North American Society for Pediatric Gastroenterology, Hepatology & Nutrition

N E W S VOL. 8, NO.4

President’s Perspectives . . . . . . . . .B UK Li, MD • President, North American Society for Pediatric Gastroenterology, Hepatology and Nutrition

WINTER 2008

table of contents2 . . . . Secretary–Treasurer’s Report

3 . . . . 2008 NASPGHAN/CDHNF Conference Highlights

7 . . . . Committee Reports

9 . . . . American Academy of Pediatrics Corner /American Board of Pediatrics (ABP) Liaison Report

10 . . . . NASPGHAN Meetings & Important Deadlines /Meetings of Interest / New Members

11 . . . . First-Year Fellows / Murray Davidson Award Announcement12 . . . . Billing & Coding14 . . . . Advocacy Update15 . . . . Classifieds

Change 2008“ They must often change, who would be

constant in happiness or wisdom.”Confucius, Analects, 488 BC

“ It is not the strongest of the species that survive nor the most intelligent, but the one most responsive to change.”Attr. Charles Darwin, 1858

“ We are the change we seek.” Barack Obama, 2008

In this historic political season, the term “change” has been ballyhooed andbantered about. But what does it mean? The quotations spanning twoand a half millennia reflect three important facets: that change is essentialto human attainment, that change provides an adaptive advantage, andthat we are responsible for the change we desire. So, perhaps it is not justa seasonal political sales pitch, and certainly not new, that change is what it is . . . quintessential.

In appreciation of serviceSpeaking of change, we, too, are undergoing a transition in NASPGHANofficers. Let me first thank the team of John “JB” Barnard, Phil Shermanand Ivor Hill who just completed their respective terms as President, Past-President (6 years total), and Secretary Treasurer (3 years). John ledthe strategic planning of 2006 and refocused our attention on the triad of quality care, research, and education. Phil initiated the advocacy committee and advocacy efforts. Ivor kept a close fiscal and ethical eye on our organization. As you looked closely, the three were diversified bygeography (the frozen North, the deep South, and the deepest South[Africa]) and by attire the rumpled, starched and drip-dry golf shirt!Please thank them for their service when you see them. Many thanks tothe dedicated service of our outgoing councilors Judy O’Connor andDavid Piccoli, and committee chairs Karen Murray, Laurie Fishman, BrentPolk, Sulamain Bharwani, Rob Shulman, Ron Sokol, and Karen Francolla.

The transition teamThe elected and geographically-balanced transition team is comprised ofKathy Schwarz, President-elect from the East, David Gremse, Secretary-

Treasurer from the West, and myself from the Midwest. Our newcouncilors Karen Murray and Alex Flores bring a focus on professional development and international relations with other societies. They join councilors Estella Alonso, George Fuchs, Nicola Jones and Jim Heubi who are distributed along liver-GI and Canadian-US divide. Our new committee chairs are Mitch Shub (Professional Development), John Pohl (Professional Education), David Rudnick (Research), SamNurko (Neurogastroenterology & Motility– a new committee), Maria Mascarenhas (Nutrition), John Udall (Advocacy), and Rebecca Cherry(Fellows).

Who is NASPGHAN?In our transition meeting, Kathy asked what is NASPGHAN’s principalstrength. John and I immediately responded that it is you, our proactivemembers, with your collective energy, collegiality, and desire for clinical,scientific and professional excellence that have rendered NASPGHAN ahigh quality, yet social and fun, organization. NASPGHAN represents98% of the practicing pediatric gastroenterologists in Canada and the US,now 1,500 members including 35 Canadian and 239 US trainees. You are 34% female and 62% male and an astounding 20% of you serve oncommittees. We take special care of our trainees through our Teachingand Tomorrow and three Fellows’ Conferences. The critical glue thatholds us together is our dedicated home office with Margaret Stallings,Sandy Fasold and Kim Rose in a humble suite in bucolic Flourtown. Theyalso serve as staff of our foundation – The Children’s Digestive Healthand Nutrition Foundation (CDHNF), the Federation of InternationalSocieties for Pediatric Gastroenterology, Hepatology and Nutrition(FISPGHAN) – the 4 international societies, and the Association ofPediatric Gastroenterolog y and Nutrition Nurses (APGNN), ouraffiliated nurses.

What is the strategic triad of NASPGHAN?Meeting the manifold professional, educational and research needs of ourpractitioners, trainees and academic members underscores these strategies.Quality care and its corresponding committee led by Steve Schwarzhave implemented due process for initiating, overseeing and updating clinical guidelines. We continue to increase the practice-related sessions on practice management and billing and coding. Research–through CDHNF,

B Li, MDPresident, NASPGHAN

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our fundraising arm, supports 5 young investigator awards, 1 fellow-to-faculty transition award and has built an endowment of $2 million-plusunder Bill Balistreri and George Ferry’s leadership. We hope to expand support for collaborative research, allied research and quality improvementprojects. Education primarily at the Annual Meeting continues as thehighest rated society activity and we will begin to facilitate maintenanceof certification and practice improvement activities. Other educational additions include the Capsule Endoscopy and inaugural Therapeutic Endoscopy Courses (with ASGE), our extensive trainee venues, and faculty conferences ( Junior Faculty Academic Skills Workshop). TheeQIPP module on GERD will soon be available and will serve as an important resource for completion of Part IV of the Maintenance of Certification. The release of the quality improvement eQIPP module on Diagnosis and Management of GERD and GER will take place in early 2009 – in time for clinicians to initiate this process in order to comply with the American Board of Pediatrics maintenance ofcertification process. This web-based interactive module, developed inpartnership of CDHNF, will offer you the opportunity to satisfy Part IVof the American Board of Pediatrics Maintenance of Recertification requirement.

What issues does NASPGHAN face?Although it cannot be compared to the subprime morass that engulfs us, there are still significant challenges ahead of NASPGHAN. At theupcoming winter retreat at the end of January 2009, we will brainstormstrategically. Some of the specific questions and topics we will address:

1) How do we incorporate practice improvement, maintenance of certification and simulation activities into our educational venues? ( John Pohl)

2) How should we strategically refocus our research efforts – including collaborative research? (David Rudnick)

3) How do we prepare for a potential decline in revenue? (David Gremse)

4) Reexamine the factors that will influence the workforce needs in the near future. (Rob Squires)

5) How can we enhance flexibility in training to meet the varied career needs of trainees? (Alan Leichtner)

6) How do we reach out to the global community and our multidisciplinary practice partners – nutritionists and medical psychologists? (Ruben Quiros)

7) Develop a mid career leadership development seminar (Mitch Shub)

8) What are our principal messages for the planned NASPGHAN ‘Day on Capitol Hill’ on Wednesday November 12th? ( John Udall)

We need your input! If you have ideas and interest, please share them withyour leadership above before January 25th. We look forward to hearingfrom you.

Happy New Year to all NASPGHANees and APGNNees and your families.

