Letter from the Editor

Dear Friends,

This issue of The New Gastroenterologist marks my first year completed as faculty. It has been both the best year and the HARDEST year. I celebrated many successes, felt intellectually and emotionally drained by difficult and complicated cases, and learned that there is so much more I still do not know. But that’s the beauty of our field — we are constantly learning to be better physicians for our patients. To trainees and my fellow gastroenterologists in practice, never stop asking questions!

In this issue’s “In Focus,” Dr. Rajan Singh and Dr. Baharak Moshiree describe a practical approach to patients with bloating by evaluating and investigating the pathophysiology and etiology of bloating, such as food intolerances, visceral hypersensitivity, pelvic floor dysfunction, abdominophrenic dyssynergia, gut dysmotility, and small intestinal bacterial overgrowth, as well as treatment management. In the “Short Clinical Review” section, Dr. Ahmad Bazarbashi and his colleagues review when to refer complex polyps to an advanced endoscopist and the different techniques of advanced tissue resection, including endoscopic mucosal resection, endoscopic submucosal dissection, submucosal tunneling endoscopic resection, and full thickness resection.

Locum practices have become more popular among gastroenterologists. Dr. Catherine Bartholomew is a retired professor of medicine who was chief of gastroenterology at an academic institution, and is now working as a GI locum after retirement. She details what a locum tenens is, the role of the company, being an independent contractor, and the benefits.

Navigating and negotiating maternity and paternity leave may be challenging in private practice. Dr. Marybeth Spanarkel gives her opinion on the nuances of maternity/paternity leave in private practices, what it may mean financially, and things to inquire of the practice if planning to have children.

As we move from joining non-traditional practices and navigating family planning with private practices, Dr. Vasu Appalaneni shares her experiences with financial planning for retirement. She describes ways to financially plan a retirement, but also to consider aspects that affect financial well-being during retirement, including healthcare coverage, lifestyle and traveling, legal and estate, professional development, and emotional and social support.

If you are interested in contributing or have ideas for future TNG topics, please contact me (tjudy@wustl.edu) or Danielle Kiefer (dkiefer@gastro.org), communications/managing editor of TNG.

Until next time, I leave you with a historical fun fact because we would not be where we are not without appreciating where we were: The first colonic polypectomy using an electrosurgical snare was performed by Dr. Hiromi Shinya at Beth Israel Medical Center in New York City, in 1969.
 

Yours truly,

Judy A. Trieu, MD, MPH

Editor-in-Chief

Interventional Endoscopy, Division of Gastroenterology

Washington University in St. Louis

Dear Friends,

This issue of The New Gastroenterologist marks my first year completed as faculty. It has been both the best year and the HARDEST year. I celebrated many successes, felt intellectually and emotionally drained by difficult and complicated cases, and learned that there is so much more I still do not know. But that’s the beauty of our field — we are constantly learning to be better physicians for our patients. To trainees and my fellow gastroenterologists in practice, never stop asking questions!

In this issue’s “In Focus,” Dr. Rajan Singh and Dr. Baharak Moshiree describe a practical approach to patients with bloating by evaluating and investigating the pathophysiology and etiology of bloating, such as food intolerances, visceral hypersensitivity, pelvic floor dysfunction, abdominophrenic dyssynergia, gut dysmotility, and small intestinal bacterial overgrowth, as well as treatment management. In the “Short Clinical Review” section, Dr. Ahmad Bazarbashi and his colleagues review when to refer complex polyps to an advanced endoscopist and the different techniques of advanced tissue resection, including endoscopic mucosal resection, endoscopic submucosal dissection, submucosal tunneling endoscopic resection, and full thickness resection.

Locum practices have become more popular among gastroenterologists. Dr. Catherine Bartholomew is a retired professor of medicine who was chief of gastroenterology at an academic institution, and is now working as a GI locum after retirement. She details what a locum tenens is, the role of the company, being an independent contractor, and the benefits.

Navigating and negotiating maternity and paternity leave may be challenging in private practice. Dr. Marybeth Spanarkel gives her opinion on the nuances of maternity/paternity leave in private practices, what it may mean financially, and things to inquire of the practice if planning to have children.

As we move from joining non-traditional practices and navigating family planning with private practices, Dr. Vasu Appalaneni shares her experiences with financial planning for retirement. She describes ways to financially plan a retirement, but also to consider aspects that affect financial well-being during retirement, including healthcare coverage, lifestyle and traveling, legal and estate, professional development, and emotional and social support.

If you are interested in contributing or have ideas for future TNG topics, please contact me (tjudy@wustl.edu) or Danielle Kiefer (dkiefer@gastro.org), communications/managing editor of TNG.

Until next time, I leave you with a historical fun fact because we would not be where we are not without appreciating where we were: The first colonic polypectomy using an electrosurgical snare was performed by Dr. Hiromi Shinya at Beth Israel Medical Center in New York City, in 1969.
 

Yours truly,

Judy A. Trieu, MD, MPH

Editor-in-Chief

Interventional Endoscopy, Division of Gastroenterology

Washington University in St. Louis

Dear Friends,

This issue of The New Gastroenterologist marks my first year completed as faculty. It has been both the best year and the HARDEST year. I celebrated many successes, felt intellectually and emotionally drained by difficult and complicated cases, and learned that there is so much more I still do not know. But that’s the beauty of our field — we are constantly learning to be better physicians for our patients. To trainees and my fellow gastroenterologists in practice, never stop asking questions!

In this issue’s “In Focus,” Dr. Rajan Singh and Dr. Baharak Moshiree describe a practical approach to patients with bloating by evaluating and investigating the pathophysiology and etiology of bloating, such as food intolerances, visceral hypersensitivity, pelvic floor dysfunction, abdominophrenic dyssynergia, gut dysmotility, and small intestinal bacterial overgrowth, as well as treatment management. In the “Short Clinical Review” section, Dr. Ahmad Bazarbashi and his colleagues review when to refer complex polyps to an advanced endoscopist and the different techniques of advanced tissue resection, including endoscopic mucosal resection, endoscopic submucosal dissection, submucosal tunneling endoscopic resection, and full thickness resection.

Locum practices have become more popular among gastroenterologists. Dr. Catherine Bartholomew is a retired professor of medicine who was chief of gastroenterology at an academic institution, and is now working as a GI locum after retirement. She details what a locum tenens is, the role of the company, being an independent contractor, and the benefits.

