently read that Nature + Nurture = Success.Seems this is true in most areas of professional life,including academia. As a research institute directorat a major children’s hospital and president of theNASPGHAN Foundation, I have a lot of ideas

about Nature and Nurture in the context of biomedical research careers,especially at the level of junior physician faculty.

One of the most important types of Nurture is the concept of protectedtime for research. For the purposes of this discussion, I mean research thatis cutting edge, paradigm-shifting original investigation with the potentialto achieve funding by the National Institutes of Health or equivalentfunding agency. In the modern hypercompetitive era of biomedical research, protection from clinical, teaching and administrative duties isvitally important for research success. Said another way, protected timemeans the urgencies of clinical care and other non-research priorities donot erode one’s day. Faculty must have time to read and understand theliterature relevant to their work, confer with colleagues, perform and supervise experiments, manage regulatory matters, write manuscripts andwrite compelling grant applications, among many other important duties. Junior investigative physicians must complete the equivalent of a graduate student and post-doctoral education in a mentored setting in a few short years in order to compete with more traditionally trained PhDcolleagues for funding. This can only be accomplished with adequate protected time to concentrate on research during fellowship and as a junior faculty member.

How much protected time is enough? To my knowledge there is no published evidence supporting a specific number. Historically, many institutions have followed the 80:20 rule. That is, 80% research time and20% clinical, teaching and administrative time. Along the same line ofthinking, the NIH and many other young investigator grants, like our NASPGHAN Foundation Young Investigator development grants,require 70-80% protected time. For example, a K23 career developmentaward from the NIH supports junior faculty in patient-oriented researchand requires a commitment of 75% protected time. So does a K08 award,which funds laboratory oriented research.

I am often asked if clinical research requires the same level of protectedtime as laboratory research. In my view, it definitely does. Clearly, theNIH believes it does as well, as the required protected time for K08 anda K23 grant is the same, 75%. Internal K-award programs administered

by Clinical and Translational Science Awards (CTSA) also require 75%protected time. The demands of clinical research are equally, if not more,imposing in my view.

I am also often asked what constitutes 20% clinical effort. Roughly, thisis one half-day clinic a week and two months annually on the inpatient orconsult service. However, there are so many caveats and nuances beyondthe scope of this discussion. The most obvious is how many hours a weekis one willing to work? Twenty percent of a 70 hour work week is very different from 20% of a 40 hour work week! You get the point. These arethings that one must negotiate and then monitor in good faith with one’s department chair or division chief with clear understanding of mutual expectations and outcomes. It is best to agree in advance with departmental or divisional leadership on a clear formula to be appliedover the first 3-5 years that links research time to performance measures.

Finally, protected time is not a life-long commitment to a junior facultymember’s career. At some point, protected time becomes externallyfunded time. The reason for this is simple: protected time is expensive, asit requires the institution to directly support research salary and supplies,but also support indirect costs, which are usually 50% to 80% of directcosts. As a research administrator, I urge you to remember these indirectcosts are very real for one’s institution. Given these issues, it should not besurprising that there are many institution-dependent approaches to jumpstarting a junior faculty member’s research career. Some departments require a junior faculty member obtain a K award during fellowship.More typically, 2-3 years of protected time are permitted those with a promising aptitude and work ethic required of a research career. A K-award will extend this interval for another 3-6 years. Thereafter, transition to independent funding like an R01 is soon required. Again, this is institution dependent and an item for negotiation and discussion with institutional leadership.

If you find this type of review of research Nature + Nurture valuable,please signal me by e-mail at (john.barnard@nationwidechildrens.org)and encourage me to do more. I will be pleased to do so if there is sufficient interest among NASPGHAN members and trainees.

John Barnard, MDPresident, The NASPGHAN FoundationNationwide Children’s HospitalColumbus, OH

Brief Musings Regarding Protected Time for Research

2013 NASPGHAN Annual Meeting Registration

Early-bird registration deadline for the 2013 NASPGHAN AnnualMeeting October 10—12 in Chicago, Illinois will be July 29. To receiveearly-bird rates, envelopes must be postmarked no later than July 29, orStandard rates will apply. Standard rates will apply until September 11.After September 11, on-site fees will apply.

Registration forms and details for the 2013 NASPGHAN Annual Meeting are available online at (www.naspghan.org). Click on MemberCenter and Event Registration is on the left-hand side of the memberpage. You can also download and print the registration form and fax ormail it to the NASPGHAN National office, PO Box 6, Flourtown, PA,19031.

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NASPGHAN Foundation NewsJohn Barnard, MD, President, NASPGHAN Foundation

“Controversies in Fatty Liver Disease”On-Demand Webinar Now Available

In this NASPGHAN Foundation webinar, a panel of experts in pediatricliver disease and nutrition present a case-based program examining controversies in nonalcoholic fatty liver disease (NAFLD). Content includes challenges with screening, diagnostic and treatment options andrecommendations from the latest national guidelines.

Miriam Vos, MD, MSPH one of the co-chairs of the program describesthe webinar: “These are complicated issues we all face on a daily basis.NAFLD is a relatively asymptomatic disease and unless children are carefully evaluated, the severe cases easily blend in with the more mildcases. In this webinar, our experts point out the pros and cons of the various approaches and update us on the most current recommendations.”

Highlights:

NAFLD is the most common liver disease in children with a prevalencethat may surpass other common childhood illnesses such as asthma.

Screening is important to identify new cases of NAFLD and the genderspecific cutoffs of ALT < 22 (girls) and ALT<26 (boys) should be usedfor the upper limit of normal.

Liver biopsy is generally safe and is necessary to establish the diagnosis ofnonalcoholic steatohepatitis (NASH).

Children with NASH are at risk for serious hepatic and non-hepaticoutcomes. Lifestyle changes remain the primary mode of treatment currently, but new therapies are being tested in ongoing clinical trials.

To access the program please go to (http://tinyurl.com/czl3zla).

Co-chairs of the program are Miriam Vos, MD, MSPH and Rohit Koli, MD.

Support provided by Synageva BioPharma

New Capsule Endoscopy Hand-Out for Patients and their Parents

“CAPPY’S GREAT ADVENTURE”

The NASPGHAN Foundation recently developed new informationalmaterials to explain video capsule endoscopy in a fun, easy-to-understandvisual format. It is designed for parents and children. The first part is acomic book explaining the procedure, and is aimed at readers of all ages.The back of the pamphlet provides additional detail about capsule endoscopy for parents. We believe this pamphlet will answer your patientand family questions and ensure a greater understanding of the procedure.

Thanks to Athos Bousvaros, MD, for his vision in bringing this project tofruition along with Herb Trimpe, a professional comic artist, for puttingtogether the story of “Cappy the Capsule.”

Members will receive a link and instructions on how to order the pamphlet.

Support provided by Given Imaging

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Please join us in honoring these outstanding individuals at theAwards Ceremony on Friday, October 11 from 4:15—5:15 pmduring the 2013 NASPGHAN Annual Meeting in Chicago, IL

SHWACHMAN AWARDMitchell B. Cohen, MD

DISTINGUISHED SERVICE AWARDJohn N. Udall, Jr., MD, PhD

AAP MURRAY DAVIDSON AWARDPhilip Rosenthal, MD, FAAP

Awards!

WelcomeNew NASPGHAN Members

Salvador Villalpando, MDPerla Rodriguez, MD

Uwe Blecker, MDErika F. Hurtado-López, MD

Chunyue Yin, PhD

Congratulations to Kim Rose!Kim Rose, who has been Director of Membership atNASPGHAN the last eight years, has been promoted to Associate Director. As Associate Director, she will assist Executive Director Margaret Stallings and will continue tooversee membership activities, including the Annual Meeting registration.

Doug Fishman, MD, chairman of NASPGHAN’s Endoscopy andProcedures Committee, presents David Troendle, MD, with the 2013Endoscopy Prize given during DDW 2013 in Orlando, FL, for Dr.Troendle’s presentation, “Pediatric Gastroenterologists Can Safelyand Effectively Perform ERCP”.

NASPGHAN Endoscopy Prize

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NASPGHAN Members attend DDW Reception

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Watch for Details of NASPGHAN Foundation 2013 Research Grants!

The NASPGHAN Foundation grant submissions for 2013 will soon be open. Information including eligibility requirements and

submission instructions will be available on the NASPGHAN website. The submission deadline for all 2013 grants is August 2, 2013.

✴ NASPGHAN Foundation/NASPGHAN George Ferry Young Investigator Development Award

FOUNDATION GRANTSGrant Submissions Due August 2, 2013

NASPGHAN FOUNDATION grant submissions for 2013 are due August 2, 2013. The grant site is now open at (http://mc.manuscriptcentral.com/naspghanfoundation). Additional information including eligibility requirements and submission instructions is available on the NASPGHANFoundation tab of the NASPGHAN website (www.naspghan.org).

NASPGHAN FOUNDATION YOUNG INVESTIGATOR DEVELOPMENT AWARDS

Description:

1. NASPGHAN Foundation/George Ferry Young Investigator Development Award: This two-year grant is available to junior faculty to support research activities that have the potential for evolution to an independent research career in pediatric gastroenterology, hepatology or nutrition. Monies are awarded in support of a meritorious research project in the clinical or basic sciences to study the diseases of the gastrointestinal tract, liver or pancreas in children.

2. NASPGHAN Foundation/Nestlé Nutrition Institute Young Investigator Development Award: This two-year grant is available tojunior faculty to support research activities that have the potential for evolution to an independent research career in pediatric gastroenterology,hepatology or nutrition. This grant, generously supported by Nestlé Nutrition Institute, is awarded to support meritorious basic or clinical research relating to nutrition in infancy, childhood or adolescence.

3. NASPGHAN Foundation/Crohn’s and Colitis Foundation of America Young Investigator Development Award: This two-yeargrant, funded in conjunction with the Crohn’s & Colitis Foundation of America, is available to junior faculty in support of research relating to aclinical, epidemiological or a basic scientific aspect of pediatric Crohn’s disease and/or ulcerative colitis.

NASPGHAN FOUNDATION FELLOW TO FACULTY TRANSITION AWARD IN INFLAMMATORY BOWEL DISEASE

Description: This award provides $75,000 salary support to enable promising senior pediatric gastroenterology fellows to spend an additional year engaged in full-time research and patient care related to pediatric inflammatory bowel diseases (IBD). The goal is to prepare physicians forindependent research careers in IBD by allowing them:

— To further develop a promising clinical, epidemiologic, outcomes or basic science project.— To build on previously acquired skills and make a transition to IBD Research.— To learn new techniques and/or clinical skills by pursuing a formal curriculum at either their sponsoring institution and/or as a visitor for an

extended period at a pediatric or internal medicine IBD center at another institution.

NASPGHAN FOUNDATION/TAKEDA PHARMACEUTICAL PRODUCTS INC. RESEARCH INNOVATION AWARD

Description: The NASPGHAN Foundation/Takeda Pharmaceutical Products Inc. Research Innovation Award will provide $75,000 annually for two years (total $150,000) for innovative, high-impact research in pediatric gastroenterology, hepatology and nutrition. The intentof this research award is to stimulate scientific inquiry in an area that is exceptionally innovative and has the potential to impact the field in a highly novel manner. Applicants at any career level may apply.

NASPGHAN FOUNDATIONIN OFFICE MEMBER GRANT FOR DEVELOPMENT OF PATIENT EDUCATION PROTOTYPES

Description: This one year grant supports the development and implementation of prototype projects which focus on patient education in practice settings. The Foundation will award up to two grants, each ranging from $500—$2000.

Objectives: The goal of this grassroots program is to support patients’ needs through prototypic concepts that could potentially be utilized by theNASPGHAN/APGNN community in the future.

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Committee ReportsNEUROGASTROENTEROLOGY AND

MOTILITY COMMITTEE

Chair: Joseph M. Croffie, MD

The Neurogastroenterology and Motility Committee continues towork on promoting research, education and quality patient care in thefields of pediatric functional GI and motility disorders.

The committee continues to bring the performance of common GImotility diagnostic procedures to the fingertips of NASPGHANmembers. The committee successfully organized a hands-on workshopon anorectal manometry at the 2012 Annual Meeting in Salt Lake City.This was as popular as the previous year’s workshop on esophagealmanometry in Orlando, Florida. We will continue to offer the hands-on experience in motility testing to the NASPGHAN membershipand will once again, at the October meeting in Chicago, offer a workshop on high resolution esophageal manometry.

In our efforts to continue to promote research in functional GI andmotility disorders, the committee once again, through a generous grantfrom MMS, awarded two prizes of $500 each to the best basic scienceand clinical research abstracts in neurogastroenterology and motilitypresented at the national meeting in Salt Lake City. We want to thankMMS for irts commitment to continue to support this effort for thenext 3 years. We again encourage members to submit their work forconsideration for these prizes.

In the area of research we will continue to collaborate with the ResearchCommittee to push forward the research agenda for functional GI andmotility disorders under the umbrella of the NASPGHAN strategicresearch plan (see related story, page 11).