Best Regards,B UK Li, MDPresident, NASPGHANMilwaukee, WI

Secretary–Treasurer’sReport . . . Dear Friends and Colleagues:Greetings from Las Vegas! I would like to take the opportunity in my firstcontribution to the NASPGHAN Newsletter to you as your Secretary/Treasurer to thank you for your support and for the opportunity to servein this capacity. I would also like to thank Ivor Hill for his outstandingleadership and dedicated service as Secretary/Treasurer. Through his efforts, the Council, and our fantastic National Office Staff of MargaretStallings, Sandy Fasold and Kim Rose, NASPGHAN’s finances remainsound. I am pleased to report that NASPGHAN is not gambling with its financialreserves. Even during a period when the economy is suffering, the vast majority of NASPGHAN’s holdings have been in money marketaccounts or other cash equivalents all along, well before the downturn in thestock market. This leaves our reserves in a good financial shape as we enterinto 2009.Although NASPGHAN starts 2009 with a healthy reserve fund, we facemany challenges as an organization, many of which were outlined by Ivor Hill in the last newsletter, including the uncertainty of the future of pharmaceutical industry support for medical organizations. Two significant sources of revenue for NASPGHAN include membershipdues and registration for our Annual Meeting. Therefore, we need yourcontinued support to keep NASPGHAN strong.NASPGHAN continues to provide new services to meet the needs ofmembers and make renewing of your membership worthwhile. It was exciting to see the participation in the Clinical & Scientific Conferencein San Diego in November. The turnout demonstrated how many rely on NASPGHAN for professional education, CME, and networking.Members have come to depend on the educational programs ofNASPGHAN to keep up-to-date and as a source of CME. Just as in the 1990’s when acquiring CME hours became required for maintenanceof licensure in renewing your state medical license, beginning in 2010 participation in quality improvement projects will become an importantcomponent of Maintenance of Certification. NASPGHAN is developingnew opportunities to meet that need. One quality improvement program involving NASPGHAN members is the PIBDNet: The Pediatric IBD Network for Research and QualityImprovement. PIBDNet has been approved by the American Board ofPediatrics as a project that would satisfy MOC Part 4: Performance inPractice requirements. Another QI project that will benefit NASPGHANmembers is a joint venture of NASPGHAN/CDHNF and the AAP.This joint venture is an eQIPP module on GERD that will be offered toNASPGHAN members at a discount. Participation in this eQIPP module will also generate points to satisfy MOC Part 4 for Pediatric Gastroenterologists. These are two examples of how NASPGHAN servesas a voice for pediatric gastroenterologists with other organizations and isreaching out and collaborating with sister organizations to make it easierfor NASPGHAN members to maintain our professional standing. So, ifyou haven’t already done so, please take time to renew your membership.Thank you again for the opportunity to be NASPGHAN Secretary/Treasurer. I look forward to working with you in the coming years.

Best regards,

David Gremse, MD Secretary-Treasurer

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2008 NASPGHAN/CDHNF Clinical & Scientific Conference

1998 - 2008

SAN DIEGO, CA – AWARDS CEREMONY – NOVEMBER 15, 2008

Harland Winter, MD, Richard Colletti, MD & John Barnard, MD John Barnard, MD, Jay Perman, MD & John Watkins, MD

William Balistreri, MD, Patricia Robuck, PhD, B Li, MD & John Barnard, MDJohn Barnard, MD, Michael Thaler, MD & Melvin Heyman, MD

NASPGHAN DISTINGUISHED SERVICE AWARD

Presented to Richard Colletti, MD by Harland Winter, MDThe NASPGHAN Distinguished Service Award is presented to an

individual to recognize excellence and service to the field of pediatric gastroenterology, hepatology, and nutrition by achieving national

and/or international recognition in their field.

HARRY SHWACHMAN AWARD

Presented to Michael Thaler, MD by Melvin Heyman, MDThe Shwachman award is given by NASPGHAN to a person who has mademajor, life long scientific or educational contributions to the field of pediatricgastroenterology, hepatology or nutrition in North America. The award is designed to preferentially honor a member of NASPGHAN for his/her

achievements in the field.

AAP MURRAY DAVIDSON AWARD

Presented to Jay Perman, MD by John Watkins, MDThe Murray Davidson Award recognizes an outstanding clinician and educator and scientist who has made a significant contribution to the

field of pediatric gastroenterology and nutrition.

NASPGHAN PEDIATRIC RESEARCH ADVOCACY AWARD

Presented to Patricia Robuck, PhD by John Barnard, MD

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Aliye Uc, MD University of IowaHEME OXYGENASE-1: REGULATION AND FUNCTION IN

NON-STEROIDAL ANTI-INFLAMMATORY DRUG-INDUCEDSTOMACH ULCERS

Mamata Sivagnanam, MD University of California, San DiegoINTESTINAL EPITHELIAL FUNCTION OF EPITHELIAL

CELL ADHESION MOLECULE: LEARNING LESSONS FROM A RARE DISEASE, CONGENITAL TUFTING ENTEROPATHY

Kara Gross, MD Columbia University ENTERIC NEURONAL DEVELOPMENT AS A

DETERMINANT OF INTESTINAL INFLAMMATION

Richard Kellermayer, MD Baylor College of Medicine NUTRITIONAL INFLUENCE ON THE EPIGENETIC

DEVELOPMENT OF THE COLONIC MUCOSA

James Franciosi, MD Cincinnati Children’s Hospital Medical Center

HEALTH RELATED QUALITY OF LIFE AND SYMPTOM SEVERITY OUTCOME MEASURES IN EOSINOPHILIC ESOPHAGITIS:

BEYOND EOSINOPHIL COUNTING

Michael Rosen, MD Vanderbilt University THE ROLE OF IL-13 AND NATURAL KILLER T-CELLS IN

NEW ONSET PEDIATRIC ULCERATIVE COLITIS

CDHNF/AstraZeneca Research Award for Acid Peptic Related Diseases 20082010

George Ferry Young Investigator Award/CDHNF/Nestlé Nutrition Research

Young Investigator Award 20082010

William Balistreri, MD, Aliye Uc, MD & John Barnard, MD

William Balistreri, MD, Mamata Sivagnanam, MD & John Barnard, MD

NASPGHAN/CDHNF Young Investigator Award 20082010

CDHNF/Crohn’s & Colitis Foundation of America Young Investigator Award

William Balistreri, MD, Kara Gross, MD, & John Barnard, MD William Balistreri, MD, Michael Rosen, MD & John Barnard, MD

William Balistreri, MD, Richard Kellermayer, MD & John Barnard, MD

NASPGHAN/CDHNF Fellow to Faculty Transition Award In Inflammatory Bowel Diseases

Supported by an educational grant from Centocor and Procter & Gamble

CDHNF 2008 RESEARCH AWARDS

CDHNF/AstraZeneca/Takeda Young Investigator Award in Eosinophilic Esophagitis

William Balistreri, MD, James Franciosi, MD & John Barnard, MD

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2008 NASPGHAN/CDHNF Clinical & Scientific ConferenceNovember 13–15, 2008

Sheraton San Diego Hotel & Marina • San Diego, CA

1998 - 2008

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2008 NASPGHAN/CDHNF Clinical & Scientific ConferenceNovember 13–15, 2008

Sheraton San Diego Hotel & Marina • San Diego, CA

1998 - 2008

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RESEARCH COMMITTEE

Chair: David Rudnick, MD

Thirteen of the NASPGHAN Research Committee members metat the NASPGHAN-CDHNF Conference in November in SanDiego to review the progress on action plan items and make plans for the upcoming year.