Navigating and negotiating maternity and paternity leave may be challenging in private practice. Dr. Marybeth Spanarkel gives her opinion on the nuances of maternity/paternity leave in private practices, what it may mean financially, and things to inquire of the practice if planning to have children.

As we move from joining non-traditional practices and navigating family planning with private practices, Dr. Vasu Appalaneni shares her experiences with financial planning for retirement. She describes ways to financially plan a retirement, but also to consider aspects that affect financial well-being during retirement, including healthcare coverage, lifestyle and traveling, legal and estate, professional development, and emotional and social support.

If you are interested in contributing or have ideas for future TNG topics, please contact me (tjudy@wustl.edu) or Danielle Kiefer (dkiefer@gastro.org), communications/managing editor of TNG.

Until next time, I leave you with a historical fun fact because we would not be where we are not without appreciating where we were: The first colonic polypectomy using an electrosurgical snare was performed by Dr. Hiromi Shinya at Beth Israel Medical Center in New York City, in 1969.
 

Yours truly,

Judy A. Trieu, MD, MPH

Editor-in-Chief

Interventional Endoscopy, Division of Gastroenterology

Washington University in St. Louis

Dear Friends,

The prevailing theme of this issue is “Success.” I have learned that “success” is personal and personalized. What “success” looked like 10, or even 5, years ago to me is very different from how I perceive it now; and I know it may be different 5 years from now. My definition of success should not look like another’s — that was the best advice I have gotten over the years and it has kept me constantly redefining what is important to me and placing value on where I want to allocate my time and efforts, at work and at home.

This issue of The New Gastroenterologist highlights topics from successful GIs within their own realms of expertise, offering insights on advancing in academic medicine, navigating financial wellness with a financial adviser, and becoming a future leader in GI.

Yours truly,

Judy A. Trieu, MD, MPH

Editor-in-Chief
Interventional Endoscopy, Division of Gastroenterology
Washington University in St. Louis

Dear Friends,

The prevailing theme of this issue is “Success.” I have learned that “success” is personal and personalized. What “success” looked like 10, or even 5, years ago to me is very different from how I perceive it now; and I know it may be different 5 years from now. My definition of success should not look like another’s — that was the best advice I have gotten over the years and it has kept me constantly redefining what is important to me and placing value on where I want to allocate my time and efforts, at work and at home.

This issue of The New Gastroenterologist highlights topics from successful GIs within their own realms of expertise, offering insights on advancing in academic medicine, navigating financial wellness with a financial adviser, and becoming a future leader in GI.

Yours truly,

Judy A. Trieu, MD, MPH

Editor-in-Chief
Interventional Endoscopy, Division of Gastroenterology
Washington University in St. Louis

Dear Friends,

The prevailing theme of this issue is “Success.” I have learned that “success” is personal and personalized. What “success” looked like 10, or even 5, years ago to me is very different from how I perceive it now; and I know it may be different 5 years from now. My definition of success should not look like another’s — that was the best advice I have gotten over the years and it has kept me constantly redefining what is important to me and placing value on where I want to allocate my time and efforts, at work and at home.

This issue of The New Gastroenterologist highlights topics from successful GIs within their own realms of expertise, offering insights on advancing in academic medicine, navigating financial wellness with a financial adviser, and becoming a future leader in GI.

Yours truly,

Judy A. Trieu, MD, MPH

Editor-in-Chief
Interventional Endoscopy, Division of Gastroenterology
Washington University in St. Louis

Dear Friends,

After 6 months in my first faculty position, I have come to appreciate the term “multidisciplinary approach” more than ever. Not only does this facilitate optimal patient care, but I have personally learned so much from experts in other fields. This theme resonates across this issue of The New Gastroenterologist, from treating complex gallbladder disease, to caring for sexual and gender minorities, and collaborating with the tech industry to advance patient care.

Our “In Focus” feature, written by Dr. Andrew Gilman and Dr. Todd Baron, is on endoscopic management of gallbladder disease. They review endoscopic treatment options in patients with benign gallbladder disease, with emphasis on working with surgical and interventional radiology colleagues, as well as relaying endoscopic tips and techniques to achieve success in these complicated procedures.

In the “Short Clinical Reviews” section, Dr. David Chiang and Dr. Victor Chedid highlight the gaps in research and clinical care and competency for sexual and gender minorities, particularly in patients with inflammatory bowel disease. They describe the creation of the Pride in IBD clinic at Mayo Clinic in Rochester, Minn., that creates a culturally sensitive space to care for this community.

As trainees transition to early faculty, becoming a mentor is a new role that can be very rewarding and daunting at the same time. Dr. Anna Lok, recipient of the AGA’s Distinguished Mentor Award, and Dr. Vincent Chen share invaluable experiences and advice on being a mentor from senior and early-career perspectives, respectively. Similarly in the transition to early faculty, Erin Anderson, CPA, answers five common financial questions that arise to better understand and manage a significant increase in salary.

Lastly, Dr. Shifa Umar describes her unique experience as part of the AGA’s annual Tech Summit Fellows Program, a cross-section of medicine, technology, and innovation.

If you are interested in contributing or have ideas for future TNG topics, please contact me (tjudy@wustl.edu), or Jillian Schweitzer (jschweitzer@gastro.org), managing editor of TNG.

Until next time, I leave you with a historical fun fact because we would not be where we are now without appreciating where we were: The concept of the clinicopathologic conference (CPC) was introduced by Dr. Walter B. Cannon as a medical student at Harvard Medical School.
 

Yours truly,

Judy A. Trieu, MD, MPH

Editor-in-Chief

Interventional Endoscopy, Division of Gastroenterology

Washington University in St. Louis

Dear Friends,

After 6 months in my first faculty position, I have come to appreciate the term “multidisciplinary approach” more than ever. Not only does this facilitate optimal patient care, but I have personally learned so much from experts in other fields. This theme resonates across this issue of The New Gastroenterologist, from treating complex gallbladder disease, to caring for sexual and gender minorities, and collaborating with the tech industry to advance patient care.

Our “In Focus” feature, written by Dr. Andrew Gilman and Dr. Todd Baron, is on endoscopic management of gallbladder disease. They review endoscopic treatment options in patients with benign gallbladder disease, with emphasis on working with surgical and interventional radiology colleagues, as well as relaying endoscopic tips and techniques to achieve success in these complicated procedures.