In the area of patient care, we continue to work on standardizing motility testing among pediatric gastroenterologists. Our committeehopes, in the near future, to complete work on minimum standards for GI motility tests such as impedance/pH testing, esophageal manometry, antroduodenal manometry, colonic manometry andanorectal manometry to share with the NASPGHAN membership.We have completed a registry of available referral centers for the performance of motility procedures in children to serve as a resourcefor members who would like to refer patients to a motility center closerto home and this has been submitted for posting on the website. In thesame light we are working on a registry of psychologists with expertisein cognitive behavioral therapy, guided imagery and hypnotherapy andwill post this on the website as well when completed.

For members who may be interested, we have generated a list of pathologists with expertise in neuroenteric staining techniques to beposted on the website. Our goal with this is to establish a tissue bank inthe future to serve as a resource for future research into neuroentericdisorders.

In closing, I would like to thank members of the committee for their dedication and welcome any suggestions from the membership ofNASPGHAN as a whole. Please contact us to let us know how we can better serve you. Wish you all a wonderful summer.

PUBLIC EDUCATION COMMITTEE

Chair: Ricardo A. Caicedo, MD

In an ongoing effort to broaden the reach of our Society and develop theNASPGHAN “brand,” the Public Education Committee presentsGIKids, the newest version of our website for patients and families, at(www.gikids.org).

For 2013, the Public Education Action Plan includes:

A comprehensive review and revision of the GIKids.org site, in conjunction with the Society leadership, Internet service provider,NASPGHAN Foundation, medical editor, and the TechnologyCommittee.

Content development—expansion of topic articles in four major categories: 1) General Topics (nausea/vomiting, jaundice, milkprotein intolerance, IBS) 2) Emerging/”Hot” Topics (C. difficile, probiotics, special diets) 3) Specialized areas, from our experts in nutrition, hepatology, motility, endoscopy and pancreaticobiliary disorders and 4) Child Safety (prevention and management of ingestions, including high powered magnets, disc batteries, detergentpods).

Content enhancement—illustrations, animations, audiocasts andvideos to accompany our core topics including functional abdominalpain, constipation/soiling, gastroesophageal reflux, diarrhea, healthyeating, gastrointestinal bleeding, and diagnostic procedures.

Content governance—plan for frequent surveillance of the websitefor functionality and troubleshooting.

Partnering with the Technology Committee to make the site easier tonavigate and more visually appealing to our target audience.

I welcome any ideas from colleagues for improving or expanding ourpublic education outreach—please don’t hesitate to contact me at (Ricardo.Caicedo@carolinas.org).

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AASLD / NASPGHAN Joint Pediatric Symposium to be Held at The Liver Meeting 2013

November 1, 2013Walter E. Washington Convention Center

Washington, D.C.

The joint AASLD/NASPGHAN Pediatric Symposium at TheLiver Meeting 2013 will be held Friday, November 1, 2013 fromnoon—3 pm at the Walter E. Washington Convention Center inWashington, D.C. The title of this year’s course is “New Insightsand Controversies in Liver-based Metabolic Diseases.” Course directors are NASPGHAN members Drs. Udeme Ekong andSimon Horslen. During the three-hour symposium, national andinternational experts in both pediatrics and internal medicine willreview the pathophysiology of liver-based metabolic disorders whileoffering insights into the latest treatment options in different clinical settings. Registration will open July 17 for AASLD membersand July 31 for non-members and groups and will be available at(www.aasld.org).

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NASPGHAN—Abbott Nutrition Second–Year Pediatric GI Fellows Conference

Course Director: Binita M. Kamath, MD

The NASPGHAN Second–Year Fellows Conference took place March14–17, 2013 in Scottsdale, Arizona. The focus of this conference is careerchoices and strategies for approaching the job market. We were extremelyfortunate to have many wonderful role models attend the conference whospecialize in motility, private practice, nutrition, hepatology, advancedprocedures, research, administration and industry.

The format of the conference was modified this year to include morebreakout sessions, small group workshops and less didactic lectures. Thisstrategy appeared to work well and resulted in fabulous participation bythe fellows. This also allowed for some wonderful acting opportunitiesfor the faculty during mock interviews! Topics covered included CVpreparation, interviewing and presentation techniques.

There were also ample opportunities for relaxing. Two blissfully warm afternoons were spent at the pool, hiking, horse riding and equally strenuousexcursions to the mall.

Many thanks to the incredible faculty who dedicated their time and energyin helping to make this conference a success: Drs. Carlo Di Lorenzo, Neera Gupta, Gary Fanjiang, Steven Liu, Petar Mamula, Alex Miethke,Mike Narkewicz, Cary Sauer, Kathleen Schwarz, Justine Turner and Nada Yazigi. This event could not exist without the dedication and support of Abbott Nutrition and Bob Dahms who goes above and beyond to ensure the success of the conference. Also, particular thanks to the NASPGHAN staff including Heidi Jetter and especially MargaretStallings, NASPGHAN Executive Director, for her continuous guidanceand devotion to this effort.

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American Board of Pediatrics News

Jonathan Teitelbaum, MDChairperson of the ABP Subboard for Pediatric Gastroenterology

In March of 2013, the American Board of Pediatrics (ABP) hosted a meeting with representatives of the pediatric subspecialties to begin the process of identifying the core Entrustable Professional Activities (EPAs) that the group felt should be required for subspecialty training. EPAs are the routineprofessional–life activities of physicians that trainees can be trusted to perform with minimal or no supervision by the end of their training. Assessmentof EPAs allow for the incorporation/contextualization of various milestones and core competencies. The 2–day meeting facilitated a constructive dialogue on EPAs, milestones, and fellowship training in general. In addition, the group tackled the more concrete task of defining pediatric EPAs thatwould be applicable to all subspecialties, and created a framework for developing subspecialty-specific EPAs. Currently, NASPGHAN is working with the ABP to create a set of EPAs that are unique to our subspecialty. The initial draft of these EPAs is slated to be completed by June 2013.

It is also worth remembering that our 5–year maintenance of certification (MOC) cycles continue to march on. Members are encouraged to look at theABP website where they can identify potential part 2 activities such as the Pediatric Gastroenterology Subspecialty Self-Assessment, in which recent corepublished articles are identified and MOC credits awarded for correctly answering “open –book” multiple-choice questions derived from the articles.NASPGHAN is working hard to create GI–specific MOC part 4 activities for its members (see related story page 10).

Finally, it is my pleasure to announce that Ivor Hill has been elected by acclamation as the next chair of the Pediatric Gastroenterology subboard at the ABP,and will begin his 2–year term in January 2014. Please feel free to contact me with any ABP related questions at (JTeitelbaum@barnabashealth.org).

Pediatric gastroenterologists, especially those involved in mentoring and supervising trainees, need to familiarize themselves with a new concept, the “entrustable professional activity”. I asked Dr. Cary Sauer to review this topic with us, and what it means for NASPGHAN members. —Athos Bousvaros MD, MPH

WHAT IS AN “ENTRUSTABLE PROFESSIONAL ACTIVITY” (EPA)?An entrustable professional activity (EPA) is a measurable outcome used to assess trainees. It encompasses multiple ACGME competencies and manyof the American Board of Pediatrics Milestones into an observable outcome. Together, a group of EPAs are meant to reflect the core of a profession andencompass all competencies and milestones.

Entrustable activities are not new to any physician, mentor or parent. Parents entrust their toddlers to go upstairs without help, entrust their school-aged children to ride a bus home from school by themselves, and entrust their teenagers to drive a car. Applying these principles to medicine is no different. As faculty train fellows they must prepare to entrust the care of patients to them by the end of a fellowship and therefore, EPAs are the essential outcome of all training programs.

WHAT ARE SOME EXAMPLES OF EPAS? EPAs can be split into general and subspecialty specific EPAs. General EPAs in which all physicians are competent can include“Providing consultation” and “Apply quality improvement into practice.” Subspecialty specific EPAs would include “Care ofchildren and adolescents with IBD” or “Management of common outpatient GI disorders (FGIDs, reflux, constipation).”

WHY DO WE NEED EPAS; WE HAVE ALWAYS TRAINED OUR FELLOWS WELL?EPAs are observable and make the appropriate transition to competency-based assessment of fellows. It is a practical outcome of the 7 ACGME Competencies and over 50 ABP Pediatric Milestones. In the form of an EPA, they can be used to more appropriately assess fellows in a real-world applicable manner.

ARE EPAS REQUIRED AND WHEN WILL THEY BE NECESSARY?The use of ACGME Competencies and ABP Pediatric Milestone are required for pediatric subspecialties in July 2014 (generalpediatrics July 2013). EPAs are the vehicle to assess milestones and competencies and thus will be integrated into assessment oftraining by July 2014.

WHAT IS NASPGHAN DOING ABOUT EPAS?The NASPGHAN Training Committee has developed an EPA Task Force that is developing 5 pilot EPAs to be tested from May-Sept 2013 at any institution that would like to be part of testing. Based on the testing, EPAs will be revised and additionalEPAs will be developed to be implemented by all programs in July 2014. EPA assessment will be reported to the ACGME NextAccreditation System for subspecialty training demonstrating assessment of competencies and milestones within training.

HOW CAN I HELP?If you would like to help in the creation or testing of EPAs please do so by contacting the EPA Task Force Co-Chairs: Cary Sauer(csauer@emory.edu) and Toba Weinstein (tweinste@nshs.edu) or consider joining the NASPGHAN Training Committee.

Role of Entrustable Professional Activity (EPA) and the Training of Pediatric GI Fellows

Cary Sauer, MD

Toba Weinstein, MD

WHERE ARE WE WITH MOC? The NASPGHAN MOC Task Force is working hard to provide members with resourcesthat will meet the requisite 40 MOC Part IV credits for each 5-year cycle. For your own specific requirements, please refer to your individualAmerican Board of Pediatrics MOC portfolio.

Resources to be provided include quality improvement and practice performance projects that will qualify for MOC Part IV credits and be rel-evant to the practicing pediatric gastroenterologist. Currently, four modules are in development on the topics of Colonoscopy, Upper Endoscopy, Failure to Thrive, and Informed Consent. NASPGHAN will charge a nominal fee for participation in these modules at an initial offering priceof $250 for participation in any or all of the 4 modules for one 5-year cycle. This time-limited price will be available to NASPGHAN membersuntil March, 2014; after that, we expect prices to increase. Each module will be worth 25 MOC Part IV credits; thus, taking 2 modules will fulfill all ABP part 4 MOC requirements for a 5-year cycle.

While development of these modules is ongoing, it is expected that the Colonoscopy and Failure to Thrive Modules will be available to members beginning in July 2013. The remaining modules will be available by the end of the year. Please look out for additional announcementsre: how to register and begin your MOC Part IV activities at (http://NASPGHN.informz.net/survistapro/s.asp?id=11541).

We look forward to providing this much needed service to members.

Sincerely,

Your MOC Task Force Chairs—Jeannie Huang, MD, MPHJenifer Lightdale, MD, MPH

Any questions? Email us at (naspghanmoc@ucsd.edu)!

From left, Drs. Sohail Husain, Neera Gupta and Arvind Srinath, members ofNASPGHAN’s Research Committee, visited with NIH officials and membersof Congress during NASPGHAN Washington Day June 17.

From left, Drs. David Brumbaugh, Emily Perito, Deborah Goldman and Amethyst Kurbegov were part of the group of NASPGHAN members who visitedCongressional offices in Washington as part of NASPGHAN Washington Day.

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NASPGHAN Washington Day — June 17, 2013

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Research Committee LaunchesPediatric GI Research AgendaLast month, the NASPGHAN Research Committee completed NASPGHAN’s updatedPediatric GI Research Agenda.

1. What is the NASPGHAN Pediatric GI Research Agenda? The Agenda highlights the research interests and priorities of our community of pediatricgastroenterologists. It was formulated by NASPGHAN members who are topic experts in the respective fields and was written in Scientific American language. Section topics include Inflammatory Bowel Disease, Functional Gastrointestinal, Motility, Allergic, Liver,Pancreatic, and Nutritional disorders. The goal of the Agenda is to raise public awarenessabout research needs in Pediatric GI.

2. How can I use the Agenda in my practice?NASPGHAN has printed several thousand copies of the Research Agenda and is makingthem available free of cost to our members. The Agenda is also available to download, forward, or print out from our website, (http://www.naspghan.org/user-assets/ Documents/pdf/PediatricGIResearchAgendaBrochure_3-6-13-Final.pdf). Please keep copies with

you in clinic or in work stations and share the Agenda with patient families and advocates for PediatricGI research. This could also include philanthropists as well as local government or administrative officials. Finally, the Agenda may offer a starting point for trainees looking for research ideas.

3. How will NASPGHAN use the Agenda on an organizational level?In this lean economic climate, the Agenda is NASPGHAN’s proactive strategy for reaching out to congressional leaders, philanthropic organizations, foundations, and industry partners in order to garnersupport for research in Pediatric GI. Please do let us know where else we can leverage the NASPGHANPediatric GI Research Agenda.

Sincerely,

Sohail Husain, MD; Editor and Research Committee ChairMeenakshi Rao, MD, PhD; Research Committee MemberArvind Srinath, MD; Associate Editor and Research Committee Member

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CME Credits Earned by Reading JPGN ArticlesThanks to the efforts of the Editors, the authors and the Professional Education Committee, you can now easily earn CME credit by reading current articles in JPGN.