The Research committee will be seeking suggestions for invited speakers and possible thematic development with the research interestgroup (RIG).

We reviewed 22 grant applications for CDHNF in 2008, with thisyear’s review process including the first ever face-to-face CDHNF research committee study section. Members of the committee met in Chicago for one day in September for grant application review.Based on committee recommendations, the CDHNF announced sixresearch awards at the national meeting. The committee membersagreed that this format for review was highly effective and rewarding.

We identified participants from the committee for the annualNASPGHAN-Mead Johnson Fellows Research Conference, whichwill be March 19–22 in Scottsdale, AZ. Once again, the focus of thismeeting will be on the transition from fellowship to faculty.

We reviewed activities of the past year and plans for the coming yearwith respect to each of the committee’s action items, including theAnnual Meeting program, CDHNF and other grant reviews, thethird-year fellows conference, and promotion of the Research InterestGroup. We also discussed developing approaches to meeting thestrategic goals of NASPGHAN, including development of:

a timeline and process for making recommendations to NASPGHAN council for updating the NASPGHANresearch agendaongoing strategic and actionable approaches for partnershipwith CDHNFtactics to nurture, strengthen, support, and increase research networks and multi-institutional studies in our discipline

We thanked Brent Polk, Glenn Gourley, Stephen James, CaraMack, and Anne Wolf for their tremendous service to NASPGHANthrough work on the grant review, RIG, and third-year fellows’conference subcommittees. We also recognized Steve Guthery whowas asked to serve for another year as an ad hoc member of this committee to continue working on developing collaborative researchnetworks. We also welcomed new members Jorge Bezerra, YoramElitsur, Glenn Furuta, and Neera Gupta.

ENDOSCOPY & PROCEDURES COMMITTEE

Chair: Jenifer R Lightdale, MD, MPH

The Endoscopy and Procedures Committee continues to focus onpromoting education, research and quality in the field of pediatric endoscopy. In October 2008, we held the first Therapeutic Pediatric

Endoscopy “Hands On” Course at the American Society of Gastroin-testinal Endoscopy’s Interactive Training and Technology (IT&T)Center in Oakbrook, IL. There was considerable NASPGHANcommunity interest in attending the course and we were able to draw60 participating pediatric endoscopists from across the country to thespecialized training center near Chicago.

The Hands-On Endoscopy Course co-directed by Petar Mamula andJenifer Lightdale, featured a faculty of nine senior pediatric and twoleading adult endoscopists, and covered topics designed to address the needs of established pediatric endoscopists who were interested inimproving their knowledge of familiar and new procedural techniques.Emphasis was placed on the specialized use of therapeutic endoscopy ininfants and children, including both the limitations and potential applications of advanced or unique techniques in pediatric patients.Attendees specifically learned about hemostasis: heater/bipolar probes,clipping techniques, argon plasma coagulation, variceal banding and sclerotherapy. In addition, saline assisted polypectomy, balloondilation, video capsule deployment, wireless pH probe placement, foreign body removal, and enteral access were covered. The coursefeatured some presentations and roundtable discussions, but it wasindisputably the hands-on instruction at the IT&T Center that waswell received by attendees. Plans are underway for repeating the coursein early fall 2009. There is also interest in implementing a hands-oncourse in pediatric endoscopy for fellows. Additional information canbe found at www.naspghan.org as it becomes available.

Hands-on instruction in clipping techniques was also featured thisyear in a “break-out” session led by Marsha Kay at the NASPGHAN-CDHNF November meeting in San Diego. The NASPGHANmeeting also featured a number of endoscopy research abstracts in theposter sessions. Earlier in May 2008, the pediatric endoscopy sessionat Digestive Disease Week enjoyed a standing-room only crowd anda write-up in the DDW Daily News where Tom Lin was the recipientof a $500 award for his research in double-balloon enteroscopy. The E&P Committee remains committed to supporting EndoscopyAwards – both at the fall meeting and at DDW– and encourages allNASPGHAN members to compete!

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Committee Reports

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A burgeoning interest in endoscopy research continues to drive an evidence-basis for improving the quality of pediatric GI procedures.Khalid Khan participated on the 2008 ASGE’s Standards of PracticeCommittee where position statements and guidelines, including oneson Sedation and Anesthesia and Laboratory Values for Routine Procedures, continue to specifically address pediatric endoscopy. TheE&P Committee is also participating in the Training Committee’sinitiative to update the guidelines for fellow education, includingguidelines for training in pediatric endoscopy.

TRAINING COMMITTEE

Chair: Alan M Leichtner, MDThe Training Committee provides on-going support for outstandingand innovative programs, such as the summer student researchprogram, Teaching and Tomorrow Program, and three annual fellowconferences. In addition, the committee has a major new initiative to revise the NASPGHAN training guidelines. Here are some highlights.

Fifty-six residents, the highest number since its inception, attended the Teaching and Tomorrow Program at our NovemberNASPGHAN/CDHNF meeting in San Diego. Merit-based travelstipends were awarded to 35 of them. Prospective fellows learnedabout our field and how to obtain and negotiate a fellowship. Mostimportantly, they had an opportunity to network with each other,fellows, and faculty. The program was generously supported byShire. The contribution of the program directors was also greatly appreciated.

The process of revising NASPGHAN’s training guidelines isfirmly underway. The current guidelines were written in 1999 andneed to be updated to include advances in knowledge, the changingnature of diagnostic and therapeutic procedures, and the ACGMEcompetencies and assessment tools. The revised guidelines will be more flexible to accommodate preparation for different futurecareer paths. Under the direction of the Steering Committee(Lynette Gillis, Sandeep Gupta, Jim Heubi, Tom Sferra, and AlanLeichtner), task force leaders were appointed for 11 different content areas and additional contributors are being sought. A draftdocument is planned for mid-year.

The Match is alive and well! Again for its third year, more than 75%of training programs (with 75% of the available training slots) will be participating in the Match. In this program, residents canopt to visit a number of different programs without being subjectedto the pressure of making early decisions, and feedback has been excellent. The training committee continues to encourage universalparticipation of training programs.

The training committee is responsible to promote exchange of ideasamong program directors. In San Diego, Paul Rufo moderated alively session on Assessing Competencies of Fellows, and a sessionon the challenging topic of Teaching Procedures is planned for theAnnual Meeting this fall.