In the “Short Clinical Reviews” section, Dr. David Chiang and Dr. Victor Chedid highlight the gaps in research and clinical care and competency for sexual and gender minorities, particularly in patients with inflammatory bowel disease. They describe the creation of the Pride in IBD clinic at Mayo Clinic in Rochester, Minn., that creates a culturally sensitive space to care for this community.

As trainees transition to early faculty, becoming a mentor is a new role that can be very rewarding and daunting at the same time. Dr. Anna Lok, recipient of the AGA’s Distinguished Mentor Award, and Dr. Vincent Chen share invaluable experiences and advice on being a mentor from senior and early-career perspectives, respectively. Similarly in the transition to early faculty, Erin Anderson, CPA, answers five common financial questions that arise to better understand and manage a significant increase in salary.

Lastly, Dr. Shifa Umar describes her unique experience as part of the AGA’s annual Tech Summit Fellows Program, a cross-section of medicine, technology, and innovation.

If you are interested in contributing or have ideas for future TNG topics, please contact me (tjudy@wustl.edu), or Jillian Schweitzer (jschweitzer@gastro.org), managing editor of TNG.

Until next time, I leave you with a historical fun fact because we would not be where we are now without appreciating where we were: The concept of the clinicopathologic conference (CPC) was introduced by Dr. Walter B. Cannon as a medical student at Harvard Medical School.
 

Yours truly,

Judy A. Trieu, MD, MPH

Editor-in-Chief

Interventional Endoscopy, Division of Gastroenterology

Washington University in St. Louis

Dear Friends,

After 6 months in my first faculty position, I have come to appreciate the term “multidisciplinary approach” more than ever. Not only does this facilitate optimal patient care, but I have personally learned so much from experts in other fields. This theme resonates across this issue of The New Gastroenterologist, from treating complex gallbladder disease, to caring for sexual and gender minorities, and collaborating with the tech industry to advance patient care.

Our “In Focus” feature, written by Dr. Andrew Gilman and Dr. Todd Baron, is on endoscopic management of gallbladder disease. They review endoscopic treatment options in patients with benign gallbladder disease, with emphasis on working with surgical and interventional radiology colleagues, as well as relaying endoscopic tips and techniques to achieve success in these complicated procedures.

In the “Short Clinical Reviews” section, Dr. David Chiang and Dr. Victor Chedid highlight the gaps in research and clinical care and competency for sexual and gender minorities, particularly in patients with inflammatory bowel disease. They describe the creation of the Pride in IBD clinic at Mayo Clinic in Rochester, Minn., that creates a culturally sensitive space to care for this community.

As trainees transition to early faculty, becoming a mentor is a new role that can be very rewarding and daunting at the same time. Dr. Anna Lok, recipient of the AGA’s Distinguished Mentor Award, and Dr. Vincent Chen share invaluable experiences and advice on being a mentor from senior and early-career perspectives, respectively. Similarly in the transition to early faculty, Erin Anderson, CPA, answers five common financial questions that arise to better understand and manage a significant increase in salary.

Lastly, Dr. Shifa Umar describes her unique experience as part of the AGA’s annual Tech Summit Fellows Program, a cross-section of medicine, technology, and innovation.

If you are interested in contributing or have ideas for future TNG topics, please contact me (tjudy@wustl.edu), or Jillian Schweitzer (jschweitzer@gastro.org), managing editor of TNG.

Until next time, I leave you with a historical fun fact because we would not be where we are now without appreciating where we were: The concept of the clinicopathologic conference (CPC) was introduced by Dr. Walter B. Cannon as a medical student at Harvard Medical School.
 

Yours truly,

Judy A. Trieu, MD, MPH

Editor-in-Chief

Interventional Endoscopy, Division of Gastroenterology

Washington University in St. Louis

When we launched GIHN’s monthly Member Spotlight column in January of this year, our vision was to provide a platform to recognize AGA members’ unique accomplishments across all career stages and practice settings, highlight the diversity of our membership, and build a sense of community by learning more about one another.

As physicians, we are fortunate to have the opportunity to meaningfully impact the lives of our patients through the practice of clinical medicine, or by spearheading groundbreaking research that improves patient outcomes. However, some physicians arguably make their greatest mark outside of medicine.

To close out the inaugural year of our Member Spotlight feature, we introduce you to gastroenterologist Eric Esrailian, MD, MPH, chair of the division of gastroenterology at UCLA. He is an Emmy-nominated film producer and distinguished human rights advocate. His story is inspirational, and poignantly highlights how one’s impact as a physician can extend far beyond the walls of the hospital. We hope to continue to feature exceptional individuals like Dr. Esrailian who leverage their unique talents for societal good. We appreciate your continued nominations as we plan our 2024 coverage.

Also in the December issue, we summarize the results of a pivotal, head-to-head trial of risankizumab (Skyrizi) and ustekinumab (Stelara) for Crohn’s disease, which was presented in October at United European Gastroenterology (UEG) Week in Copenhagen.

We also highlight the FDA’s recent approval of vonoprazan, a new pharmacologic treatment for erosive esophagitis expected to be available in the U.S. sometime this month. Finally, Dr. Lauren Feld explains how gastroenterologists can advocate for more robust parental leave and return to work policies at their institutions and why it matters.

We wish you all a wonderful holiday season and look forward to seeing you again in the New Year.

Megan A. Adams, MD, JD, MSc
Editor-in-Chief

When we launched GIHN’s monthly Member Spotlight column in January of this year, our vision was to provide a platform to recognize AGA members’ unique accomplishments across all career stages and practice settings, highlight the diversity of our membership, and build a sense of community by learning more about one another.

As physicians, we are fortunate to have the opportunity to meaningfully impact the lives of our patients through the practice of clinical medicine, or by spearheading groundbreaking research that improves patient outcomes. However, some physicians arguably make their greatest mark outside of medicine.

To close out the inaugural year of our Member Spotlight feature, we introduce you to gastroenterologist Eric Esrailian, MD, MPH, chair of the division of gastroenterology at UCLA. He is an Emmy-nominated film producer and distinguished human rights advocate. His story is inspirational, and poignantly highlights how one’s impact as a physician can extend far beyond the walls of the hospital. We hope to continue to feature exceptional individuals like Dr. Esrailian who leverage their unique talents for societal good. We appreciate your continued nominations as we plan our 2024 coverage.