June 2013–Characterization of Esophageal Motility Following Esophageal Atresia Repair Using High-Resolution Esophageal ManometrySafety, Tolerability, and Clinical Response After Fecal Transplantation in Children and Young Adults With Ulcerative Colitis

May 2013–Microbiota and Gut–Liver Axis: Their Influences on Obesity and Obesity-Related Liver DiseaseInfliximab-Induced Psoriasis and Psoriasiform Skin Lesions in Pediatric Crohn Disease and a Potential Association With IL-23 Receptor Polymorphisms

April 2013–Psychosocial Issues in Pediatric Inflammatory Bowel Disease: Report of the North American Society for Pediatric Gastroenterology,Hepatology, and Nutrition

CONGRATULATIONS To the newly elected councilors of NASPGHAN!Kara Gross Margolis, MD / Norberto Rodriguez-Baez, MD / Alfredo Larossa-Haro, MD

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JPGN:News from the Editor

The Journal of Pediatric Gastroenterologyand Nutrition continues to thrive. Severalinnovations are being expanded which arediscussed below.

CME UPDATE—In addition to offering CME credits for completed reviews, JPGN has teamed with NASPGHAN to offerCME credit to readers of the journal! Authors of selected articles will be invited to provide learning objectives and draft CME questions.Our new CME Editor, Dr. Sandeep Gupta, will be providing oversightto assure appropriate material is available on the designatedNASPGHAN CME website. Readers interested in obtaining CME credit shouldlook for the following icons attached to articles offering CME credit.

Follow the instructions within each CME article to claim your credit.JPGN is excited to offer this additional educational value to our readers!

SOCIAL MEDIA—Over the next year, JPGN will be expanding itsparticipation in Facebook and Twitter. We are seeking interestedNASPGHAN members who would be willing to take on the role of helping to develop this initiative as the JPGN Social Media Editor.If you are interested, please draft a brief synopsis of your experienceand how you propose to help in this effort and send it to Dr. Mel Heyman, Editor-in-Chief, at (mheyman@peds.ucsf.edu).

If you currently use Twitter, we encourage you to Tweet about articlesin JPGN. Use the hash tag #jpgnonline. Follow JPGN on Facebook at(www.facebook.com/thejpgn).

CALL FOR PAPERS!—JPGN solicits original researchmanuscripts in areas of developmental biology and pathogenesisbroadly related to intestinal, hepatobiliary, and pancreatic functions.All articles are published as PAP (Published-Ahead-of-Print) within3–5 days of acceptance. The backlog of Original Articles is now

only 3–4 months for in-print publication. Manuscripts with novel scientific data or findings of primary public health importance maybe submitted for rapid publication. These submissions are prioritizedfor publication following a rapid review process completed in 10 daysor less. The usual turnaround time from initial submission to PAP is less than 2 weeks, with publication in the next issue (approximately2 months). Manuscripts can be submitted online to: (http://www.editorialmanager.com/jpgn-na/).

EDITORIAL MANAGER CONTACT INFORMATION—All JPGN authors and reviewers have a profile in Editorial Manager.We encourage you to periodically visit the site and update your contact information and affiliation. This can be done at the “UpdateMy Information” link at the top of every page.

The benefits of updating your contact information are, as an author,your manuscript submission will automatically populate with the correct affiliation; the JPGN Editorial Office will be able to contactyou with any updates regarding your manuscript and/or review, andyou will be eligible to receive invitations to review manuscripts andsubmit commentaries and other invited content.

CALL FOR REVIEWERS—JPGN provides CME credit for ourreviewers (3 CME credits per review). If you are interested in servingas a reviewer for JPGN, please contact (thejpgn@gmail.com) with thefollowing information: full name, email address, institution and CV.You will then receive an email invitation to log into JPGN's EditorialManager site and update your profile. Potential reviewers include fellows in Pediatric GI, Hepatology & Nutrition, practicing pediatricgastroenterologists, and post docs and scientists/investigators in related fields.

Keep sending your papers to JPGN, your journal! And have a greatsummer!

Mel Heyman, MDEditor-in-Chief, Journal of Pediatric Gastroenterology and Nutritionmheyman@peds.ucsf.edu

Mel Heyman, MD, Editor-in-Chief,Western Hemisphere, JPGN

JPGN on the iPad and Social MediaJPGN is available as an iPad app. In the App Store, search for “JPGN.” The app is free to download,and issues from October 2012 through June 2013 are open to all. Starting with July, members willneed to sign in to download new issues as a benefit of membership. If you already have a user nameand password on JPGN.org, please use that to sign into the app. If not, on the iPad, tap “sign in,” then“create an account.” Or, register at jpgn.org by clicking the “register” link. JPGN on the iPad includesthe full text of each issue in a format optimized for the iPad screen.

To keep up with JPGN please “like” the journal on Facebook at (facebook.com/thejpgn). Follow JPGN on Twitter at(@jpgnonline). Share your thoughts about what you are reading in JPGN by using the hashtag (#jpgnonline).

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American Academyof Pediatrics CornerThe AAP remains highly committed to working collaboratively with NASPGHAN to improve the health and well-being of all children and promotethe pediatric profession. The AAP has been pleased to partner with NASPGHAN in heightening awareness regarding battery ingestions. Discussions are underway involving representatives from NASPGHAN and AAP’s Section on Surgery,Section on Otolaryngology, Section on Gastroenterology,Hepatology and Nutrition, and Council on Injury, Violence &Poison Prevention. A new survey instrument is currently underdevelopment to determine the prevalence and outcome of button battery ingestions.

In March, more than 300 pediatric leaders from the UnitedStates and Canada discussed leading child health topics and thefuture of the profession at the AAP Annual Leadership Forum.Resolutions serve as advice to the Board of Directors on the future direction of AAP policies and procedures, and often serveas the “springboard” for AAP initiatives. This year, the SOGHNsponsored/provided input into resolutions on Medicare andMedicaid payment parity, food security for children/families, theeffect of glucose and fructose sweetened beverages and foods, andthe prevention of button battery injury to children. These fourwere among the 65 adopted resolutions this year.

This year’s National Conference and Exhibition (NCE), the annual meeting for AAP members with over 14,000 attendees,will take place in Orlando, October 26-29, 2013. The SOGHNwill sponsor a host of educational sessions on Constipation andEncopresis (Carlo Di Lorenzo), Whiners-Fussy Babies (MarkGilger/Bruno Chumpitazi), The Child with Difficulty Swallowing(Jeffrey Bornstein), The Vomiting Child (B Li/Colin Rudolph),Swallowing Dysfunction in Infants (Leo Heitlinger), and a Ple-nary on Celiac Disease and Non Celiac Gluten Sensitivity(Alessio Fasano). The SOGHN continues to play a significantrole in recommending topics specific to our specialty, and we intend to maintain close communication with NASPGHAN’sProfessional Education Committee on future CME programs.

A reminder that the national AAP election season is officiallyunderway, and the two President-Elect candidates are SandraHassink (general pediatrician at Nemours in Wilmington) andThomas Tryon (general pediatrician at Children’s Mercy Hospitalin Kansas City). Additional information regarding each candidateand the election process can be found on the Academy’s website.Voting for the next President-Elect will take place October 25—November 25.

Wishing a great summer to all!

Leo Heitlinger, MDChair, AAP Section on Gastroenterology, Hepatology and NutritionEmail: (heitlil@slhn.org)

�The second N2U Course was held April 19—20 in Chicago. Thisprogram was designed to provide specialized nutrition education in areas associated with the practice of pediatric gastroenterologyand nutrition for third-year postdoctoral fellows and graduates ofpediatric gastroenterology training programs.

The course included a pro and con discussion about the use of fiber in the treatment of IBD, Nutrition Jeopardy and six detailedcased-based discussions.

Ann Scheimann, Course Director, explains, “This year we exploredmore in-depth discussions reviewing the latest practice methods anddata while sharing hands on approaches to every day challenges”.

A special thank you to Faculty Chair Ann Scheimann, MD,MBA who worked tirelessly to make this Course a success againthis year. Additional thanks to faculty:Praveen Goday, MBBS,CNSC; Maria Mascarenhas, MBBS; Robert Shulman, MD; Valeria Cohran, MD, MS, and Patricia A. DeRusso, MD, MSand CME content reviewer, Sunny Z. Hussain, MD.

Reviewers who scored applications included Ann Scheimann,MD, MBA; Charles Vanderpool, MD; Praveen Goday, MBBS,CNSC; Stavra Xanthakos, MD, MS; Sabina Ali, MD; AlanSacks, MD, and Rebecca Cherry, MD.

We look forward to our attendees serving as ambassadors to sharethe information within their practices and home institutions.

Support provided by Nutricia

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20134 JULY 29, 2013

Early-bird deadline for 2013 NASPGHAN Postgraduate Course and Annual Meetingwww.naspghan.org

4 AUGUST 2, 2013 NASPGHAN–NASPGHAN Foundation GrantSubmission Deadlinewww.naspghan.org

4 SEPTEMBER 11, 2012 Standard rate deadline for 2013 NASPGHAN Postgraduate Course and Annual MeetingOn-site rates applywww.naspghan.org

4 OCTOBER 10–12, 2013 2013 Annual MeetingChicago Hilton Downtown—Chicago, IL

4 NOVEMBER 18, 2013 2013 Certifying Exam in Pediatric GastroenterologyRegistration for first-time applicants: February 4, 2013—April 30, 2013Registration for re-registrants: March 14, 2013— June 17, 2013www.abp.org

20144 JANUARY 9-12, 2014

2014 First-Year Fellows ConferenceFort Lauderdale, FL

4 FEBRUARY 6-9, 2014 2014 Third-Year Fellows ConferenceScottsdale, AZ

4 MARCH 6-8, 2014 2014 Third-Year Fellows ConferenceScottsdale, AZ

4 OCTOBER 22–25, 2014 2014 NASPGHAN Annual MeetingAtlanta Hilton—Atlanta, GA

20154 OCTOBER 7–10, 2015

2015 NASPGHAN Annual MeetingWashington Hilton—Washington, DC

NASPGHAN Meetings & Important Deadlines

Meetings of Interest35th Annual Aspen Conference on Pediatric Gastrointestinal Disease

• Date: July 15–19, 2013• Location: Viceroy Snowmass Hotel, Aspen, CO• Contact: cme@cchmc.org

Kunwar Viren Oswal Course in Pediatric Gastroenterology,Hepatology, Liver Transplantation and Nutrition

• Date: August 28 –September 1, 2013• Location: Auditorium, Indraprastha Apollo Hospital,

New Delhi, India• Contact: drvidyut@gmail.com or akshaydr80@yahoo.co.in

ESPGHAN Monothematic Conference Current Paradigmsand Novel Strategies in Paediatric Liver Transplantation

• Date: September 12-14, 2013• Location: Courtyard Hannover Maschsee, Hannover, Germany• Contact: www.espghan.kongressregistrierung.de

15th International Celiac Disease Symposium

• Date: September 22-25, 2013• Location: Sheraton Chicago Hotel and Towers, Chicago, IL• Contact: wwww.icds2013.org

Pediatric Sedation Outside of the Operating Room:Full-day Sedation Symposium

• Date: September 27, 2013• Location: New York Marriott Downtown• Contact: www.pediatricsedationconference.com

Full-day High Fidelity Pediatric Sedation Simulation Workshops

• Date: September 27, 2013• Location: New York Marriott Downtown• Contact: www.pediatricsedationconference.comWeekend Course: Frontiers of Sedation

• Date: September 28-29, 2013• Location: New York Marriott Downtown• Contact: www.pediatricsedationconference.com

Gastroenterology Regulatory Endpoints and the Advancement of Therapeutics II

• Date: October 21-22, 2012• Location: Bethesda, MD NIH Campus• Contact: andrew.mulberg@fda.hhs.gov,

aisha.peterson@fda.hhs.gov or juli.tomaino@fda.hhs.gov

2013 Advances in Inflammatory Bowel DiseasesCrohn’s & Colitis Foundation’s Clinical and Research Conference

• Date: December 12-14, 2013• Location: Hollywood, FL• Contact: www.advancesinibd.com

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FEE SCHEDULE UPDATE• Sequestration yielded a 2% decrease in the Medicare physician fee schedule on April 1, 2013. • January 1, 2014, is another deadline for fee schedule reduction. Please make sure to contact your congressman to

encourage work on the SGR to avoid this issue in the future.

HIPAA OMNIBUS (MEGA) RULEReleased January 25, 2013, and effective September 23, 2013, all practices must be in compliance or face penalties. Some of the revisions/updatesare listed below:

• Any BA (Business Associate Agreement) signed prior to January 25, 2013, will have up to September 22, 2014, to obtain a renewed/revised agreement.• Any BA signed after January 25, 2013, will only have to September 22, 2013 to obtain revised agreement.

New definition of business associate:• Someone who creates, receives, maintains or transmits PHI on behalf of the covered entity.