I would like to thank all who participate in the training of our fellows and remind everyone that fellows are the future of our societyand our specialty.

PROFESSIONAL EDUCATIONCOMMITTEE

Chair: John Pohl, MDThis year’s Postgraduate course was a tremendous success! We had 480individuals attend the NASPGHAN course in San Diego, Californiaon November 13, 2008. For the past two years, NASPGHAN hastried to provide attendees with a wide spectrum of information, divided as five modules in a one-day course. Our emphasis for thisyear’s postgraduate course was on nutrition, and we had 15 speakersfrom around the country present updates on parenteral nutrition complications, enteral feeding and the infant gut, pediatric obesitymanagement, vitamin and mineral deficiencies and treatment, and allergy prevention from a dietary standpoint. Please mark your calendar for 2009 as next year’s NASPGHAN Annual Meeting willoccur from November 12–15 in National Harbor, Maryland.

We have tried very hard to incorporate your suggestions into each year’s postgraduate course, so please fill out your evaluations to help improve future educational activities. Also, we continue to incorporate non-pediatric GI speakers (registered dieticians, PhDs,adult gastroenterologists) to provide a wide array of information, andyour suggestions about future topics and speakers is always carefullyconsidered.

As we begin to prepare for next year’s meeting, we will contactNASPGHAN members for speaker references. The Professional Education Committee strives to obtain evaluations regarding the abilityof speakers prior to inviting them to present at the postgraduatecourse.

Finally, we have recorded this year’s postgraduate course (audio only) tobe released as a podcast, and the Professional Education Committee is grateful to Daniel Gelfond, MD for his hard work in beginning an annual recording of this course. The Professional Education Committee and the NASPGHAN leadership are working on the logistics of releasing the podcast to the Society’s membership.

We enjoyed seeing many of you in San Diego, and we look forward tomeeting again in National Harbor!

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American Board ofPediatrics (ABP)Liaison Report . . .During our recent national meeting in San Diego I was given theopportunity to make the case for improving quality and safety inpediatric gastroenterology via the Maintenance of Certification(MOC) process. Not surprisingly, I did receive some feedback after the presentation.A handful of members remain convinced that the development ofpractice standards and guidelines is acceptable for NASPGHAN andthe ABP, but that it should not be applied to them as individuals.The arguments are that each patient is different and that no doctorshould be able to sit as judge over another. However, the public and ultimately the government along with payers are demandingquality improvements and some form of certification that doctorsare competent. These larger organizations also know the value of knowledge, standardization, and guidelines. Hospitals and their regulators such as The Joint Commission are also asking that doctors demonstrate their competency. This is a difficult task. Butthe ABP is working with these groups to use board certification andMOC as a means of demonstrating the competency of diplomatesand, more importantly, improving quality for our patients. Despite the few negative comments, I was very grateful for the overwhelming number of supportive comments from NASPGHANmembers. I am sure that most of us are convinced that we must continually improve to better serve our patients. The ABP and theAmerican Board of Medical Specialties are both in agreement. The only real remaining question is how do we get there? It will be a journey. Initially, MOC will not be perfect. But the ABP willbe working with NASPGHAN and its members to develop theneeded meaningful and useful tools that will appear in future communications. Chris J. Dickinson, MDChair, GI SubboardAmerican Board of Pediatrics

on constipation for the pediatrician, written information on celiacdisease, cyclic vomiting, and gastroesophageal reflux (to coincidewith the new eQIPP module under joint development by the AAP/SOGHN and NASPGHAN/CDHNF). We areencouraging development of other educational materials on topical issues, including hepatitis and obesity, so anyoneinterested should contact me or Debra Burrowes to potentiallybecome involved in these products. Finally, the SOGHN has submitted a proposal for considerationat AAP’s Annual Leadership Forum (March 12-15, 2009) wherethe Academy’s policy is prioritized. Our proposal is to promotespecific reimbursement codes for pediatric specialists for extendedtime required for family discussions pertinent to procedures orunderlying diseases. We will keep you informed regarding theprogress of this proposal.I wish all of you a happy and healthy holiday season and look forward to another great year ahead.Mel Heyman, MDChair, AAP Section on Gastroenterology, Hepatology and NutritionE-Mail: mheyman@peds.ucsf.edu

American Academy of Pediatrics Corner

Congratulations again to Jay Perman, MD, who receivedthe 2008 Murray Davidson Award, to Michael Thaler,

MD, Shwachman Award recipient, and to Richard Colletti,MD, who was awarded the NASPGHAN DistinguishedService Award, for their outstanding contributions to our subspecialty. Many thanks to all of you who were able to attend the NASPGHAN/CDHNF Awards Ceremony in San Diego!Already, we are starting the process again. A call for nominationshas been issued for the 2009 AAP Murray Davidson Award,supported, in part, through an educational grant from AbbottNutrition. Specifically, this award recognizes an outstandingclinician and educator (primary) and scientist (secondary)who has made a significant contribution(s) to the field of pediatric gastroenterology (including hepatology) andnutrition. Nominations must be in writing and should be limited to one per nominator. The nomination should includea CV, a letter of nomination, and two (no more) letters of support. These are due in the AAP Office no later than April 1, 2009. A separate call for nominations has been issued for the 2009AAP Samuel J. Fomon Nutrition Award. This award recognizesan individual or project for outstanding achievement in research relating to the nutrition of infants and children. Theaward is made for research conducted in the United States and Canada that has been completed or publicly reported.Nominations must be in writing and should be limited to oneper nominator. The letter should contain a description of the nominee’s achievements and state clearly the basis for therecommendation (including references to the literature thatdescribes his/her work). It is requested that the nominee’s curriculum vitae, bibliography, nominating letter, and copiesof available reprints be submitted. Letters supporting the nomination (no more than five) are to be solicited andscreened by the nominator. This award is made possible by agrant from the International Formula Council.Please submit nominations for both awards to:Debra Burrowes, ManagerDivision of Technical and Medical ServicesAmerican Academy of Pediatrics141 Northwest Point Blvd.Elk Grove Village, IL 60007-1098dburrowes@aap.orgSpecial thanks to Susan Baker, Ajay Kaul, Kathleen Motil,Warren Bishop, and Carlo DiLorenzo for their excellent presentations at the 2008 AAP National Conference and Exhibition (NCE) in Boston. Please note, next year’s NCE will take place October 17-20, 2009, in Washington D.C. We hope to see many of you there!I invite you to join the AAP Section on Gastroenterology, Hepatology and Nutrition (SOGHN) and become active invarious initiatives that will help inform and strengthenrelationships with our pediatric colleagues. We continue to seek additional expertise in the “translation” of several existing evidence-based NASPGHAN policy statements into condensed, summary formats to disseminate to pediatricians.Current projects underway include developing a clinical report

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Meetings of Interest

A.S.P.E.N. Research Workshop 2009Micronutrients in Parenteral Nutrition: Too Little or Too Much?