Also in the December issue, we summarize the results of a pivotal, head-to-head trial of risankizumab (Skyrizi) and ustekinumab (Stelara) for Crohn’s disease, which was presented in October at United European Gastroenterology (UEG) Week in Copenhagen.

We also highlight the FDA’s recent approval of vonoprazan, a new pharmacologic treatment for erosive esophagitis expected to be available in the U.S. sometime this month. Finally, Dr. Lauren Feld explains how gastroenterologists can advocate for more robust parental leave and return to work policies at their institutions and why it matters.

We wish you all a wonderful holiday season and look forward to seeing you again in the New Year.

Megan A. Adams, MD, JD, MSc
Editor-in-Chief

When we launched GIHN’s monthly Member Spotlight column in January of this year, our vision was to provide a platform to recognize AGA members’ unique accomplishments across all career stages and practice settings, highlight the diversity of our membership, and build a sense of community by learning more about one another.

As physicians, we are fortunate to have the opportunity to meaningfully impact the lives of our patients through the practice of clinical medicine, or by spearheading groundbreaking research that improves patient outcomes. However, some physicians arguably make their greatest mark outside of medicine.

To close out the inaugural year of our Member Spotlight feature, we introduce you to gastroenterologist Eric Esrailian, MD, MPH, chair of the division of gastroenterology at UCLA. He is an Emmy-nominated film producer and distinguished human rights advocate. His story is inspirational, and poignantly highlights how one’s impact as a physician can extend far beyond the walls of the hospital. We hope to continue to feature exceptional individuals like Dr. Esrailian who leverage their unique talents for societal good. We appreciate your continued nominations as we plan our 2024 coverage.

Also in the December issue, we summarize the results of a pivotal, head-to-head trial of risankizumab (Skyrizi) and ustekinumab (Stelara) for Crohn’s disease, which was presented in October at United European Gastroenterology (UEG) Week in Copenhagen.

We also highlight the FDA’s recent approval of vonoprazan, a new pharmacologic treatment for erosive esophagitis expected to be available in the U.S. sometime this month. Finally, Dr. Lauren Feld explains how gastroenterologists can advocate for more robust parental leave and return to work policies at their institutions and why it matters.

We wish you all a wonderful holiday season and look forward to seeing you again in the New Year.

Megan A. Adams, MD, JD, MSc
Editor-in-Chief

Dear Friends,

It’s been a year since I have become editor-in-chief of The New Gastroenterologist and I am so grateful for our readers and contributors. Thank you for being a part of the TNG family. This issue highlights topics that may be overwhelming for trainees and early faculty, including the increasing armamentarium of inflammatory bowel disease treatments, taking on leadership roles in diversity, equity, and inclusion, and tackling financial planning.

In this issue’s In Focus, Drs. Ariela K. Holmer, Shannon Chang, and Lisa Malter break down the factors that contribute to selecting therapies for moderate to severe IBD, such as disease activity and severity, extraintestinal manifestations, safety, prior anti–tumor necrosis factor exposure, perianal disease, and patient preference.

Drs. Michael G. Rubeiz, Kemmian D. Johnson, and Juan Reyes Genere continue our journey with IBD in the Short Clinical Review section, describing advances in endoscopic therapies in IBD. They review the resection of colitis dysplasia and management of luminal strictures with dilation and stricturotomy.

Early-career faculty are being requested to spearhead diversity, equity, and inclusion (DEI) efforts at their institutions or for their groups. Drs. Cassandra D.L. Fritz and Nicolette Juliana Rodriguez highlight important aspects that should be considered prior to taking on DEI roles.

In the Finance section, Dr. Animesh Jain answers five common questions for young gastroenterologists. He addresses student loans, disability insurance, life insurance, retirement, and buying a first house.

If you are interested in contributing or have ideas for future TNG topics, please contact me (tjudy@wustl.edu), or Jillian Schweitzer (jschweitzer@gastro.org), managing editor of TNG.

Until next time, I leave you with a historical fun fact because we would not be where we are now without appreciating where we were: The first biologic therapy for IBD, infliximab, was only approved 25 years ago in 1998.

Yours truly,

Judy A Trieu, MD, MPH
Editor-in-Chief
Interventional Endoscopy, Division of Gastroenterology
Washington University in St. Louis

Dear Friends,

It’s been a year since I have become editor-in-chief of The New Gastroenterologist and I am so grateful for our readers and contributors. Thank you for being a part of the TNG family. This issue highlights topics that may be overwhelming for trainees and early faculty, including the increasing armamentarium of inflammatory bowel disease treatments, taking on leadership roles in diversity, equity, and inclusion, and tackling financial planning.

In this issue’s In Focus, Drs. Ariela K. Holmer, Shannon Chang, and Lisa Malter break down the factors that contribute to selecting therapies for moderate to severe IBD, such as disease activity and severity, extraintestinal manifestations, safety, prior anti–tumor necrosis factor exposure, perianal disease, and patient preference.

Drs. Michael G. Rubeiz, Kemmian D. Johnson, and Juan Reyes Genere continue our journey with IBD in the Short Clinical Review section, describing advances in endoscopic therapies in IBD. They review the resection of colitis dysplasia and management of luminal strictures with dilation and stricturotomy.

Early-career faculty are being requested to spearhead diversity, equity, and inclusion (DEI) efforts at their institutions or for their groups. Drs. Cassandra D.L. Fritz and Nicolette Juliana Rodriguez highlight important aspects that should be considered prior to taking on DEI roles.

In the Finance section, Dr. Animesh Jain answers five common questions for young gastroenterologists. He addresses student loans, disability insurance, life insurance, retirement, and buying a first house.

If you are interested in contributing or have ideas for future TNG topics, please contact me (tjudy@wustl.edu), or Jillian Schweitzer (jschweitzer@gastro.org), managing editor of TNG.

Until next time, I leave you with a historical fun fact because we would not be where we are now without appreciating where we were: The first biologic therapy for IBD, infliximab, was only approved 25 years ago in 1998.