First step is to create an internal security team: usually someone from clinical and IT and conduct a risk assessment:• Make sure that any mobile technology devices (I-pads, tablets, smart phones) are encrypted. If data is encrypted and instruments are lost, for

example, this is not considered a breach.• Remote access is another problem. Make sure that any desktops at home, etc., are encrypted and sign off as soon as you are finished. • Make sure that you have a plan in place if a breach is detected. If a breach occurs that involves over 500 patients, then you have to do an

official report to HHS, local media, and the patients affected. If not, a fine of $1.5 million is assessed for each of those violations.

• Create a list of those vendors who you release PHI (Protected Health Information). Subcontractors are also included. Stage 2 of meaningful use requires a patient portal so a lot of the EHRs will subcontract this out to other vendors.

For further information: (http://www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/ contractprov.html)

RUC REVIEW FOR ALL ENDOSCOPY CODESRelative Value Unit Committee will be reviewing all endoscopic procedure codes. All societies need input from physicians including:

• Physician time it takes to perform a service• Physician mental effort and judgment• Physician technical skill and physical effort• Physician psychological stress that occurs when an adverse outcome has serious consequences

To volunteer, email (surverys@asge.org) with your name and contact information.If we do not obtain a minimum number of responses for each survey, we are at risk that CMS will make the final decisions regarding reimbursementwithout GI input.

ENDOSCOPY SURVEYS TIMELINE

Kathleen A. Mueller

Billing &CodingProvided by Kathleen A. Mueller, RN, CPC, CCS–P, CCC Healthcare Consultant in association withMcVey Associates, Inc.

PROCEDURE FAMILY CODE RANGE SURVEY DATE

EGD 43235-43259 COMPLETEDERCP 43260–43273 COMPLETED

ENTEROSCOPY TO ILEUM 44376–44382 COMPLETED

ILEOSCOPY & POUCHOSCOPY 44380–44386 SUMMER 2013

FLEXIBLE SIGMOIDOSCOPY 45330–45345 SUMMER 2013

COLONOSCOPY THROUGH STOMA 44387–44397 FALL 2013

COLONOSCOPY 45378–45392 FALL 2013

Billing & Coding continues on the following page

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CLARIFICATION ON TIME BILLINGCPT revised descriptors for time based billing in 2013. Providers should often bill by time in certain circumstances. Listed below are the revisionswith corresponding examples:

OFFICE (CLINIC) VISITS:• Face-to-face time (office and other outpatient visits and office consultations): For coding purposes, face-to-face time for these services is

defined as only that time spent face-to-face with the patient and/or family. This includes the time spent performing such tasks as obtaininga history, performing an examination, and counseling the patient.

EXAMPLE:CC: Patient and family returns for follow up on colonoscopy results—Patient returns to clinic today following a colonoscopy done for rectal bleeding, abdominal cramping, and diarrhea. Symptoms have improvedbut biopsy results did show significant ulceration of colon consistent with ulcerative colitis. Patient looks well and is in no acute distress, vitalsigns are stable. I spoke with the patient and her parents at length regarding new diagnosis of ulcerative colitis. Currently, her symptoms haveimproved but I would like to start her on Asacol 2-400mg tabs 3x daily until flare resolves. I discussed medication side effects and disease progression– all questions were answered. I would like to see her back in clinic next month. I spent a total time of 30 minutes with the patient. Time spent in discussing new diagnosis and treatment options – 20 minutes.

FACILITY VISITS:• Unit/floor time (hospital observation services, inpatient hospital care, initial inpatient hospital consultations, nursing facility): For

reporting purposes, intraservice time for these services is defined as unit/floor time, which includes the time present on the patient’s hospital unit and at the bedside rendering services for that patient. This includes the time to establish and/or review the patient’s chart, examine the patient, write notes, and communicate with other professionals and the patient’s family.

EXAMPLE:CC: Acute pancreatitisS: No further abdominal pain since yesterday morning. Denies SOB. Feels much better. O: NAD, PERRLA, Heart sounds RRR. No murmurs. Lungs clear. Abdomen soft.A: Pancreatitis resolving. Abnormal CT scan. P: Enzymes returning to normal. Review of labs and CT scan done with patient and family. CT scan shows shadows surrounding the

pancreatic head suggestive of malignancy. Will ask for surgical consultation. Spoke with Dr. ____________________________. Total time in patient care today: 50 minutes.

Time is not the usual basis for billing for new patient visits since this should rely on decision making with associated history and physical exam requirements. The time thresholds are listed in the CPT book next to the levels of visits. Make sure all providers are educated on E&M levels.

ICD-10 CODING SCENARIO (EFFECTIVE DATE 10–1–2014)5-year-old who returns for follow-up of Crohn’s disease of the ileum. The patient is currently experiencing some occasional diarrhea.

CURRENT ICD-9 CODE:555.0 Regional enteritis of the small intestine787.91 Diarrhea

NEW ICD-10 CODE(S):K50.018 Crohn’s of the small intestine with other complicationsR19.7 Diarrhea

This is a new description. Instead of regional enteritis, the description now states Crohn’s. Make sure your systems are updated appropriately. Whenthe new codes go into effect, non-specific diagnosis codes will be routinely denied. Now is the time to look at all of the new codes and customizeyour diagnosis code lists whether on superbills or contained in each provider’s list of favorites in your EHR.

• Look at (www.cms.gov/ICD10) for a list of all the diagnosis codes• ICD-10 laminated pediatric GI code sheets are available at (www.askmuellerconsulting.com)

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In June, members of NASPGHAN’s Public Affairs and Advocacy (PAAC) are traveling toWashington, DC to meet with lawmakers as partof NASPGHAN’s annual Washington Day.During this “boots-on-the-ground” advocacyevent, NASPGHAN members are meetingwith nearly 30 congressional offices on CapitolHill. During their visits these pediatric GIs arepromoting NASPGHAN’s policy agenda andcultivating relationships with their lawmakers.They, however, need air support from theirNASPGHAN colleagues—that’s you—for their ground operations.

During seven weeks of summer, June 17—August 2, all NASPGHANmembers are encouraged to make one contact with their U.S. senatorsand representative on at least one of NASPGHAN’s priority issues. Additional resources, including issue fact sheets, will be available at (www.NASPGHAN.org). Simply click on the “NASPGHAN Advocacy” link on the home page to access additional information, including how to take action. NASPGHAN members are encouragedto take action by mailing or emailing letters to their members of Congress. NASPGHAN members should also look for opportunities to connect face to face with their members of Congress when they are home in August during the congressional summer recess. The voiceof pediatric gastroenterology will be heard if every NASPGHANmember commits to taking action.

The PAAC has identified four issues that will be at the center ofNASPGHAN’s summer lobbying efforts. NASPGHAN members areencouraged to contact their members of Congress on the issue or issuesthat concern them most and to personalize in their communicationswhy congressional attention or action is needed. Remember, “all politicsare local.” Members of Congress want to know how their actions willbenefit their constituents, and letters that have been personalized aremore likely to solicit a response.

Pediatric Subspecialty Loan RepaymentThe Affordable Care Act (ACA) created a loan repayment program forqualified individuals who agree to provide two years of pediatric medicalor surgical subspecialty or child and adolescent mental and behavioralservices in a health professional shortage area or a medically underservedarea as determined by the Secretary of Health and Human Services(HHS). In return, the program will provide up to $35,000 in loan repayment for each year of service, for a maximum of three years. Whilethe program has been authorized since fiscal year (FY) 2010, it has yet tobe funded by Congress.

Because the loan repayment program will expire for pediatric medicaland surgical subspecialists in FY 2014, NASPGHAN is also pursuingreauthorization of the program through FY 2018.

NASPGHAN Message to Congress: Fund the Pediatric SubspecialtyLoan Repayment Program at $5 million in the FY 2014 Labor-HHS-Education Appropriations bill, and cosponsor H.R. 1827, the “PediatricSubspecialty and Mental Health Workforce Reauthorization Act.”

Gluten in MedicineLegislation has been introduced in the House of Representatives thatwould require the label of drugs intended for human use contain a parenthetical statement identifying the source of any ingredient constituting or derived from a grain or starch-containing ingredient.NASPGHAN has endorsed the bill and has also commented to theFood and Drug Administration (FDA) on the issue.

NASPGHAN Message to Congress: Cosponsor H.R. 2003, the“Gluten in Medicine Disclosure Act.”

Pediatric Digestive Disease ResearchOn March 1, 2013, as required by law, President Obama signed an orderinitiating an across-the-board cut (or sequestration) to the federalbudget. Sequestration requires a 5 percent cut, or $1.55 billion, to theNational Institutes of Health’s (NIH’s) FY 2013 budget. This cut will be applied evenly across the NIH, which means every area of medical research is affected. For the National Institute of Diabetes andDigestive and Kidney Diseases (NIDDK), the result is 215 fewer competing and non-competing research projects in FY 2013. These cutsdelay medical progress and put our nation’s scientific workforce at risk.

NASPGHAN Message to Congress: Recognize the NIH as a national priority by providing at least $32 billion in the FY 2014Labor-HHS-Education Appropriations bill. This request representsthe minimum investment necessary to avoid further loss of promisingresearch and allows the NIH's budget to keep pace with biomedicalinflation.

Parenteral Nutrition ShortagesThe shortage of parenteral nutrition products and certain trace mineraland vitamins has become widespread. The result is that pediatric GIs arestruggling to provide optimal care to their patients, and many patientsare going without needed nutrients. Currently, 133 medicines are inshort supply. Most shortages in 2013 have been of IV nutritional productsmade by American Regent, Inc. which shut down manufacturing because of quality issues. The FDA has responded by announcing inMay that it would use its regulatory discretion to allow Fresenius KabiUSA, LLC, to import trace elements and phosphate injection from itsplant in Norway. FDA action should provide some temporary relief ofthe shortage of parenteral nutrition products but shortages of otherproducts, such as IV fat emulsion, persist.

NASPGHAN Message to Congress: Shortages of parenteral nutrition products and certain trace minerals and vitamins persist, putting our country’s most vulnerable citizens— infants andchildren—at risk. NASPGHAN commends the FDA for its recentaction to import parenteral nutrition components from overseas manufacturing plants but remains concerned about the long-term, reliable availability of parenteral nutrition products.

Camille S. Bonta

Washington UpdateCamille S. Bonta, NASPGHAN Washington Representative

TAKE TIME FOR ACTION DURING SEVEN WEEKS OF SUMMER

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On June 17, in conjunction with the NASPGHAN Washington Day, members of NASPGHAN’s Research Committee were joined by members of NASPGHAN’s Public Affairs and Advocacy Committee in an afternoon of meetings at the National Institutes of Health. The purpose of the meetings was to promote NASPGHAN’s updated research agenda. Meetings were scheduled with the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute of Child Health and Human Development, and the National Instituteof Allergy and Infectious Diseases.

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Inaugural NASPGHAN Symposium for DietitiansSaturday, October 12, 2013

NASPGHAN is hosting a Nutrition Symposium for Registered Dietitians as part of its Annual Meeting in Chicago. The one–day symposium will be held on Saturday, October 12 and will feature expert presentations and

breakout sessions in which participants will be able to interact with faculty.

NASPGHAN NUTRITION SYMPOSIUM FOR DIETITIANSSATURDAY, OCTOBER 12, 2013—CHICAGO HILTON DOWNTOWN

8:30-9:15AM FOOD ALLERGIESMarion Groetch MS, RD, CDNAs a result of this session the learner will:

• Understand the epidemiology of food allergies in children• Understand the correlation of food allergies with nutritional deficiencies• Be able to manage the nutritional challenges posed by the child with food allergies

9:15-10:00AM BEHAVIORAL ISSUES RELATED TO EATINGMary Beth Feuling, MS, RD, CNSDAlan Silverman PhDAs a result of this session the learner will:

• Understand the causes of behavioral feeding disorders in children• Understand the behavioral interventions that are employed in children with feeding disorders• Able to implement the nutritional interventions that need to be employed in children with feeding disorders

10:15-11:00AM NUTRITION IN INFLAMMATORY BOWEL DISEASERobert N. Baldassano, MDAs a result of this session the learner will:

• Understand the causes of growth failure in children with inflammatory bowel disease• Understand the strategies employed to improve growth and nutritional status of children with inflammatory

bowel disease• Able to implement an exclusive enteral diet for a patient with inflammatory bowel disease

11:00-11:45PM ENERGY BALANCE AND ITS IMPLICATIONS FOR WEIGHT MANAGEMENT Dale Schoeller, PhDAs a result of this session the learner will:

• Understand the complex mechanisms that underlie energy balance• Understand the disorders of energy balance that lead to obesity• Understand the strategic interventions that aim to correct disorders of energy imbalance

12:30-1:15PM NUTRITION AND BONE HEALTH Craig Langman, MDAs a result of this session the learner will:

• Understand the role of nutrition in bone health• Understand the changes caused by common pathological conditions that affect bone health in children• Understand the nutritional and medical strategies to optimize bone health in children

1:30-1:50PM ROUNDTABLE #1 (PICK FROM 4 ROUNDTABLES)

1:50-2:10PM ROUNDTABLE #2 (PICK FROM 4 ROUNDTABLES)

Symposium for Dieticians continues on the following page

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2:10-2:30PM ROUNDTABLE #3 (PICK FROM 4 ROUNDTABLES)

ROUNDTABLE TOPICS

PARENTERAL NUTRITION SHORTAGESAs a result of this session the learner will:

• Understand the recent parenteral nutrition shortages• Know the alternatives available for some of the parenteral elements that have been in short supply• Be able to better manage some common shortages

BLENDERIZED TUBE FEEDING As a result of this session the learner will:

• Understand the role of blenderized tube feeding in children• Understand the pros and cons of using a blenderized diet• Be able to design a basic blenderized diet

FUNCTIONAL ABDOMINAL PAIN/FODMAPSAs a result of this session the learner will:

• Understand the role of diet in abdominal pain• Understand the foods that need to be avoided in the FODMAP diet• Be able to design a basic FODMAP diet

PSYCHOSOCIAL ISSUES WITH G-TUBE PLACEMENTAs a result of this session the learner will:

• Understand the basic psychological issues associated with G-tube placement• Understand how to support the family of a child that is undergoing/has undergone G-tube placement• Successfully deal with basic psychosocial issues associated with G-tube placement

2013 NASPGHAN/ESPGHAN Travel Award Recipient–Alexander Miethke Alexander Miethke, MD, of Cincinnati Children’s Hospital Medical Center has received the NASPGHAN/ESPGHAN 2013 travel award. This award is designed to support the expenses of of a young investigator orfellow/trainee who wants to travel and visit Europe for the purpose of learning a new technique, carrying out a shortproject or observing a different health system. The award is part of a collaboration between ESPGHAN andNASPGHAN begun in 2012 when ESPGHAN funded the first award.