• Date: January 30–31, 2009• Location: New Orleans, LA• Contact: www.nutritioncare.org/cnw/micronutrients09

International Symposium on Pediatric Inflammatory Bowel Disease

• Date: September 9–12, 2009• Location: Paris, France• Contact: www.consensus.nih.gov

� JANUARY 22–25, 2009First–Year Fellows ConferenceSupported by a grant from the Nestlé Nutrition FoundationFort Lauderdale, FL

�FEBRUARY 13–MARCH 13, 2009American Gastroenterological Association accepts late-breaking abstractshttp://ddw2009.abstractcentral.com

�MARCH 12–15, 2009Second–Year Fellows ConferenceSupported by a grant from Abbott Nutrition Scottsdale, AZ

�MARCH 19–22, 2009Third–Year Fellows ConferenceSupported by a grant from Mead Johnson Nutritionals Scottsdale, AZ

�NOVEMBER 12–15, 2009NASPGHAN Annual Meeting and Postgraduate Course 2009Gaylord NationalNational Harbor, MD

�NOVEMBER 16, 20092009 Certifying Examination in Pediatric Gastroenterology• Registration Dates: February 3, 2009–April 30, 2009

• Registration for Re-registrants: March 17, 2009–through June 16, 2009

• Register on American Board of Pediatrics Website: www.abp.org

NASPGHAN Meetings &Important Deadlines

Welcome New NASPGHAN Member

AZAM SOROUSH, MD

New Members

On Friday, November 14, 2008 the first “Hands-on Endoscopy” session was held during the NASPGHAN-CDHNF Partnership Conference in San Diego. Participants were able to learn the technique of endoscopic clipping at no cost to attendees. More than120 physicians participated in this program and the attendeesthought the session was useful. The faculty for the session includedMarsha Kay, MD; Bradley Barth, MD; George Gershman, MD;Mark Gilger, MD; Petar Mamula, MD; David Piccoli, MD, and Will Treem, MD. The activity was supported by Olympus Corporation. Plans are already underway for additional “Hands on Endoscopy” sessions at the NASPGHAN Annual Meetingin 2009 in National Harbor, Maryland.

Conference Hands-On Course

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Majdi Abu-Salih, MDFareed Ahmad, MDKhalid Alghamdi, MDOsama Almadhoun, MDEnory Almanza, MDFawaz Al-Refaee, MDDina Al-Zubeidi, MDStephanie Appleman, MDAmal Aqul, MDKatherine Atienza, DOVishal Avinashi, MDAhmet Aybar, MDRobert Bandsma, MDJulie Bass, DOJulie Bhardwaj, MDJulia Bracken, MDLuis Caicedo, MDSamson Cantu, MDEdaire Cheng, MDLay Har Cheng, MD, MSPHThomas Ciecierega, MDSteven Colson, MDRobert Cornfeld, MDElisabeth De Greef, MDNirav Desai, MDLuis Antonio Diaz Vega, MDMichael Docktor. MDLina Maria Felipez, MDMegan Gabel, MDRupa Gill, MDRene D Gomez-Esquivel, MDMariana Gomez-Najera, MDAlex Green, DOReema Gulati, MDAileen Har, MDSanjiv Harpavat, MD, PhDLina Hernandez, MDGilberto Hernandez Martinez, MDMeredith Hitch, MDAnna Hunter, MDSamar Ibrahim, M.B.Ch.B.Mutaz Idrees Sultan, MDNicole Jordan, MDJess Kaplan, MDMelissa Kennedy, MDMuhammad Khan, MD, MPHSahar Khorsheed, MDRobin Kindig, MDDale King, MDDale Knight, MD

Israel Kochin, MDBenjamin Kuhn, DOSavita Kumari, MDSachin Kunde, MD, MPHSally Lawrence, MDSindy Ledezma, MDJulie Lemale, MDRay Mun Loo, MDBeth Loveridge-Lenza, MDElizabeth Marcus, MDKatherine McGoogan, MDMaireade McSweeney, MDElizabeth Mileti, MDSaeed Mohammad, MDJavier Monagas, MDBrigitte Moreau, MDKun Tae (K.T.) Park, MDRaza Patel, MDMaria Perez, MDJoshua Prozialeck, MDJonathan Ramprasad, MDCamilla Richmond, MDSara Waller Rippel, MDEileen Rivera, MDKeren Sagiv-Friedgut, MDTiffany Schaible, MDSeth Septer, DOMohammad Shagrani, MDJason Shapiro, MDDarla Shores, MDSarah Shrager, MDClaudia A. Sifuentes-Vela, MDIng Shian Soon, MDInbar Spofford, MDPhilip Stein, MDJanis Stoll, MDSuma Sudheendran, MDJillian Sullivan, MDKara Sullivan, MDSenen Marino Tellez Salmeron, MDMila Tempel, DOJuli Tomaino, MDAnna Trauernicht, MDAmy Tsai, MDCharles Vanderpool, MDAlexandra Vasilescu, DOStephanie Willot, MDLaura Wozniak, MDYuanyuan Xie, MDMonica Zherebtsov, MD

AMERICAN ACADEMY OF PEDIATRICS

Section on Gastroenterology, Hepatology & Nutrition

2009 MURRAY DAVIDSONAWARD

Call for Nominations – April 1, 2009

Since its establishment in 1989, the American Academy ofPediatrics (AAP) Murray Davidson Award recognizes an outstanding clinician and educator (primary) and scientist (secondary) who has made a significant contribution(s) to the field of pediatric gastroenterology and nutrition. Currentmembers of the AAP Section on Gastroenterology, Hepatologyand Nutrition Executive Committee are ineligible to be nominated for this award.

We are requesting nominations from pediatric gastroenterolo-gists and other interested persons for this prestigious award.Nominations must be in writing and should be limited to oneper nominator. The nomination should include a CV, a letter of nomination, and two (no more) letters of support. These are due in the AAP Office no later than April 1, 2009. Send allnominations to the attention of:

Debra Burrowes, ManagerDivision of Technical and Medical ServicesAmerican Academy of Pediatrics141 Northwest Point BoulevardElk Grove Village, Illinois 60007-1098

E-mail: dburrowes@aap.org

The Academy appreciates your effort to assist in the appropriateselection of a deserving person for this award. The selection of theAward recipient is made by the Section on Gastroenterology,Hepatology and Nutrition’s Executive Committee and approvedby the Board of Directors.

The Murray Davidson Award provides an honorarium of$1,000, a round trip tourist class airfare, and two days lodgingfor the recipient to attend the NASPGHAN Annual Meeting.

This award is supported, in part, through an educational grantfrom Abbott Nutrition.

2008 First-Year Fellows

12(continued)

Billing &Coding Provided by Kathleen A. Mueller, RN, CPC, CCS–P, CCC Healthcare Consultant in association with McVey Associates, Inc.