Yours truly,

Judy A Trieu, MD, MPH
Editor-in-Chief
Interventional Endoscopy, Division of Gastroenterology
Washington University in St. Louis

Dear Friends,

It’s been a year since I have become editor-in-chief of The New Gastroenterologist and I am so grateful for our readers and contributors. Thank you for being a part of the TNG family. This issue highlights topics that may be overwhelming for trainees and early faculty, including the increasing armamentarium of inflammatory bowel disease treatments, taking on leadership roles in diversity, equity, and inclusion, and tackling financial planning.

In this issue’s In Focus, Drs. Ariela K. Holmer, Shannon Chang, and Lisa Malter break down the factors that contribute to selecting therapies for moderate to severe IBD, such as disease activity and severity, extraintestinal manifestations, safety, prior anti–tumor necrosis factor exposure, perianal disease, and patient preference.

Drs. Michael G. Rubeiz, Kemmian D. Johnson, and Juan Reyes Genere continue our journey with IBD in the Short Clinical Review section, describing advances in endoscopic therapies in IBD. They review the resection of colitis dysplasia and management of luminal strictures with dilation and stricturotomy.

Early-career faculty are being requested to spearhead diversity, equity, and inclusion (DEI) efforts at their institutions or for their groups. Drs. Cassandra D.L. Fritz and Nicolette Juliana Rodriguez highlight important aspects that should be considered prior to taking on DEI roles.

In the Finance section, Dr. Animesh Jain answers five common questions for young gastroenterologists. He addresses student loans, disability insurance, life insurance, retirement, and buying a first house.

If you are interested in contributing or have ideas for future TNG topics, please contact me (tjudy@wustl.edu), or Jillian Schweitzer (jschweitzer@gastro.org), managing editor of TNG.

Until next time, I leave you with a historical fun fact because we would not be where we are now without appreciating where we were: The first biologic therapy for IBD, infliximab, was only approved 25 years ago in 1998.

Yours truly,

Judy A Trieu, MD, MPH
Editor-in-Chief
Interventional Endoscopy, Division of Gastroenterology
Washington University in St. Louis

Among the many healthcare system vulnerabilities exposed by the COVID-19 pandemic was the growing mismatch between the supply of specialist physicians and other providers and the growing population-level demand for care. Impacts of this supply-demand mismatch are felt daily in our GI practices as we strive to expand access in our clinics and endoscopy suites, particularly in rural and urban underserved communities. In gastroenterology, increased demand for care has been driven by a perfect storm of population growth, increased patient awareness of GI health, and rising incidence of digestive diseases.

Between 2019 and 2034, the U.S. population is expected to grow by 10.6%, while the population aged 65 and older expands by over 42%. Recent increases in the CRC screening–eligible population also have contributed to unprecedented demand for GI care. Furthermore, care delivery has become more complex and time-consuming with the evolution of personalized medicine and high prevalence of comorbid conditions. At the same time, we are faced with a dwindling supply of gastroenterology providers. In 2021, there were 15,678 practicing gastroenterologists in the U.S., over half of whom were 55 years or older. This translates to 1 gastroenterologist per 20,830 people captured in the U.S. Census.

Megan A. Adams, MD, JD, MSc
Editor-in-Chief

Among the many healthcare system vulnerabilities exposed by the COVID-19 pandemic was the growing mismatch between the supply of specialist physicians and other providers and the growing population-level demand for care. Impacts of this supply-demand mismatch are felt daily in our GI practices as we strive to expand access in our clinics and endoscopy suites, particularly in rural and urban underserved communities. In gastroenterology, increased demand for care has been driven by a perfect storm of population growth, increased patient awareness of GI health, and rising incidence of digestive diseases.

Between 2019 and 2034, the U.S. population is expected to grow by 10.6%, while the population aged 65 and older expands by over 42%. Recent increases in the CRC screening–eligible population also have contributed to unprecedented demand for GI care. Furthermore, care delivery has become more complex and time-consuming with the evolution of personalized medicine and high prevalence of comorbid conditions. At the same time, we are faced with a dwindling supply of gastroenterology providers. In 2021, there were 15,678 practicing gastroenterologists in the U.S., over half of whom were 55 years or older. This translates to 1 gastroenterologist per 20,830 people captured in the U.S. Census.

Megan A. Adams, MD, JD, MSc
Editor-in-Chief

Among the many healthcare system vulnerabilities exposed by the COVID-19 pandemic was the growing mismatch between the supply of specialist physicians and other providers and the growing population-level demand for care. Impacts of this supply-demand mismatch are felt daily in our GI practices as we strive to expand access in our clinics and endoscopy suites, particularly in rural and urban underserved communities. In gastroenterology, increased demand for care has been driven by a perfect storm of population growth, increased patient awareness of GI health, and rising incidence of digestive diseases.

Between 2019 and 2034, the U.S. population is expected to grow by 10.6%, while the population aged 65 and older expands by over 42%. Recent increases in the CRC screening–eligible population also have contributed to unprecedented demand for GI care. Furthermore, care delivery has become more complex and time-consuming with the evolution of personalized medicine and high prevalence of comorbid conditions. At the same time, we are faced with a dwindling supply of gastroenterology providers. In 2021, there were 15,678 practicing gastroenterologists in the U.S., over half of whom were 55 years or older. This translates to 1 gastroenterologist per 20,830 people captured in the U.S. Census.

Megan A. Adams, MD, JD, MSc
Editor-in-Chief

At DDW in May, the AGA Ethics Committee sponsored a well-attended clinical symposium focused on key legal, regulatory, and ethical considerations relating to use of artificial intelligence (AI) in health care.

It was a thought-provoking discussion of how to ethically and equitably design and regulate these exciting new technologies to maximize their potential to achieve meaningful improvements in health for our patients while avoiding unintended consequences.

Indeed, one of the vexing challenges in this space is the fact that many AI algorithms and resulting tools are proprietary, impeding the ability to achieve the level of transparency necessary to understand data inputs, outputs, and outcomes, and assess for potential algorithmic bias.

This is an area that remains largely unregulated, with a lack of common standards to guide responsible design, development, and adoption of these tools. This is something that is top of mind for federal regulatory agencies, including the Food and Drug Administration, which in September 2022, announced plans to expand its regulation of AI-powered clinical decision support tools as medical devices.