The award allows Dr. Miethke to collaborate with Professor Sibylle Koletzko, head of the Division of Pediatriac Gastroenterology & Hepatology at the Dr. von Hauner Kinderspital of the Ludwig Maximilian University in Munich, Germany. In his proposal, Dr. Miethke pointed out that the Munich institution has an exceptional IBD program and follows the largest cohort of pediatric IBD patients in Germany.

At Cincinnati Children’s, Dr. Miethke has been examining cases based on preliminary data suggesting that poorly controlled inflammatory boweldisease (IBD) adversely effects progression of autoimmune liver disease (AILD) in those patients with both conditions concomitantly present.“There is no reliable therapy for patients with Primary sclerosing cholangitis (PSC) – thus the disorder may progress to end-stage liver disease,”Dr. Miethke said. “In addition, there can be a high recurrence rate following liver transplantation. It has been suggested that active colitis inpatients with concomitant Inflammatory Bowel Disease (IBD) and PSC may significantly impact the disease course of PSC. We have begunto review patient characteristics, disease course, medical and surgical management, and outcomes in children and adolescents with PSC caredfor at our institution in Cincinnati, OH. Since treatment of pediatric IBD is thought to vary between North America and Europe, for instancein regards to nutritional therapy, we formed a collaboration with Professor Sibylle Koletzko at Dr. von Hauner Kinderspital in Munich, Germany. The goal is to compare management of children with IBD and PSC at both institutions.”

Classifieds . . . .

• Alaska–

Providence Health & Services is seeking apediatric gastroenterologist to join a busypractice at The Children´s Hospital at Providence (TCHAP). Currently the groupincludes one pediatric gastroenterologistand one Advanced Nurse Practitioner. Thisis an opportunity to cover the full range ofPeds GI and candidates must be comfortablewith all major areas of the specialty (otherthan peri-operative transplant care) and virtually all relevant procedures. Advantagesof this practice include availability of experienced endoscopy assistants and anesthesiologists for all procedures, including those done after hours. A full pediatric hospitalist service is available; pediatric gastroenterologists are consultonly. Clinic is currently utilizing Epic EMR.The practice draws from the populationbase of the entire state of Alaska, about723,000 people. Academic and clinical research activities are available, as well as opportunities for consultative practice with other facilities in the area. This hospital-employed position offers highly competitive compensation with cost-of-living adjustment and generous,comprehensive benefits. Private practicemodel also available. Open to J-1 Visa candidates. Possible loan assistance.

The Children’s Hospital at Providence(TCHAP), part of Providence Alaska Medical Center, is the only comprehensiveChildren’s Hospital in Alaska, with a 9-bedPICU, 20-bed Med/Surg unit, and 47-bedNICU. There are more than 2,000 Pediatric/PICU admissions and 2,500 deliveries per year. We offer advanced subspecialty care and research, including

a genetics collaborative and centers of excellence in children’s cancer, diabetes, cystic fibrosis and special needs.

Alaska offers financial, cultural and recreational opportunities beyond compare.Anchorage, with 285,000 residents, is amodern American city surrounded by spectacular scenery. There are shoppingmalls, world-class restaurants, brewpubs,two universities, a sports arena and a performing arts center. The combination of urban and wild is what makes Anchoragesuch a special place.

Contact:Barbara WorthingtonSenior RecruiterPhysician Services & Development4400 NE Halsey Street, Building 1, Suite 289Portland, OR 97213Email: barbara.worthington@providence.orgPhone: 503.215.1130Fax: 502.215.0775www.providence.org/physicianopportunities

• California–

Sutter Medical Group (SMG) is a successful,600-plus member multi-specialty group offering physicians the opportunity to buildtheir practices within a progressive, financiallysound and collaborative organization.

SMG seeks a BE/BC pediatric gastroenterolo-gist to join its busy Pediatric Subspecialtyteam. This opportunity offers newly built outpatient offices, a compassionate team of pediatric specialists and a soon to becompleted Women’s & Children’s Hospital.

Join us and enjoy:• Income guarantee with shareholder track• Generous compensation and benefits,

including 401(k) and profit sharing• Advanced practice technology, including

Electronic Medical Records • Beautiful Northern California location

Our inviting Northern California location offers a rich variety of lifestyle advantages.Come experience exhilarating outdooractivities with convenient access to the NapaValley wine country, the splendor of LakeTahoe, the majestic Sierra Nevada Mountainsand the excitement of San Francisco.

Sacramento, the state capital of California,is the core cultural and economic engine of afour-county metropolitan area exceeding 2.1million residents. Centrally located wherethe American and Sacramento rivers meet,

it is an hour and a half from Lake Tahoe or San Francisco and just a short drive to Napa Valley.For more information contact:Nick Crespo, Physician RecruiterSutter Health Sacramento Sierra Region2750 Gateway OaksSacramento, CA 95833Phone: 800.650.0625Email: develops@sutterhealth.orgwww.checksutterfirst.org

• California–

This dynamic and thriving institution isseeking a faculty position in the field of Pediatric Gastroenterology. Join a team ofphysicians, whose areas of expertise cover all facets of Pediatric Gastroenterology, Hepatology and nutrition support. These new clinical faculty positions arebeing added as two world-class children’shospitals prepare for a new affiliation to create a regional program.

Candidates who are well-rounded and havestrong clinical training will thrive among thisgroup of diverse, intelligent, compassionatephysicians. Faculty will have the chance to livein a community that many dream of enjoyingand have an unrivaled lifestyle without compromising professional satisfaction.

• Combined program consists of 10 clinical and academic faculty, plus 7 Nurse Practitioners

• Association with major liver transplant, IBD, motility and intestinal rehab programs

• Teaching role in a Pediatric GI fellowship• Collaboration with world-class Pediatric

specialists in all medical and surgical specialties

• Congenial, close knit group of physicians • Strong tenure and divisional stability• Outstanding benefits

In addition to joining a dynamic program, you will enjoy living in one of the most sought after metropolitan areas in the nation.With no shortage of culture, fine dining, professional sports and outdoor recreation,the Bay Area has something for everyone.

For information, contact:Amy WalzPhone: 866.406.0269Fax: 972.983.0715Email: medcareers@merritthawkins.comREF: # PG-163898:3

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• To post your ad, contact Kim Rose at:krose@naspghan.org or 215.233.0808. The deadline for the next newsletter isAugust 1, 2013.

QUARTERLY EMPLOYMENT ADS =$275 per quarter. This includes one printad in one quarterly newsletter and oneonline ad (NASPGHAN website) for 3 months.

ANNUAL EMPLOYMENT ADS =$1,000 for 12 months. This includes oneprint ad in four quarterly newslettersand one online ad (NASPGHAN website)for 12 months.

• Colorado–Children's Hospital Colorado has definedand delivered pediatric healthcare excellencefor more than 100 years. Children's Coloradois a leading pediatric network entirely devotedto the health and well-being of children.Continually recognized as one of the nation'soutstanding hospitals by U.S. News & WorldReport, Children's Colorado is known both for its nationally and internationallyrecognized medical, research and educationprograms as well as the full spectrum ofeveryday care for kids throughout the area.A career at Children's Colorado will challenge you, inspire you, and motivate you to make a difference in the life of a child.

In collaboration with service line medicaland administrative leadership, you are responsible for the organization, planningand directing of clinical programming andprofessional practice in gastroenterology.You will also provide oversight and leadershipfor a focused continuous quality improvementand consistent service excellence and programoutcomes.

Qualifications:

• Minimum RN and 5 years clinical experience required; 2 years progressive leadership and 2 years of specialty clinical nursing experience; pediatric nursing experience strongly preferred.

• Basic computer skills; Excellent customer service and communication skills with hospital/clinic staff, children, parents and visitors.

• Knowledge of medical/clinical operations, collaborative practice models, and budget management.

• Demonstrated excellence in the delivery ofclinical care; focus on outcomes with ability to establish effective processes to achieve outcomes.

• Understands the importance and integration of research and education programs with clinical programs; must be a systems thinker.

• Specialty or PNP certification preferred.• Master’s Degree required; Masters of

Science in Nursing preferred.• ANCC or Magnet Approved Certification;

specialty certification if appropriate.• BLS for Healthcare Providers/CPR.

Equal Opportunity Employer.

For a detailed job description and to apply,visit the “Careers” section of our websitehttp://www.childrenscolorado.orgOr, email Karen Barber, RN at karen.barber@childrenscolorado.org

• Connecticut–The Department of Pediatrics, Section ofPediatric Gastroenterology and Hepatologyat Yale University School of Medicine isseeking an Assistant/Associate Professor inPediatric Gastroenterology and Hepatologywith training and expertise in Pediatric Hepatology and Transplant Hepatology. Experience in the clinical diagnosis andmanagement of pediatric liver disease andpediatric liver transplantation is required.Candidates should be board-certified in Pediatrics and Sub-Board certified- oreligible in Pediatric Gastroenterology andTransplant Hepatology.

Yale University is an equal opportunity, affirmative action employer. Women and minorities are encouraged to apply.

Submit curriculum vitae and a list of 3 references to:Udeme D. Ekong, MD, MPHSection of Pediatric Gastroenterology and HepatologyYale University School of Medicine333 Cedar Street, LMP 4093BPO Box 208064New Haven, Connecticut 06520Phone: 203.785.4649Fax: 203.785.3365Email: udeme.ekong@yale.edu

• Illinois–The Division of Gastroenterology, Hepatology, and Nutrition in the Department of Pediatrics at NorthwesternUniversity’s Feinberg School of Medicineand Ann & Robert H. Lurie Children’sHospital of Chicago is seeking a board-certified/eligible pediatric gastroenterologistinterested in full-time clinical practice toserve as a sub-specialist at a vibrant, growingpartner hospital, Central DuPage Hospitalin Winfield, Illinois. Salary will be commensurate with clinical responsibilitiesand the individual’s experience.

Northwestern University is an AffirmativeAction/Equal Opportunity Employer.Women and minorities are encouraged toapply. Hiring is contingent upon eligibilityto work in the United States.

Applications will be accepted until the position is filled.

Contact person is:Barry K. Wershil, MDAnn & Robert H. Lurie Children’s Hospital of Chicago225 E. Chicago AveChicago, IL 60611Phone: 312.227.4200

• Illinois–The Department of Pediatrics, Division of Gastroenterology, at Southern Illinois University (SIU) seeks an additional board certified/board eligible general pediatric gastroenterologist to join two well-established colleagues. This positioncan accommodate visa candidates.

Position offers competitive salary along with a full and comprehensive benefits package. A faculty appointment is availablethrough Southern Illinois University at theassistant or associate professor level basedupon experience and track record. This is atremendous opportunity to further developan established gastroenterology program andparticipate in training residents and medicalstudents. Protected research opportunitiesexist within the division and departmentand are encouraged and supported. The division also maintains a strong relationshipwith Washington University's St. LouisChildren's Hospital with available researchand teaching opportunities. Additionally,you will have the opportunity to work withbasic scientists..

The Department of Pediatrics is rapidly expanding and has added numerous sub-specialists. Their main affiliate, St. John'sChildren's Hospital, is a member of the National Association of Children's Hospitals and Related Institutions, the only facility in their region dedicated to the well-being of children. They are alsocommitted to education with a fully accredited Pediatric residency training program.

Southern Illinois University School of Medicine is located in beautiful Springfield,the state capital. With a service area of500,000, Springfield accounts for more than 25 percent of the total population.Local residents have access to a wide varietyof social, educational, artistic, historic andrecreational activities that serve to enhancequality of life. Springfield has had theunique opportunity to capture a surprisinglyurban business and social climate.