Subsequent inpatient neonatal critical care, per day, forthe E/M of a critically ill neonate, 28 days of age or less

Initial inpatient pediatric critical care, per day, for theE/M of a critically ill infant or young child, 29 daysthrough 24 months of age

Subsequent inpatient pediatric critical care, per day,for the E/M of a critically ill infant or young child, 29 days through 24 months of age

Initial inpatient pediatric critical care, per day, for the E/M of a critically ill infant or young child,2-5 years of age

Subsequent inpatient pediatric critical care, per day,for the E/M of a critically ill infant or young child,2-5 years of age

Subsequent intensive care, per day, for the E/M of the recovering low birth weight infant (present body weight less than 1500 grams)

Subsequent intensive care, per day, for the E/M of therecovering low birth weight infant (present bodyweight of 1500-2500 grams)

Subsequent intensive care, per day, for the E/M of therecovering low birth weight infant (present bodyweight of 2501-5000 grams)

Initial hospital or birthing center care, per day, for E/M of normal newborn infant

Initial care, per day, for E/M of normal newborn infant seen in other than hospital or birthing center

Subsequent hospital care, per day, for E/M of normalnewborn

Initial hospital or birthing center care, per day, for E/M of normal newborn infant admitted & discharged on same date

Attendance at delivery (when requested by the delivering physician) and initial stabilization of newborn

Delivery/birthing room resuscitation, provision of positive pressure ventilation and/or chest compressionsin the presence of acute inadequate ventilation and/orcardiac output

Critical care services delivered by a physician, face-to-face, during an interfacility transport of critically ill or critically injured pediatric patient, 24months or age or less; first 30-74 minutes of hands-oncare during transport

Each additional 30 minutes (List separately in addition to code for primary service)

Initial inpatient neonatal critical care, per day, for theE/M of a critically ill neonate, 28 days of age or less

99460 –

99461 –

99462 –

99463 –

99464 –

99465 –

99466 –

99467 –

99468 –

2009 CPT UPDATE

Even though there were multiple new CPT codes added in 2009,there was only one specific GI code added for gastroenterologypractices and this code would not be used by the majority of pediatric gastroenterologists. This code is for cholangioscopy(spyglass) during ERCP and is billed with the specific ERCP procedure performed. Since this is an add-on code, it is noteligible for multiple surgery reduction and should be reimbursedat 100% of the carrier’s approved fee.

+43273 –Endoscopic cannulation of papilla with direct visualization of common bile duct(s) and/or pancreatic duct(s) (List separately in addition to code(s) for primary procedure)

Here is the list of the new neonatal/infant codes for reference. Thesereplace the 2008 CPT codes with the same descriptions.

99469 –

99471–

99472 –

99475 –

99476 –

99478 –

99479 –

99480 –

2009 ICD-9-CM UPDATEThere were several ICD-9 codes added prior to the effective dateof 10/1/2008 that impact pediatric gastroenterology. These arelisted below:

530.13 – Eosinophilic esophagitis

535.70 – Eosinophilic gastritis, without mention of hemorrhage

535.71 – Eosinophilic gastritis, with hemorrhage

558.41 – Eosinophilic gastroenteritis

558.42 – Eosinophilic colitis

780.60 – Fever, unspecified

780.61 – Fever presenting with conditions classified elsewhere

780.62 – Postprocedural fever

780.63 – Postvaccination fever

780.64 – Chills (without fever)

RED FLAG Effective November 1, 2008, any business that accepts credit or checkpayments, must have some type of policy in place to prevent/detectstolen identity. This even includes physician practices and hospitals.By having this policy in place, it also protects the practices from falseclaim penalties by preventing use of stolen health insurance cards, too.Something as simple as asking for a valid photo identification such asa driver’s license at the time of registration is essential in protectingboth the practice and the patient. Since most pediatric practices arenot dealing with the patient’s identity but the parent/guardian, itwould be a requirement for verifying the identity of the responsibleparty. For more information, type in “red flag” in your web browser.

PHYSICIAN FEE SCHEDULE UPDATEThe 2009 fee schedule for Medicare was published in the FederalRegister on November 19, 2008, and will be effective on January 1,2009. It is essential to download this information, not just for the national RVUs but also for a list of the global days assigned to eachprocedure. Global days are 0, 10 or 90 days. All endoscopy codes have0 global days assigned meaning that the only day you could not bill a related visit to the procedure would be that same date as the procedure. There are some carriers, however, that have assigned globaldays different from those listed above, and unless they have policy that differs in writing, most will accept the policy in the Federal Register, and pay if the claim was initially denied due to global issuesupon appeal.

Here is the way to access the Federal Register publication:

Type in federal register in your browser and hit go. It should open up to the main page.

On the left side is the word browse. Click on that and go to the right side to previous issues and pick the year 2008.

Access issue November 19, 2008 and double click

Scroll down to the Center for Medicare and Medicaid services and you will see two entries. 2009 Physician fee schedule. Download into PDF file. It is close to 520 pages. You want to open to around page 292 for the first GI CPT codes. The last column contains the global days for each procedure. The other columns give you the RVUs for each procedure.

CCI POLICY UPDATECCI policy was revised on October 1, 2009, and contained a revisionconcerning visits on the same date as minor surgical procedures:

If a procedure has a global period of 000 or 010 days, it is defined as a minor surgical procedure. The decision to perform a minor surgical procedure is included in the payment for the minor surgical procedure and should not be reported separately as an E&M service. However, a significant and separately identifiable E&Mservice unrelated to the decision to perform the minor surgical procedure is separately reportable with modifier -25. The E&M service and minor surgical procedure do not require different diagnoses. If a minor surgical procedure is performed on a new patient, the same rules for reporting E&M services apply. The fact that the patient is “new” to the provider is not sufficient alone to justify reporting an E&M service on the same date of service as a minor surgical procedure.

For example:

If the patient is seen in the Emergency Room after swallowing a coinand the ER doctor contacts the pediatric gastroenterologist for removal, the visit would be considered part of the foreign body removal if the patient has no other symptoms or other GI issue thatwould have to be evaluated. Just going in and evaluating the patientprior to the procedure is not enough to justify a separate visit that day.

However, if the patient has a food impaction and has had some difficulty swallowing prior to this incident, a visit most likely can be billed, since there will be further follow-up and management of the pre-existing procedure not just performing the procedure that day.

13

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The 2008 Presidential and Congressional elections led to a substantial shift in the balance of political power in Washington,DC and health care reform has emerged as a major theme as the new Congress gets underway. Barack Obama campaigned onpolicies in healthcare that were at odds with the dominant thinking of the last eightyears. The stronger Democratic majorities

in the House (21 new Democrats) and Senate (8 new Democrats) areeager to flex their muscle and act on health legislation that has beendormant for some time.

The overarching theme is healthcare reform. President Obama articulated his views during the campaign and will now have to translate those into more specific legislative proposals. He will be assisted by Health and Human Services Secretary-designate TomDaschle who will be a leading voice on health policy for the Administration.