There are also attempts underway to harmonize standards and reporting for health AI and educate end-users on how to evaluate these technologies to drive their responsible adoption. For example, the Coalition for Health AI, a community of academic health systems, organizations, and expert practitioners of AI and data science, recently released its Blueprint for Trustworthy AI Implementation Guidance and Assurance for Healthcare in April 2023. This is a topic we will surely hear more about in the coming years, and one I encourage you to read about in greater depth as it is truly eye-opening.

In this month’s issue of GI & Hepatology News, we update you on a new fatty liver disease nomenclature (including several new acronyms) that will be critical to incorporate into your clinical practice moving forward. In a new recurring article reprinted from Gastro Hep Advances, we highlight important Pearls from the Pros from hepatologists Dr. Lawrence Friedman and Dr. Paul Martin on the management of incidental hepatic steatosis. Our August Member Spotlight features Orlando-based gastroenterologist Dr. Mariam Naveed, who shares her passion for medical education and experience starting a new GI fellowship program.

We hope you enjoy these and all the stories featured in our August issue.

Megan A. Adams, MD, JD, MSc
Editor-in-Chief

At DDW in May, the AGA Ethics Committee sponsored a well-attended clinical symposium focused on key legal, regulatory, and ethical considerations relating to use of artificial intelligence (AI) in health care.

It was a thought-provoking discussion of how to ethically and equitably design and regulate these exciting new technologies to maximize their potential to achieve meaningful improvements in health for our patients while avoiding unintended consequences.

Indeed, one of the vexing challenges in this space is the fact that many AI algorithms and resulting tools are proprietary, impeding the ability to achieve the level of transparency necessary to understand data inputs, outputs, and outcomes, and assess for potential algorithmic bias.

This is an area that remains largely unregulated, with a lack of common standards to guide responsible design, development, and adoption of these tools. This is something that is top of mind for federal regulatory agencies, including the Food and Drug Administration, which in September 2022, announced plans to expand its regulation of AI-powered clinical decision support tools as medical devices.

There are also attempts underway to harmonize standards and reporting for health AI and educate end-users on how to evaluate these technologies to drive their responsible adoption. For example, the Coalition for Health AI, a community of academic health systems, organizations, and expert practitioners of AI and data science, recently released its Blueprint for Trustworthy AI Implementation Guidance and Assurance for Healthcare in April 2023. This is a topic we will surely hear more about in the coming years, and one I encourage you to read about in greater depth as it is truly eye-opening.

In this month’s issue of GI & Hepatology News, we update you on a new fatty liver disease nomenclature (including several new acronyms) that will be critical to incorporate into your clinical practice moving forward. In a new recurring article reprinted from Gastro Hep Advances, we highlight important Pearls from the Pros from hepatologists Dr. Lawrence Friedman and Dr. Paul Martin on the management of incidental hepatic steatosis. Our August Member Spotlight features Orlando-based gastroenterologist Dr. Mariam Naveed, who shares her passion for medical education and experience starting a new GI fellowship program.

We hope you enjoy these and all the stories featured in our August issue.

Megan A. Adams, MD, JD, MSc
Editor-in-Chief

At DDW in May, the AGA Ethics Committee sponsored a well-attended clinical symposium focused on key legal, regulatory, and ethical considerations relating to use of artificial intelligence (AI) in health care.

It was a thought-provoking discussion of how to ethically and equitably design and regulate these exciting new technologies to maximize their potential to achieve meaningful improvements in health for our patients while avoiding unintended consequences.

Indeed, one of the vexing challenges in this space is the fact that many AI algorithms and resulting tools are proprietary, impeding the ability to achieve the level of transparency necessary to understand data inputs, outputs, and outcomes, and assess for potential algorithmic bias.

This is an area that remains largely unregulated, with a lack of common standards to guide responsible design, development, and adoption of these tools. This is something that is top of mind for federal regulatory agencies, including the Food and Drug Administration, which in September 2022, announced plans to expand its regulation of AI-powered clinical decision support tools as medical devices.

There are also attempts underway to harmonize standards and reporting for health AI and educate end-users on how to evaluate these technologies to drive their responsible adoption. For example, the Coalition for Health AI, a community of academic health systems, organizations, and expert practitioners of AI and data science, recently released its Blueprint for Trustworthy AI Implementation Guidance and Assurance for Healthcare in April 2023. This is a topic we will surely hear more about in the coming years, and one I encourage you to read about in greater depth as it is truly eye-opening.

In this month’s issue of GI & Hepatology News, we update you on a new fatty liver disease nomenclature (including several new acronyms) that will be critical to incorporate into your clinical practice moving forward. In a new recurring article reprinted from Gastro Hep Advances, we highlight important Pearls from the Pros from hepatologists Dr. Lawrence Friedman and Dr. Paul Martin on the management of incidental hepatic steatosis. Our August Member Spotlight features Orlando-based gastroenterologist Dr. Mariam Naveed, who shares her passion for medical education and experience starting a new GI fellowship program.

We hope you enjoy these and all the stories featured in our August issue.

Megan A. Adams, MD, JD, MSc
Editor-in-Chief

Dear friends,

Fall is a time of transitions in our field so with that I would like to extend a huge welcome to all of our new gastroenterology fellows and best wishes to those entering practice. This fall, I will also be starting my first position out of fellowship. I look forward to many opportunities and challenges to come.

This month in In Focus, Dr. Mai Sedki and Dr. W. Ray Kim unpack the nuances of assessing and risk-stratifying patients with nonalcoholic fatty liver disease by using non-invasive testing in daily practice. Beyond daily practice, it is important to know where our field is advancing to offer patients more options. In Short Clinical Reviews, Dr. Aileen Bui and Dr. James Buxbaum review how the field of endohepatology is expanding into endoscopic ultrasound–guided liver biopsies, portal pressure measurements, and interventions of gastric varices.

In our Early Career feature, Dr. Corlan Eboh, Dr. Victoria Jaeger, and Dr. Dawn Sears describe how gastroenterologists are uniquely positioned for burnout and what can be done to prevent and treat it, particularly among new and transitioning gastroenterologists. In post-COVID era, practices have experienced an increase in portal messages and other non-face-to-face patient care, which may be contributing burnout.

In our Finance section this month, Dr. Luis Nieto and Dr. Jami Kinnucan review the types of patient encounters and billing options to optimize your compensation for time spent.