The SIU School of Medicine values a raciallyand culturally diverse workforce. SouthernIllinois University is an affirmative action/equal opportunity employer.

Contact:Beth BriggsPhone: 800.678.7858Email: ebriggs@cejkasearch.comID#143271QX

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• Indiana–Peyton Manning Children’s Hospital at St.Vincent in Indianapolis, Indiana is seeking a BC/BE pediatric gastroenterologist to join four pediatric GI physicians within awell-established and growing practice.

• Clinical position with a ready referral base.• Outstanding support staff with a collegial

atmosphere: 4 NPs, 4 Nurses, 5 MedicalAssistants and a Practice Manager.

• Newly designed office space adjacent to hospital.

• Rapidly growing, free-standing Peyton Manning Children’s Hospital at St. Vincent has 46 inpatient, 15 PICU and 17 ED beds with Indiana’s largest Level III NICU (85 beds).

• Special pediatric rooms in OR and Endoscopy Suites.

• 24-hr Peds ER staffing and inpatient admission to in-house attending PediatricHospitalist Service with resident support.

• Extraordinary general pediatricians and pediatric subspecialists.

• Complete multi-disciplinary support froma full range of subspecialties and ancillary services- Pediatric Surgery, Pediatric Radiology, Pediatric Neuropsychology, GI/Liver-Pathology and Inpatient/Outpatient Dietitians.

• Established Aerodigestive Team- Ability to conduct combined procedures withPediatric ENT, Pulmonology, GI; Additional support from Developmental Pediatrics, I/P & O/P Dieticians, PediatricNeuropsychology and Speech Therapy; pH/impedance/Bravo testing in the Endoscopy Suite.

• Ambulatory Surgery Center privileges with state-of-the-art endoscopy equipment.

• Outstanding 24-hr Peds Anesthesiology support serving both Surgery Center and Hospital.

• Great support from Adult GI at St. Vincent for transition of care.

Opportunities for teaching residents and conducting clinical research.

Indiana offers low malpractice costs and is ranked as the nation's number one "physician friendly" state. Indianapolis is the 11th largest city in the nation and is thecenter of America's heartland. Indianapolissupports more than 200 arts organizations,including a world-class symphony, theater,opera, ballet, and museums, art galleries and

professional sports. Enjoy a relaxed lifestylewith numerous cultural offerings, change ofseasons and outstanding schools.

To learn more contact:Physician Recruitment Mona HansenPhone: 317-338-6140Fax: 317-338-6262Email: mhansen@stvincent.org

• Kentucky–

We are recruiting three faculty to join ourUniversity-based practice in Pediatric Gastroenterology. These faculty will providepediatric gastroenterological services at ourin-patient service at Kosair Children’s Medical Center as well as at our out-patientclinic. Our division is supported by a pediatric clinical research unit and a state of the art endoscopy suite.

Louisville offers a thriving medical community, affordable housing and a vibrant arts and sports scene. Opportunitiesfor a great life abound in Louisville, KY!

FACULTY POSITIONS (2) ( JOB ID#28081 or #27554): Board Certified or Board eligible. Responsibilitieswill include teaching medical students andpediatric residents, inpatient and outpatientclinical responsibilities and some scholarlyactivity. Rank and track commensurate with experience.

FACULTY POSITION (1) ( JOB ID#26914): Board Certified in pediatric gastroenterology with a strongbackground in pediatric rastroenterology research. Responsibilities will include serving as Fellowship Program Director,scholarly research, teaching medical students and pediatric residents and limitedclinical responsibilities. Rank and track commensurate with experience.

To apply, go to louisville.edu/jobs and applyfor faculty job ID 28081, 27554, or 26914and send your curriculum vitae to:Thomas C. Stephen, MD, ChairmanGastroenterology Search CommitteeDepartment of Pediatrics, University of Louisville School of Medicine571 S. Floyd St., Ste. 325Louisville, KY 40202Phone: 502.852.3874 Fax: 502.852.4093Email: thomas.stephen@louisville.edu

• Massachusetts–

The Department of Pediatrics at the University of Massachusetts Medical Schooland the UMass Memorial Children’s MedicalCenter is recruiting faculty for the Division of Pediatric Gastroenterology and Nutrition.We are seeking board certified or eligible pediatric gastroenterologists to join adynamic young division. An interest inteaching students and residents is essential.The position can be tailored to meet theneeds of the applicant, including resources to support a laboratory or clinical researchprogram.

The Department of Pediatrics at Universityof Massachusetts Medical School is a growing,vibrant, mid-size program with a full range ofsubspecialty services and a highly competitiveresidency. Pediatric faculty are engaged in awide range of clinical and basic research efforts; ranging from basic science discoveryto global health care, epidemiologic, clinical, and translational research. UMass is a National Children’s Study site and has an NIH-funded Clinical and TranslationalScience Center. UMass Medical School hasbeen consistently ranked in the top 10 publicschools for primary care education and hashad major growth in research endeavors andNIH funding in the past two decades.

Worcester is the second largest city in Massachusetts and in New England. Worcester and the surrounding area have astrong and diverse economic base with familyoriented communities and offer excellentschool systems and recreational opportunities.

Salary and benefits are highly competitive.UMass Memorial Children’s Medical Centerand the University of Massachusetts MedicalSchool are Equal Opportunity AffirmativeAction Employers.

Interested applicants should submit a coverletter and CV to:Dr. Peter NewburgerChair, GI Search Committeec/o Carolyn Jacobs, Physician RecruiterPhone: 508.334.0806Email: carolyn.jacobs@umassmemorial.org

• Massachusetts–The Department of Pediatrics at the University of Massachusetts Medical Schooland the UMass Memorial Children’s MedicalCenter is recruiting a Division Chief of

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Pediatric Gastroenterology and Nutrition. We are seeking a board certified pediatric gastroenterologist to lead a dynamic young division and to build research and clinicalprograms. An interest in teaching studentsand residents and mentoring junior faculty is essential. The position can be tailored tomeet the needs of the applicant, including resources to support a laboratory and/or clinical research program.

The Department of Pediatrics at the University of Massachusetts Medical School is a growing, vibrant, mid-size program with afull range of subspecialty services and a highlycompetitive residency. Pediatric faculty areengaged in a wide range of clinical and basicresearch efforts; ranging from basic sciencediscovery to global health care, epidemiologic,clinical, and translational research. UMass is a National Children’s Study site and has anNIH-funded Clinical and Translational Science Center. UMass Medical School hasbeen consistently ranked in the top 10 publicschools for primary care education and hashad major growth in research endeavors andNIH funding in the past two decades.

Worcester is the second largest city in Massachusetts and in New England. Worcester and the surrounding area have astrong and diverse economic base with familyoriented communities and offer excellentschool systems and recreational opportunities.

Salary and benefits are highly competitive.UMass Memorial Children’s Medical Center and the University of MassachusettsMedical School are Equal Opportunity Affirmative Action Employers.

Interested applicants should submit a cover letter and CV to:Dr. Peter NewburgerChair, Pediatric GI Chief Search Committeec/o Carolyn Jacobs, Physician Recruiter Phone: 508.334.0806 Email: carolyn.jacobs@umassmemorial.org

• Massachusetts–

We are seeking an outstanding MD orMD/PhD for a position as research facultyto run an independent program addressingbroad aspects of the epidemiology or outcomes research of inflammatory boweldisease in children. This is an assistant professor tenure track appointmentCandidates with innovative scholarship andexpertise in clinical medicine, epidemiology,

outcomes research, and bioinformatics areencouraged to apply. The new hire will participate in a vibrant research group, MDMD/PhD fellowship training program, and have access to a growing basic and translational research community in inflammatory bowel diseases. Applicantsmust possess a MD or MD/PhD and appropriate clinical training in gastroenterology and post-doctoral researchexperience. Candidates should have a NIH-funded research program in place or be well positioned for NIH funding in thenear term. Additional duties may includeteaching at the graduate and postgraduatelevels and clinical practice. Physician-scientists may be trained in disciplines other than pediatrics. Joint appointmentswith other Departments will be considered.

Children's Hospital and Harvard MedicalSchool are Equal Opportunity Employers.Women and minority applicants are encouraged to apply.

Send Curriculum Vitae, names of three individuals who would provide letters of reference, and a one to two page synopsishighlighting past work indicating 2-3 mostimportant papers, current research interests,and new directions to:Anna Spivak, MPH c/o Joanne McCarthyEmail: joanne.mccarthy@childrens.harvard.edu

• Missouri–

Saint Louis University is seeking applicantsto join a busy academic group. The Divisionof Pediatric Gastroenterology and Hepatologyconsists of 5 pediatric gastroenterologists, 2 clinical PNP, dedicated GI clinical nurses,dedicated pediatric psychologists and dedicated procedure staff. The division hasbusy outpatient and inpatient services basedat Cardinal Glennon Children’s MedicalCenter, a 190 licensed bed, free-standingchildren’s hospital affiliated with the SaintLouis University School of Medicine. The division serves an active liver transplantprogram, a nutritional support team, a multidisciplinary obesity clinic, and interacts with the CF center. The PediatricGastroenterology and Hepatology Divisionalso has ongoing, NIH-funded clinical andbasic science research projects within the division and a working relationship with the Saint Louis University School of PublicHealth. Close clinical and research ties aremaintained with the Saint Louis UniversityLiver Center. Excellent opportunities for

teaching in both didactic and clinical settings are available at the medical studentand post-graduate levels. Candidates mustbe BC/BE in Pediatric Gastroenterology.The institution is open to working withmany types of foreign visa holders, as well as green card holders and U.S. citizens. Saint Louis University is a Catholic, Jesuitinstitution dedicated to student learning, research, health care and service.

Saint Louis University is an affirmative action, equal opportunity employer, and encourages nominations of and applicationsof women and minorities.

All applications must be made onlineat http://jobs.slu.edu; applications must include a cover letter and curriculum vita.

Other correspondence regarding this position can be sent to:Jeffrey Teckman, MDDirector, Division of Gastroenterology, Department of PediatricsSaint Louis University School of Medicine1465 S. Grand Blvd.Saint Louis, MO 63104Phone: 314.577.5647Fax: 314.268.2775Email: teckmanj@slu.edu

• Nebraska–

The Division of Pediatric Gastroenterologyof the Department of Pediatrics at the Uni-versity of Nebraska Medical Center and theChildren’s Hospital & Medical Center isseeking a full-time BC/BE pediatric gas-troenterologist/transplant hepatologist atthe Assistant/Associate Professor rank.

• Candidates should have a strong background and interest in hepatology and transplantation.

• Currently, we have three pediatric gastroenterologists and two pediatric transplant hepatologists plus an outstanding multi-disciplinary team, performing clinical service, education, and research at the two institutions.

• We have an active Pediatric GI fellowship. We are in the process of developing a Pediatric Transplant Hepatology fellowship.

• Excellent opportunities are available for clinical and translational research and collaboration with major interdepartmentalprograms.

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• UNMC has very active liver & intestinal transplant programs with an average of 20 pediatric transplants annually.Opportunityfor growth exists.

• Children's is a 145-bed, non-profit free standing hospital that provides service to children and families across a five-state region and beyond. Supported by 24-hour,in-house pediatric critical care specialists and over 30 pediatric sub-specialties including an inpatient pediatric hospitalist service.

Omaha is a vibrant city with a metropolitanpopulation of 800,000. Offering excellentschools, Omaha is a safe, family-orientedtown. Property values are among the mostaffordable in the country for a city of thissize. Omaha is consistently ranked as one of the most livable and family-friendly cities in the United States.

Please Contact:Ruben Quiros, MD Chief, Pediatric GI, Hepatology & NutritionMedical Director, Pediatric Liver & IntestinalTransplantation, University of Nebraska Clinical Service Chief, Children’s Hospital& Medical CenterCell Phone: 402.763.7362 Office phone: 402.559.2412Email: rquiros@unmc.eduOr contact our physician recruiterBrenda Krull at 888.791.0707 Email: bkrull@childrensomaha.org

• New Hampshire–

The Children’s Hospital at Dartmouth, Dartmouth-Hitchcock Clinic and the GeiselSchool of Medicine at Dartmouth are seekinga dynamic BC/BE physician to join the section of Pediatric Gastroenterology andNutrition. We seek a clinician with experienceand a background in either clinical investigation, the science of healthcare delivery, or healthcare improvement. Depending on the candidate’s qualificationsand goals, an opportunity for a leadership position within Pediatric Gastroenterology is available. This position includes an appointment to the faculty of the GeiselSchool of Medicine at Dartmouth at a rank commensurate with experience and academic portfolio.

The Children’s Hospital at Dartmouth(CHaD) is a regional program that includes a 65-bed children’s hospital located at theDartmouth-Hitchcock Medical Center(DHMC) in Lebanon, NH. The Section ofGastroenterology and Nutrition provides a full

range of ambulatory and inpatient services at two locations, the Dartmouth-HitchcockMedical Center and the Dartmouth-Hitchcock Clinic in Manchester, NH.CHaD and the Section of Gastroenterologyalso have a clinical and academic relationshipwith the Gastroenterology Division at BostonChildren’s Hospital.