Even though the legislative and executive branches of government are firmly in Democratic hands, that does not mean that there will be universal agreement over the path to a new, improved healthcaresystem. Democratic President Bill Clinton’s health plan died in a Democratic Congress, an important lesson the Obama Administrationsays it has learned. However, senior Democratic legislators, likeCongressman John Dingell (MI) and Senator Max Baucus (MT) were quick to get their own ideas on health reform out for public review before the new Administration was in place. This political positioning will continue and be a major factor in the overall debate on broad health policy.

More specifically, how might the new Administration and Congresstreat issues that are priorities for NASPGHAN? While specific proposals have yet to appear in many areas, prior statements andpositions shed some light on how they might be treated.

Important in an indirect way is fixing the problems in the Medicarephysician fee schedule since Medicare rates influence payments by private health plans and other public programs like Medicaid. The rising sympathy for the problems in primary care could be very problematic for specialists, in both pediatric and adult medicine. Increased payments for pediatric primary care services could come out of the payments received by NASPGHAN members and otherspecialists, exacerbating problems of payment for, and access to, pediatric specialties in many parts of the country.

On a more positive note, Congress is expected to increase Medicaidfunding for the states as part of the overall economic stimulus package.The State Children’s Health Insurance Program (SCHIP) will likely be expanded when it comes up for reauthorization early in 2009.

RANDOLPH FENNINGERPresident, MARC Associates

Expanding both programs can lead to improvements in pediatric careacross all specialties and also provides NASPGHAN an opportunityto deal with problem areas, like coverage of essential nutritional therapies.

The NASPGHAN research agenda may fare better, as the expectationis that the new Administration will give stronger support to NIH, expanding its ability to fund new initiatives. Even with the currentdeficit and economic situation, NIH is seen as a positive investment bymany in Congress, so there may be better times ahead for research in anumber of areas of interest to NASPGHAN members. Also on thehorizon will be greater support for the public health agenda of the Centers for Disease Control, which could help in the effort to reducethe rates of viral hepatitis in all age groups.

The debate over healthcare reform will in part address problems of access to care and health disparities that exist among certain ethnic andlow economic populations. If economic problems do not overwhelmthe new Congress and President, there may really be an opportunity toact on some of the issues wrapped into the health reform debate andNASPGHAN could see real attention paid to the important healthdisparities problem, especially in the care of children.

The elevation of Congressman Henry Waxman (CA) to the chair-manship of the House Energy and Commerce Committee over longtime Chairman John Dingell (MI) will complicate the activitiesof pharmaceutical and medical device firms. NASPGHAN can expectmore Congressional scrutiny of some its industry partners and therewill be pressure on the Food and Drug Administration to toughen upits review of new products, both drugs and devices.

Every election brings new challenges and opportunities for groups likeNASPGHAN and the public policy agenda. There will be a real needfor effective grassroots efforts by NASPGHAN members to educatethe new Congress and Administration about the key issues facing themembership and their patients.

Advocacy Update

15

Classifieds . . . .

• Arizona –The University of Arizona Department of Pediatrics is recruiting two additional positionsat the assistant or associate professor level toserve as pediatric gastroenterologists attendingin the Section of Pediatric Gastroenterology.Job duties include patient care at UniversityMedical Center and at Tucson Medical Center.

One position is for a clinically-oriented physician, the second position is for research-oriented clinician/scientist. State-of-the-art core facilities and support to establish research careers are available.Required: MD or DO and Pediatrics Board Certified or Eligible with BC/BE inPediatric Gastroenterology. Physicians onJ1-visa will be considered.

Review of application materials will continue until the positions are filled. For more information on the Department of Pediatrics and the Steele Memorial Children’s Research Center, see(http://www.peds.arizona.edu).

The University of Arizona, located in central Tucson, is one of the top ranked research universities in the nation. A moderately-sized city of 750,000 inhabitants, Tucson is a growing economicand recreational center with a multiculturalpopulation that reflects the richness of theSouthwest. Forty-five miles from the U.S.border of Mexico, the city shares commonborders with the Tohono O’odham and the Pasqua Yaqui Indian Nations, and is surrounded by majestic desert and ruggedmountains rising to more than 9,000 feet.

Southern Arizona has more than 300 days of sunshine per year, more than any other region in the U.S.

Please reference Job # 991561 and submitCV along with a letter of interest to:Dr. Hesham A-Kader Hassan, MD, M.Sc.Professor and Chief Division of GastroenterologyThe University of Arizona1501 N Campbell Ave.PO Box 245073Tucson, AZ 85724-5073Phone: 520.626.4140Fax: 520.626.4141 E-Mail: hassan@peds.arizona.edu

• California –The Department of Pediatrics at Loma Linda University Health Care seeks BC/BE candidates specializing in pediatric gastroenterology and nutrition, to join ourfour-member division at the assistant or associate professor level. Additionally, we have a Pediatric Hospitalist on staff. The candidate will participate in teaching of residents and medical students. Research is encouraged and our division is committed to supporting the successful candidate withfunding and protected time to conduct studies.

Loma Linda University’s Medical Center andChildren’s Hospital is the only Level I traumacenter serving a four-county area that coversapproximately 25 percent of the state. TheMedical Center and Children’s Hospital are equipped with over 850 licensed beds. The Children's Hospital is one of the largest children’s hospitals in the country; it is theonly tertiary care facility serving the vast population east of Los Angeles, to the bordersof Arizona, Nevada and Mexico. The total bed count at our children’s hospital is 256. We have an active pediatric liver transplantprogram with a dedicated and fully equippedpediatric endoscopy and manometry laboratory, which performs invasive and non-invasive procedures. Our procedures are in excess of 3,000 per year.

Loma Linda University is located in the centerof Southern California in an area known asthe “Inland Empire”— with a population ofover 3.3 million and increasing at a rate ofnearly 100,000 residents per year. There areopportunities for many outdoor activities suchas mountain biking, snowboarding, skiing,surfing, and fishing. In addition, with Los

Angeles and Orange County in close proximity, the arts and culture are endless.

If you are interested in being a part of this experience, please contact:Barbara J. SharpPhone: 800.328.1163E-Mail: recruitmd@llu.eduTo view a list of current opportunities, visit:(www.llu.edu/recruitmd)

• Georgia –The Department of Pediatrics at The MedicalCollege of Georgia is seeking a third pediatricgastroenterologist. The candidate must be board certified/eligible in pediatric gastroenterology. Requirements for this position include strong clinical/proceduralskills and commitment to teaching in an academic setting. Scope of directing a fellowship program is available. Individualshould have plans/vision for translational/bench/clinical research. Excellent resources for research are available. Academic rank will be commensurate with experience. Compensation and benefits are highly competitive.

Augusta is an excellent place to live, with great weather, outdoor and cultural activities.It is within easy reach of large and mediumsize metropolitan cities, beaches and mountains. The Medical College of Georgia is a premier teaching institution of the state,with clinical and basic science wings. The Department of Pediatrics is housed in a separate Children’s Hospital with a full complement of subspecialties. The Department of Pediatrics Gastroenterologysection has two physicians, one nurse practitioner along with nurses and research assistants dedicated to the section.