In Private Practice Perspectives, Dr. David Ramsey discusses why he joined a private practice and how understanding your own goals and values can guide you to a good fit in different practice models. Lastly, Dr. Dan Kroch describes his unique journey in becoming a third-space endoscopist without an advanced fellowship year and why dedicated training is the future of advanced endoscopic resection and third-space endoscopy.

If you are interested in contributing or have ideas for future TNG topics, please contact me (jtrieu23@gmail.com), or Jillian Schweitzer (jschweitzer@gastro.org), managing editor of TNG.

Until next time, I leave you with a historical fun fact: The first endoscopic retrograde cholangiopancreatography (ERCP) was first performed by an obstetrician, Dr. William McCune in 1968, and achieved by taping an external accessory channel to a duodenoscope.
 

Yours truly,

Judy A Trieu, MD, MPH

Editor-in-Chief
Advanced Endoscopy Fellow
Division of Gastroenterology & Hepatology
University of North Carolina at Chapel Hill

Dear friends,

Fall is a time of transitions in our field so with that I would like to extend a huge welcome to all of our new gastroenterology fellows and best wishes to those entering practice. This fall, I will also be starting my first position out of fellowship. I look forward to many opportunities and challenges to come.

This month in In Focus, Dr. Mai Sedki and Dr. W. Ray Kim unpack the nuances of assessing and risk-stratifying patients with nonalcoholic fatty liver disease by using non-invasive testing in daily practice. Beyond daily practice, it is important to know where our field is advancing to offer patients more options. In Short Clinical Reviews, Dr. Aileen Bui and Dr. James Buxbaum review how the field of endohepatology is expanding into endoscopic ultrasound–guided liver biopsies, portal pressure measurements, and interventions of gastric varices.

In our Early Career feature, Dr. Corlan Eboh, Dr. Victoria Jaeger, and Dr. Dawn Sears describe how gastroenterologists are uniquely positioned for burnout and what can be done to prevent and treat it, particularly among new and transitioning gastroenterologists. In post-COVID era, practices have experienced an increase in portal messages and other non-face-to-face patient care, which may be contributing burnout.

In our Finance section this month, Dr. Luis Nieto and Dr. Jami Kinnucan review the types of patient encounters and billing options to optimize your compensation for time spent.

In Private Practice Perspectives, Dr. David Ramsey discusses why he joined a private practice and how understanding your own goals and values can guide you to a good fit in different practice models. Lastly, Dr. Dan Kroch describes his unique journey in becoming a third-space endoscopist without an advanced fellowship year and why dedicated training is the future of advanced endoscopic resection and third-space endoscopy.

If you are interested in contributing or have ideas for future TNG topics, please contact me (jtrieu23@gmail.com), or Jillian Schweitzer (jschweitzer@gastro.org), managing editor of TNG.

Until next time, I leave you with a historical fun fact: The first endoscopic retrograde cholangiopancreatography (ERCP) was first performed by an obstetrician, Dr. William McCune in 1968, and achieved by taping an external accessory channel to a duodenoscope.
 

Yours truly,

Judy A Trieu, MD, MPH

Editor-in-Chief
Advanced Endoscopy Fellow
Division of Gastroenterology & Hepatology
University of North Carolina at Chapel Hill

Dear friends,

Fall is a time of transitions in our field so with that I would like to extend a huge welcome to all of our new gastroenterology fellows and best wishes to those entering practice. This fall, I will also be starting my first position out of fellowship. I look forward to many opportunities and challenges to come.

This month in In Focus, Dr. Mai Sedki and Dr. W. Ray Kim unpack the nuances of assessing and risk-stratifying patients with nonalcoholic fatty liver disease by using non-invasive testing in daily practice. Beyond daily practice, it is important to know where our field is advancing to offer patients more options. In Short Clinical Reviews, Dr. Aileen Bui and Dr. James Buxbaum review how the field of endohepatology is expanding into endoscopic ultrasound–guided liver biopsies, portal pressure measurements, and interventions of gastric varices.

In our Early Career feature, Dr. Corlan Eboh, Dr. Victoria Jaeger, and Dr. Dawn Sears describe how gastroenterologists are uniquely positioned for burnout and what can be done to prevent and treat it, particularly among new and transitioning gastroenterologists. In post-COVID era, practices have experienced an increase in portal messages and other non-face-to-face patient care, which may be contributing burnout.

In our Finance section this month, Dr. Luis Nieto and Dr. Jami Kinnucan review the types of patient encounters and billing options to optimize your compensation for time spent.

In Private Practice Perspectives, Dr. David Ramsey discusses why he joined a private practice and how understanding your own goals and values can guide you to a good fit in different practice models. Lastly, Dr. Dan Kroch describes his unique journey in becoming a third-space endoscopist without an advanced fellowship year and why dedicated training is the future of advanced endoscopic resection and third-space endoscopy.

If you are interested in contributing or have ideas for future TNG topics, please contact me (jtrieu23@gmail.com), or Jillian Schweitzer (jschweitzer@gastro.org), managing editor of TNG.

Until next time, I leave you with a historical fun fact: The first endoscopic retrograde cholangiopancreatography (ERCP) was first performed by an obstetrician, Dr. William McCune in 1968, and achieved by taping an external accessory channel to a duodenoscope.
 

Yours truly,

Judy A Trieu, MD, MPH

Editor-in-Chief
Advanced Endoscopy Fellow
Division of Gastroenterology & Hepatology
University of North Carolina at Chapel Hill

Dear friends,

Spring is coming to an end, and in this time with the upcoming summer usually racing by, I always find myself reflecting on the past year. I celebrate my achievements (both personal and work related), try not to be too hard on myself with unaccomplished tasks, and plan goals for the upcoming year. Most importantly, it’s a time to be grateful for both opportunities and challenges. Thank you for your engagement with The New Gastroenterologist, and as you go through this issue, I hope you can find time for some spring reflections as well!

In this issue’s In Focus, Dr. Tanisha Ronnie, Dr. Lauren Bloomberg, and Dr. Mukund Venu break down the approach to a patient with dysphagia, a common and difficult encounter in GI practice. They emphasize the importance of a good clinical history as well as understanding the role of diagnostic testing. In our Short Clinical Review section, Dr. Noa Krugliak Cleveland and Dr. David Rubin review the rising role of intestinal ultrasound in inflammatory bowel disease, how to be trained, and how to incorporate it in clinical practice.