Dartmouth-Hitchcock Medical Center is astate-of-the-art facility located in the UpperConnecticut Valley of New Hampshire. Outdoor activities abound in and around this Ivy League college environment. It is a wonderful place to raise a family with excellent schools and a high-quality of life located within 2-3 hours driving from Montreal, Boston and the Maine shore and 4.5 hours from New York City.

Dartmouth-Hitchcock Clinic is an EqualOpportunity/Affirmative Action employerand encourages applications from women and members of minority groups.

Please direct letter of interest and curriculum vitae to:Daniel Levin, MDSearch Chair, Pediatric Gastroenterologyc/o Eleni PanagoulisDartmouth-Hitchcock ClinicOne Medical Center DriveLebanon, NH 03756Phone: 603.653.6042Email: PediGastro@dhphysicians.orgwww.dartmouth-hitchcock.org

• New Jersey–

Children's Regional Hospital In New Jerseynear Philadelphia, PA is seeking a BC/BEpediatric gastroenterologist to join a staff oftwo full-time pediatric gastroenterologists,one nurse educator and a nutritionist.

Children's Regional Hospital is the major pediatric tertiary care center for the 10-county southern New Jersey region, and the only state-designated children's hospital in south New Jersey.

The focus of the program is clinical care and teaching. Research endeavors will be supported. Call schedules are distributed equitably among each division. Candidatesshould be interested in clinical care, teaching,and advancing their academic careers. The40-plus full-time faculty members of the Department of Pediatrics provide the complete range of pediatric general and subspecialty care, and teach within the Department's Pediatric Residency and medical student programs. The Departmenthas an active basic and clinical research

program. The pediatric in-patient service includes a 6-bed PICU, 12-bed step downunit, 20-bed pediatric floor, and a 35-bedstate-of-the art, Level III NICU. Board Certified Pediatric Emergency Medicinephysicians staff an 8-bed Pediatric EmergencyDepartment that is a Level I Trauma Center.

Children's Regional Hospital is locatedwithin 5 minutes of downtown Philadelphia,2 hours to New York City, 3 hours to Washington, D.C. and within easy access of the New Jersey ocean beaches

Please Email a CV and cover letter for consideration. We are unable to accommodatecandidates seeking visa sponsorship at this time.

Contact: Mary PackardPracticewisemdPhone: 610.688.1612Cell : 610.283.0606Email: mpackard@practicewisemd.com

• New York–

A New Jersey and New York licensed BC/BEpediatric gastroenterologist is sought for awell-established busy two physician practicein northern New Jersey and southern NewYork states.

The physician will be responsible for the diagnosing, treating, billing, entering datainto EMR the full range of pediatric GI, liver and nutrition-related disorders. The physician should be able to perform endoscopy procedures in fully equipped endoscopy centers. The physician also will be encouraged to participate in the researchand practice management aspects. The reimbursement is top notch for the pediatricGI subspecialty. The environment is perfectfor an active, hard-working doctor.

The candidate must be able to travel betweenoffices and hospitals in Passaic County, NewJersey and Rockland & Orange Counties,New York. There is no need to travel between locations in the middle of the day.The practice offers an excellent compensationpackage, including malpractice coverage,medical insurance, retirement plan option,CME and travel reimbursement. There isenormous growth potential for the organizeddoctor with strong commitment to clinicalexcellence, private practice values and nice interpersonal skills.

Please e-mail and attach resume to:erena1@optonline.net Or, fax the resume: 845.343.0962

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• New York–

The Gastroenterology Division, Departmentof Pediatrics, SUNY Upstate Medical Centerand Upstate Golisano Children's Hospital in Syracuse, NY have initiated a nationalsearch to identify candidates for the Chief of Pediatric Gastroenterology.

The new chief will be charged with workingstrategically and collaboratively with the existing gastroenterology team and will setthe future vision for the division, grow thestaff, add and expand to existing services, implement a regional strategy, mentor staff,as well as pediatric residents and medicalstudents. The candidate must be board-certified in pediatrics and BC/BE in pediatricgastroenterology. The division is well supported by other pediatric specialties andincludes parenteral nutrition, hepatology, inflammatory bowel disease, a full array ofendoscopic procedures, as well as other services. The compensation package and academic rank will be competitive and commensurate with experience.

Highlights:

• New children’s hospital provides state-of-the art facilities and equipment that was specifically designed to provide patient and family centered care.

• Opportunity to see a wide variety of patients and clinical disorders.

• Opportunity to develop a center of excellence in IBD and expand existing clinical programs.

• Opportunity to establish a research focus to include funding.

• Large referral base with significant potential to increase patient referrals and expand programmatic scope.

• Upstate Golisano Children’s Hospital has a full complement of World Class pediatricand surgical subspecialties with ongoing interaction for clinical and research purposes.

The Department of Pediatrics/UpstateGolisano Children’s Hospital has 39 residents in its ACGME 5-year accreditedtraining program. It has pioneered a numberof graduate medical education initiatives,and is branching into new programs such as refugee medicine and global health.

For more information, please contact:Marti QuislingPhone: 817.929.3441E-mail: marti@millicansolutions.com All inquiries and referrals will remain confidential. SUNY Upstate Medical Centre is an equal opportunity employer.

• North Carolina–

The Department of Pediatrics at Duke University Medical Center invites applications for the position of Chief of theDivision of Gastroenterology, Hepatologyand Nutrition. Candidates should be physician-scientists with an established,highly competitive clinical or laboratory research program in gastroenterology andshould qualify for appointment at the rank of Associate Professor or Professorwith tenure.

The Duke Division of Gastroenterology,Hepatology and Nutrition is among the top programs in the country according toUS News and World Report rankings. Current strengths include clinical programsin inflammatory bowel disease, hepatology,intestinal manifestations of cystic fibrosis,liver and multivisceral transplantation, andgeneral gastroenterology.

The successful candidate will have opportunities for major interactions withthe Division of Adult Gastroenterology, the Division of Transplant Surgery, theDuke Translational Medicine Institute, the Duke Clinical Research Institute, the Institute for Genome Sciences & Policy(www.genome.duke.edu), the Stedman Nutrition and Metabolism Center, the Department of Cell Biology, and other relevant groups at Duke and will benefitfrom resources and a stimulating, collaborative environment within the Department of Pediatrics and across the Duke campus.

Duke University Health System is an EqualOpportunity/Affirmative Action Employer.

Interested individuals should submit a statement of academic interests and a curriculum vitae to:Joseph W. St. Geme, III, MDChairman of PediatricsDuke University Medical CenterChildren’s Health Center, Room T901Box 3352Durham, NC 27710

• Ohio –

The Division of Gastroenterology, Hepatology and Nutrition at CincinnatiChildren’s Hospital Medical Center(CCHMC) is continuing to expand to meetour long term goals to improve child healththrough better diagnosis, treatment and outcomes for our key targeted focus areasand diseases.

We are recruiting two faculty who will eachprovide clinical care while contributing to the academic mission of either ourEosinophilic Disease Program (CincinnatiCenter for Eosinophilic Disorders) or ourNeurogastroenterology and Motility Program.These recruitments represent a strategic expansion of these programs, which alreadydraw patients from throughout the world.

The successful candidate will be an excellentclinician and a strong team player. He or she will have an opportunity to advance care through innovation and new knowledgedevelopment. Cincinnati Children’s ResearchFoundation is one of the largest pediatric research programs in the nation and ranks2nd among pediatric institutions in directfunding from the National Institutes ofHealth. The Division has an NIH-fundedtraining program, and in total we train 4new clinical fellows/year and an additionaladvanced Hepatology Fellow. We participatein 6 NIH funded Translational ResearchConsortia and are home to an NIH-fundedDigestive Disease Research Core Center(Digestive Health Center) devoted to pediatric digestive diseases. The successfulcandidates will join 34 other full-time academic faculty. Women and minorities are encouraged to apply. CCHMC is an Affirmative Action/Equal Opportunity employer.

Interested candidates should contact:Mitchell B. Cohen, MDProfessor and Vice Chair of Pediatrics forClinical AffairsDirector, Division of Gastroenterology, Hepatology and NutritionCincinnati Children’s Hospital Medical Center3333 Burnet Avenue, ML 2010Cincinnati, Ohio 45229-3039Telephone: 513.636.4953Fax: 513.636.5581Email: mitchell.cohen@cchmc.org

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• Ohio –

The Division of Gastroenterology, Hepatology and Nutrition and the PediatricLiver Care Center of Cincinnati Children’sHospital Medical Center (CCHMC) inviteapplications for a faculty position at the assistant or associate professor level to pursue exciting opportunities in innovativeclinical care, research and education.

We seek MD or MD/PhD candidates whoare Transplant Hepatology CAQ-eligible or certified to complement existing strengths of the group of hepatologists,transplant surgeons, and nurse care managersof the Pediatric Liver Care Center. The Center provides comprehensive pre- andpost-transplant care for children with liverdiseases, and serves as a regional, national andinternational referral center. Responsibilitieswill include patient care and team leadershipin both outpatient and inpatient settings,training of residents and fellows, and leadership in research and/or quality improvement projects. Preference will begiven to candidates who have a demonstratedrecord of publication, and academic intereststhat complement existing programs, and acommitment to innovative clinical care. The successful applicant will be a member of a highly collaborative group of cliniciansand investigators, will benefit from an outstanding faculty development program,and will have access to state-of-the-art clinical and research resources at CCHMC.

Cincinnati Children’s Hospital MedicalCenter and Research Foundation are internationally recognized as one of the nation’s top pediatric care and research institutions. The Research Foundation ranks second nationally in NIH funding tofull-service children’s hospitals. Cincinnati is a friendly, pleasant, affordable city with agreat quality of life, including many musicaland theatrical programs, professional sportsand nearby recreational opportunities.

Interested candidates should provide a CV and contact:Jorge Bezerra, MDDirector, Pediatric Liver Care CenterEmail: jorge.bezerra@cchmc.orgOr, Mitchell Cohen, MDDirector, Gastroenterology, Hepatology and NutritionEmail: mitchell.cohen@cchmc.orgCincinnati Children’s Hospital Medical Center3333 Burnet Ave.Cincinnati, OH 45229

• Oklahoma –

The Section of Gastroenterology within theDepartment of Pediatrics at the Universityof Oklahoma Health Sciences Center isseeking candidates with senior level research, clinical and teaching expertise in gastroenterology, in addition to establishedand demonstrated leadership qualities. The successful candidate for this positionshould be Board certified in pediatric gastroenterology and will assume an Endowed Chair at the level of Associate or Full Professor. Duties will include administrative and management responsibilities for the Section ofGastroenterology and the development and expansion of a research program in gastroenterology in addition to providingclinical care for the children in the State of Oklahoma and teaching medical students and residents. Protected time and support will be provided to develop research programs with the expectation of independent extramural funding.

The Department of Pediatrics is a full-service multi-specialty department with 16 sections and more than 175 facultymembers. The faculty constitutes the principal medical and research staff of the OU Children’s Physicians and shares a common commitment to the well-being of the State’s children as well as providing a quality education to trainees.

The University of Oklahoma is an Affirmative Action/Equal Opportunity Employer.

Send letters of application and curriculum vitae to:Marcel Barbey, Vice PresidentMillicanSolutions, Inc.546 Silicon Drive, Suite 100Southlake, TX 76092marcel@millicansolutions.com

• Pennsylvania –

Lancaster General Health Pediatric Specialists is seeking to employ BE/BC pediatric gastroenterologist. This practicecurrently includes a pediatric cardiologistand pediatric gastroenterologist with theplan of adding other specialists in the nearfuture. In-patient care is provided at Lancaster General Hospital, a 623-bed Magnet facility with a 19-bed pediatric unitthat’s covered 24/7 by hospitalist service andat our free standing Women and BabiesHospital, which provides NICU services.

Endoscopy services are provided at the mainhospital and Suburban Outpatient Pavilion. This is a unique opportunity to interactwith the internationally known Clinic For Special Children in providing care tochildren with genetic metabolic diseases. Selected applicant will have the opportunityto plan and develop future scope of pediatricgastroenterology services for the system.

Lancaster County is located 65 miles west of Philadelphia and has a population of500,000. Great schools, easy commutes, reasonable cost of living and close proximityto major metropolitan areas make Lancastera great place to live and to raise a family.

Lancaster General Health physicians receive a highly competitive salary and excellent benefit package. Please contact:Ann Reid, Physician RecruiterLancaster General HealthPhone: 717.544.1927Email: areid2@lghealth.org

• South Dakota –

There is a pediatric gastroenterology opportunity located in Sioux Falls, SouthDakota, which has a population of 200,000and has been judged by Money Magazine as the “best place to live in America” for its quality of life.

Avera Children’s Hospital & Clinics is seeking a BE/BC pediatric gastroenterologistto join a team of pediatric specialists. • The Avera Children’s team consists of

over 20 pediatric specialists • Join a skilled, multi-disciplinary team of

registered nurses, nurse practitioners, physician’s assistants, case managers, social workers, dietitians, lactation consultants, patient educators, Child Life Specialist and a Family Support Specialist.