As early-career gastroenterologists, Dr. Samad Soudagar and Dr. Mohammad Bilal were tasked with establishing an advanced endoscopy practice, which may be overwhelming for many. They synthesized their experiences into 10 practical tips to build a successful practice. Our Post-fellowship Pathways article highlights Dr. Katie Hutchins’s journey from private practice to academic medicine; she provides insights into the life-changing decision and what she learned about herself to make that pivot.

In our Finance section, Dr. Kelly Hathorn and Dr. David Creighton reflect on navigating as new parents while both working full time in medicine; their article weighs the pros and cons of various childcare options in the post–COVID pandemic world.

In an additional contribution this issue, gastroenterology and hepatology fellowship program leaders at the University of Florida, Gainesville, describe their experience with virtual recruitment, including feedback from their candidates, especially as we enter another cycle of GI Match.

If you are interested in contributing or have ideas for future TNG topics, please contact me (jtrieu23@gmail.com), or Jillian Schweitzer (jschweitzer@gastro.org), managing editor of TNG.

Until next time, I leave you with a historical fun fact, because we would not be where we are without appreciating where we were: The first formalized gastroenterology fellowship curriculum was a joint publication by four major GI and hepatology societies in 1996 – just 27 years ago!
 

Yours truly,

Judy A Trieu, MD, MPH



Editor-in-Chief

Advanced Endoscopy Fellow

Division of gastroenterology & hepatology

University of North Carolina at Chapel Hill
 

Dear friends,

Spring is coming to an end, and in this time with the upcoming summer usually racing by, I always find myself reflecting on the past year. I celebrate my achievements (both personal and work related), try not to be too hard on myself with unaccomplished tasks, and plan goals for the upcoming year. Most importantly, it’s a time to be grateful for both opportunities and challenges. Thank you for your engagement with The New Gastroenterologist, and as you go through this issue, I hope you can find time for some spring reflections as well!

In this issue’s In Focus, Dr. Tanisha Ronnie, Dr. Lauren Bloomberg, and Dr. Mukund Venu break down the approach to a patient with dysphagia, a common and difficult encounter in GI practice. They emphasize the importance of a good clinical history as well as understanding the role of diagnostic testing. In our Short Clinical Review section, Dr. Noa Krugliak Cleveland and Dr. David Rubin review the rising role of intestinal ultrasound in inflammatory bowel disease, how to be trained, and how to incorporate it in clinical practice.

As early-career gastroenterologists, Dr. Samad Soudagar and Dr. Mohammad Bilal were tasked with establishing an advanced endoscopy practice, which may be overwhelming for many. They synthesized their experiences into 10 practical tips to build a successful practice. Our Post-fellowship Pathways article highlights Dr. Katie Hutchins’s journey from private practice to academic medicine; she provides insights into the life-changing decision and what she learned about herself to make that pivot.

In our Finance section, Dr. Kelly Hathorn and Dr. David Creighton reflect on navigating as new parents while both working full time in medicine; their article weighs the pros and cons of various childcare options in the post–COVID pandemic world.

In an additional contribution this issue, gastroenterology and hepatology fellowship program leaders at the University of Florida, Gainesville, describe their experience with virtual recruitment, including feedback from their candidates, especially as we enter another cycle of GI Match.

If you are interested in contributing or have ideas for future TNG topics, please contact me (jtrieu23@gmail.com), or Jillian Schweitzer (jschweitzer@gastro.org), managing editor of TNG.

Until next time, I leave you with a historical fun fact, because we would not be where we are without appreciating where we were: The first formalized gastroenterology fellowship curriculum was a joint publication by four major GI and hepatology societies in 1996 – just 27 years ago!
 

Yours truly,

Judy A Trieu, MD, MPH



Editor-in-Chief

Advanced Endoscopy Fellow

Division of gastroenterology & hepatology

University of North Carolina at Chapel Hill
 

Dear friends,

Spring is coming to an end, and in this time with the upcoming summer usually racing by, I always find myself reflecting on the past year. I celebrate my achievements (both personal and work related), try not to be too hard on myself with unaccomplished tasks, and plan goals for the upcoming year. Most importantly, it’s a time to be grateful for both opportunities and challenges. Thank you for your engagement with The New Gastroenterologist, and as you go through this issue, I hope you can find time for some spring reflections as well!

In this issue’s In Focus, Dr. Tanisha Ronnie, Dr. Lauren Bloomberg, and Dr. Mukund Venu break down the approach to a patient with dysphagia, a common and difficult encounter in GI practice. They emphasize the importance of a good clinical history as well as understanding the role of diagnostic testing. In our Short Clinical Review section, Dr. Noa Krugliak Cleveland and Dr. David Rubin review the rising role of intestinal ultrasound in inflammatory bowel disease, how to be trained, and how to incorporate it in clinical practice.

As early-career gastroenterologists, Dr. Samad Soudagar and Dr. Mohammad Bilal were tasked with establishing an advanced endoscopy practice, which may be overwhelming for many. They synthesized their experiences into 10 practical tips to build a successful practice. Our Post-fellowship Pathways article highlights Dr. Katie Hutchins’s journey from private practice to academic medicine; she provides insights into the life-changing decision and what she learned about herself to make that pivot.

In our Finance section, Dr. Kelly Hathorn and Dr. David Creighton reflect on navigating as new parents while both working full time in medicine; their article weighs the pros and cons of various childcare options in the post–COVID pandemic world.

In an additional contribution this issue, gastroenterology and hepatology fellowship program leaders at the University of Florida, Gainesville, describe their experience with virtual recruitment, including feedback from their candidates, especially as we enter another cycle of GI Match.

If you are interested in contributing or have ideas for future TNG topics, please contact me (jtrieu23@gmail.com), or Jillian Schweitzer (jschweitzer@gastro.org), managing editor of TNG.

Until next time, I leave you with a historical fun fact, because we would not be where we are without appreciating where we were: The first formalized gastroenterology fellowship curriculum was a joint publication by four major GI and hepatology societies in 1996 – just 27 years ago!
 

Yours truly,

Judy A Trieu, MD, MPH



Editor-in-Chief

Advanced Endoscopy Fellow

Division of gastroenterology & hepatology

University of North Carolina at Chapel Hill