• A total of 110 beds are devoted to the care of infants, children and adolescents in our Pediatric Unit, PICU and Level III NICUand Avera Behavioral Health Center

• An associate member of NACHRI• 2 year income guarantee plus production

incentives• Generous benefit package• Avera Children’s Hospital & Clinics is

part of Avera Health, the region’s largest and strongest health care network of over 300 facilities

• www.AveraChildrens.org

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Sioux Falls has been recognized as one of the most business-friendly communities in the nation, as well as a great place to raise a family.• The economy is strong with area

businesses in health services, financial, technology, communications, manufacturing and agribusiness. Sioux Falls is a draw area for the arts, entertainment and shopping.

• No state income tax• Recreational activities abound in Sioux

Falls, thanks to the city’s system of 64 parks intertwined with the Big Sioux River.

• Excellent array of educational opportunitiesfor all ages with 24 public elementary schools, four middles schools, 3 public high schools, 16 private school affiliations, 5 universities and a number of business and vocational schools.

• www.siouxfalls.com

Contact:Suzette HohwielerPhone: 605.371.1783E-mail: suzette.hohwieler@avera.org

• Texas–

The Department of Pediatrics at the University of Texas Health Science Centerat San Antonio is seeking a pediatric gastroenterologist to join a Division engagedin diverse clinical and academic practice including an active liver transplant program.The appointment will be at the rank of assistant or associate level, depending onqualifications and experience. Qualifiedphysician must be board certified/board eligible in pediatric gastroenterology and eligible for an unrestricted Texas medical license. Liver transplant emphasis would be helpful, but not required. The successfulcandidate will be expected to serve as attending on the gastroenterology serviceand possess excellent teaching and clinicalskills. The School of Medicine has approximately 220 medical students at eachlevel and division faculty is actively engagedin the training of these medical students as well as the 44 pediatric residents.

The University of Texas Health ScienceCenter at San Antonio is an equal employment opportunity/affirmative action employer. All faculty appointmentsare designated as security sensitive positions.

Contact:Naveen K. Mittal, MD

Professor and Division ChiefDivision of PediatricGastroenterology/LiverUT Health Science Center at San Antonio7703 Floyd Curl Drive, MC 7807San Antonio, Texas 78229-3900Phone: 210.562.5844Fax: 210.562.5350Email: mittaln@uthscsa.edu

• Vermont –

The Department of Pediatrics at the University of Vermont is seeking a full-timegastroenterologist to join the Division of Pediatric Gastroenterology, Hepatology andNutrition at the University of Vermont andVermont Children’s Hospital at FletcherAllen Health Care. We are seeking a pediatrician who is Board Certified or Board Eligible in pediatric gastroenterology.  Responsibilities include providing completegastroenterology, hepatology and nutritionalcare, sharing coverage, teaching residentsand medical students, and community outreach education. The position is for anAssistant or Associate Professor in the clinical scholar pathway.  We aim to fill thisposition by June 30, 2014, and we encouragerapid reply to this announcement from interested applicants.  Applications will beaccepted until the position is filled. 

The University of Vermont is an Equal Opportunity/Affirmative Action Employerand applications from women, veterans andpeople of diverse racial, ethnic and culturalbackgrounds are encouraged. The Universityis especially interested in candidates who cancontribute to the diversity and excellence ofthe academic community through their research, teaching, and/or service. Applicantsare requested to include in their cover letterinformation about how they will further thisgoal.

If you are interested in this position, pleasesend an email with your current curriculumvitae with bibliography to:Richard Colletti, MDVice Chair of the Department of PediatricsEmail: richard.colletti@UVM.EDU or you can apply at www.uvmjobs.com

• Virginia –

This is a great opportunity for a fourth pediatric gastroenterologist to join CarilionClinic's hospital-based pediatric specialtygroup in Roanoke, VA at Carilion Clinic

Children's Hospital with an 8-bed PICU, 27-bed inpatient unit, and 60-bed NICU/intermediate nursing unit—all part of Carilion Roanoke Memorial Hospital, a 791-bed academic/tertiary care Level 1Trauma Center serving 1.5 million peopleand a pediatric population of over 300,000throughout western Virginia.

Carilion Clinic Children’s Hospital includes a full complement of multiple pediatric subspecialties with staff pediatricians and intensivists. Full anesthesiology proceduralsupport is present plus a dedicated pediatricendoscopy suite with state-of-the-art equipment and excellent pediatric staff and space.

The practice provides outpatient and inpatient care to children from birth to 19years of age. The inpatient service is staffedwith pediatric hospitalist physicians to assistin the coordination and monitoring of inpatient care. The outpatient office utilizeselectronic medical records, centralized registration and billing, and has a completesupport system of ancillary services with extensive laboratory and radiology support.

As part of our clinically-oriented PGI practice, you will have the opportunity foracademic pursuits at the new Virginia TechCarilion School of Medicine with teaching,research, and publications. Carilion is excitedto assertively expand its commitment tomedical education with the development of multiple new fellowships and the establishment of a research institute in collaboration with Virginia Tech as part of the medical school initiative.

Qualified candidates must be ABMS/AOA-BC in Pediatrics and Fellowship trained(BE/BC) in Pediatric Gastroenterology,hold an active and unencumbered medicallicense and DEA, and possess strong clinicaland teaching skills.

A five time "All America City" and one ofVirginia's best-kept secrets, the Roanoke Valley is a metropolitan area of 300,000 located at the southern tip of theShenandoah Valley, surrounded by the beautiful Blue Ridge Mountains. SouthwestVirginia offers stunning natural beauty, exceptional amenities, and an unparalleledquality of life.

Competitive salary with incentive, comprehensive benefits to include PAIDmalpractice and tail, paid vacation, CMEdays plus allowance, and much more. Review of CV's will begin immediately and continue until position is filled.

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For more information or to apply, contact:Michael H. Hart, M.S., M.D., Professor of PediatricsDirector Pediatric GI/NutritionVirginia Tech–Carilion School of Medicine102 Highland Avenue, Suite 305Roanoke, Virginia 24013Cell: 540.529.3072Email: mhhart@carilionclinic.orgwww.CarilionClinic.orgAA/EOE

• Virginia –Loudoun Medical Group (LMG), one of the largest and most diverse physician-owned, multi-specialty group practices inVirginia, seeks an experienced pediatric gastroenterologist to oversee and coordinatethe delivery of patient care in a busy pediatrics practice in Loudoun County.

Physician will be responsible for evaluatingfor the diagnosis and treatment of disordersand diseases adversely affecting variousstructures and processes of the digestive system in pediatric patients.

Qualifications:MD, DO, or foreign equivalent, with a valid certificate issued by the EducationalCommission on Foreign Medical Graduates(ECFMG).

This is a great opportunity to work for athriving healthcare organization that employs over 175 medical providers thatserve over 160,000 patients throughout 23medical and surgical specialties in 71 clinicallocations from Berryville to Alexandria.

LMG provides competitive compensationand an excellent benefits package that includes employer sponsored health, dental,life, disability coverage and profit sharing.

Please contact:Maggie ColucciPhone: 703.737.6033Email: mcolucci@lmgdoctors.com

• Washington, DC–

When you join the Mid-Atlantic PermanenteMedical Group (MAPMG), you’ll be able to get more out of your life and your career. As a physician-owned and managed multi-specialty group with over 1,000 physiciansserving 500,000 patients at 30 medical centers, we know firsthand what it takes toadvance professionally and thrive personally.

PEDIATRIC GASTROENTEROLOGISTWe are currently seeking a BC/BE pediatricgastroenterologist to join our team at ournew, state-of-the-art Capitol Hill MedicalCenter in Washington, DC. We affiliate with Children's National Medical Center for inpatient practice.

Established over 50 years ago, we are thelargest, most experienced integrated healthcare system in the country and our programs continue to receive national awardsof excellence. Living and working in the Mid-Atlantic Region offers you all of the convenience of two major metropolitan areaswith easy access to the Chesapeake Bay,Shenandoah Mountains and Atlantic Ocean.Best of all, you are just minutes away from thecultural, historical and entertainment venuesof our nation's capital.

Our physicians enjoy: • A built-in referral base through an

integrated delivery system• Complete patient history through EMR• Collegial atmosphere and excellent team

approach to providing care• Reasonable, predictable schedules• Clinical autonomy with excellent

subspecialist support• Comprehensive benefits• 100% paid occurrence based malpractice• Pension Plan and 401K• Shareholder opportunities

EOE

To apply, please contact:Cooper J. DrangmeisterPhone: 301.816.6532Email: cooper.j.drangmeister@kp.orgOr, apply online at:http://physiciancareers.kp.org/midatl

• West Virginia–

West Virginia University School of Medicine,Department of Pediatrics is seeking an academic physician to join the Section of Pediatric Gastroenterology, Hepatology &Nutrition at the Assistant or Associate Professor level. The ideal candidate will beprimarily involved with clinical services andteaching of residents and medical students,but ample opportunities exist in both clinical and basic research.

WVU Children’s Hospital is the premiersite within the state for primary through

tertiary care of children. All pediatric subspecialties are represented in the department.The Pediatric Gastroenterology sectionenjoys access to a full range of the latesttechnology and clinical services, includinghigh definition endoscopy, pH and imped-ance monitoring, capsule endoscopy and anorectal manometry. Close collaboration is maintained with the adult digestivedisease section.

The institutional and departmental cultureconsists of a commitment within a highlycollegial atmosphere to meeting the healthneeds of all children in the state of West Virginia and adjacent areas, while embracingour duty to train the next generation ofhealth professionals and advance the scienceof care for children. If you would like to use your academic skills in a supportive environment in order to make a differencefor children, your inquiry will be receivedwith interest.

Morgantown, West Virginia, recentlyranked by Forbes as one of the Best SmallMetros in America, is located over an hoursouth of Pittsburgh, PA and just three andone-half hours from Washington, DC andBaltimore. Morgantown offers culturally diverse, large-city amenities in a safe, family setting. There is an excellent school system and an abundance of recreational opportunities.

Position will remain open until filled. Please contact:Brian Riedel, MDChief, Section of Gastroenterology, Hepatology & Nutritionc/o Laura BlakeFax: 304.293.0230http://www.wvukids.comEmail: blakel@wvuhealthcare.com

West Virginia University is an AA/EO Employer. WVU Health Sciences is a tobacco free campus. West Virginia University is the recipient of an NSF ADVANCE award for gender equity.

• West Virginia –

The Department of Pediatrics at the RobertC. Byrd Health Sciences Center of WestVirginia University, Charleston Division, is recruiting a second BE/BC pediatric gastroenterologist for a non-tenure clinicaltrack position. The successful candidatemust be BC in Pediatrics and BE/BC in Pediatric Gastroenterology, with the abilityto obtain an active and unencumbered West Virginia Medical license, DEA and

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staff privileges at Charleston Area MedicalCenter.

Join other pediatric specialists in adolescentmedicine, cardiology, endocrinology, hematology-oncology, infectious disease,nephrology, neurology, pulmonology andsurgery. This position will focus on a clinicalpractice with experience in the teaching of residents and medical students. Interest in clinical research will be activelysupported. Academic rank and salary will be commensurate with experience.

Benefits to you include a competitive salaryand a signing bonus. You and your familywill have a generous benefits package including health, dental, retirement, andpaid malpractice coverage. Applications will be accepted until a suitable candidate is identified.

West Virginia University is an Equal Opportunity/Affirmative Action Employer.Women and minorities are strongly encouraged to apply.

To apply for this opportunityplease Email CV and letter of interest to: Carol WamsleyPhysician Recruitment Fax: 304.388.6297Email: carol.wamsley@camc.org

• Wisconsin–

The University of Wisconsin School of Medicine and Public Health, Department of Pediatrics, is seeking a pediatric gastroenterologist at the assistant or associate professor (CHS) level. Candidatesshould have an interest in providing clinicalcare and teaching within a vibrant academicmedical center. Additionally, candidatesshould be board certified in Pediatrics andBC/BE in Pediatric Gastroenterology, Hepatology and Nutrition.

The new 60-bed American Family Children’sHospital, opened in August 2007, is the onlyfacility in Madison exclusively devoted to thecare and treatment of children. It receivestertiary referrals from throughout the statewhere pediatricians from every subspecialtypractice. The University is known for a beautiful lakeside setting, a top-rated recordof federal research funding and excellence inteaching both at the undergraduate level andin the Medical School.

The city of Madison (pop. 230,000+) boasts a high quality of life including the statecapital, excellent schools, fine residentialareas, low crime, clean air and abundantrecreational and cultural opportunities.

The University of Wisconsin is an Equal Opportunity/Affirmative Action employer.Wisconsin Open Records and CaregiverLaws apply. Women and members of minority groups are encouraged to apply. A background check will be conducted prior to employment.

Qualified candidates should send a letter ofinterest and curriculum vitae to: Luther Sigurdsson, MDClinical Associate Professor and Division ChiefDepartment of PediatricsMailcode: 4108, 600 Highland AvenueMadison, WI, 53792-4108Email: lsigurdsson@pediatrics.wisc.edu