The Medical College of Georgia is an EqualOpportunity and Equal Access employer. Minority, women and foreign medical graduates are encouraged to apply. Applications will be accepted until the position is filled.

Please apply to: William P. Kanto, Jr., MDChairman, Pediatric GI Search CommitteeThe Medical College of GeorgiaDepartment of Pediatrics1446 Harper Street, BT-1850Augusta, GA 30912Phone: 706.721.3466 Fax: 706.721.7311 E-Mail: kanto@mcg.edu

• To post your ad, contact Kim Rose at:krose@naspghan.org or 215.233.0808. The deadline for the next newsletter isFebruary 1, 2009

QUARTERLY EMPLOYMENT ADS =$200 per quarter. This includes one printad in one quarterly newsletter and oneonline ad (NASPGHAN website) for 3 months.

ANNUAL EMPLOYMENT ADS =$750 for 12 months. This includes one printad in four quarterly newsletters and oneonline ad (NASPGHAN website) for12 months.

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• Illinois –The Department of Pediatrics of the University of Illinois College of Medicine atPeoria (UICOMP) and Children's Hospital of Illinois (CHOI) have initiated a nationalsearch to identify candidates for an opening in the section of Pediatric Gastroenterology.

UICOMP supports a thriving education program with approximately 20 categoricalpediatric residents and 32 combined medicine-pediatrics residents. The Department of Pediatrics has 72 faculty members coveringmost pediatric subspecialties and primary care.

The Children’s Hospital of Illinois is the primary pediatric teaching facility for the University of Illinois College of Medicine atPeoria. CHOI is a 127-bed facility that offersover 50 pediatric programs and services. These programs represent over 60 pediatricspecialists in 24 different disciplines. CHOI is the only full-service tertiary hospital forchildren in central Illinois. It has a designatedLevel I Trauma Center, a Regional perinatalCenter, and has central Illinois’ only Level IIIneonatal intensive care unit.

The candidates must be board-certified orboard-eligible in pediatric gastroenterology.The academic position includes patient servicesand teaching activities with opportunities topursue research. The compensation packageand academic rank will be commensurate withexperience. Other highlights:• Regional referral center for Pediatric

Gastroenterology for central Illinois.• New state-of-the-art Children’s Hospital

scheduled for completion in 2010.• Opportunity to establish clinical,

translational, and/or basic research with the support of thriving Neuroscience and Pharmacology programs.

• Nationally respected pediatric residency program.

• Family-oriented community with a good school system, low crime rates, and a reasonable cost of living. Peoria is less than three hours from Chicago and St. Louis.

The University of Illinois is an AffirmativeAction/Equal Opportunity employer.Please contact:Bill MastersPhone: 214.507.4538E-Mail: bill@millicansolutions.com

• Indiana –The section of Pediatric Gastroenterology,Hepatology and Nutrition at Indiana University

School of Medicine is seeking additional BE/BC pediatric gastroenterologists for clinician/educator roles. The section presently includes 9physicians, 2 NP’s, as well as nurses, endoscopytechs and clerical support.

Duties include inpatient attending at RileyHospital for Children, as well as outpatientand outreach clinics, endoscopy, teaching andscholarly work. Important features of thegroup are excellent patient care, exciting academic environment and collegial workplace.

Riley Hospital for Children is a 260-bed pediatric subspecialty referral institution witha $350-million addition under construction.The Department of Pediatrics at Indiana University School of Medicine has subspecialtyoffices at several Indiana sites including a newfacility in Carmel, Indiana. The departmentranks #18 in the country in NIH funding. Education is a focus for the faculty. RileyHospital for Children is among the five largestPediatric Residency Programs in the nation.

Riley Hospital for Children and the IndianaUniversity School of Medicine are located inthe heart of downtown Indianapolis, which isthe 12th largest city in the United States with a population of 1.7 million. Indianapolis is a great place to live with affordable housing,access to excellent schools, professional sportsteams and wide-ranging cultural events.

Indiana University School of Medicine is an EEO/AA employer, M/F/D. Salary iscompetitive with excellent benefits.

For confidential consideration, please contact:Erin Lindeman, CMSRPhysician Recruiter, Clarian HealthPhone: 317.962.6681 (direct) or 866.394.4138 (toll-free)Fax: 317.962.6297 E-Mail: elindema@clarian.org

• Iowa –

The Children’s Center Pediatric SubspecialtyClinic and Dr. Daniel Di Meo at Mercy Medical Center-Des Moines seek a BC/BEpediatric gastroenterologist for a thriving established practice in the nation’s heartland.We can offer you an excellent compensationpackage with flexible practice options andtremendous upside potential.

Mercy Medical Center-Des Moines, the largest“system” in the Catholic Health Initiativesfamily, has over 900 beds in our 3 metro Hospitals. Our flagship Mercy features:• 24/7 Children’s Emergency Center

• 40-bed Level-Three NICU • Six Full-Time Neonatologists• 24-bed Pediatric Med/Surg Unit• 8-bed PICU• Full-time complement of pediatric sub-

specialists including Pediatric Surgery, Pediatric Intensivist, Pediatric Hospitalists

• Residency Programs in General Surgery and Family Practice

• Iowa’s busiest birthing center (set state record in 2007)

• Level-Two Trauma and Iowa’s most active Emergency Department

• Home of the Iowa Inflammatory Bowel Disease Center

Mercy’s affiliate network includes:• 14 rural Hospitals• 17 metro area FP and Urgent Care Clinics• 5 metro area Pediatric Clinics

The Des Moines metropolitan area is home to over 400,000 and offers affordable housing,safe neighborhoods, nationally ranked schoolsand abundant recreational opportunities. Tolearn more about the area try the followingwebsites: (www.seedesmoines.com) or(www.desmoinesmetro.com)

We invite you to take a closer look at Mercy by viewing our website(www.mercydesmoines.org) or contact mefor more information.

Contact:Roger McMahonDirector, Physician Employment ServicesMercy Medical Center-Des MoinesPhone: 515.643.8323Fax: 515.643.8831E-Mail: rmcmahon@mercydesmoines.org

• Louisiana –Ochsner Health System in New Orleans isseeking a BC/BE pediatric gastroenterologistto join an existing division. Experience in inflammatory bowel disease, common GI disorders, and nutrition is desirable. The position involves teaching medical studentsand residents from the combined programwith Tulane University School of Medicine in New Orleans. Referrals are from active pediatric tertiary care subspecialty group practices as well as from physicians throughout the Gulf South.

Ochsner Children’s Health Center is a large,multi-specialty group practice with a strongcommitment to state-of-the-art tertiary careas well as primary care. The Center includes54 pediatric specialists and 32 general

17

pediatricians, integrated into Ochsner HealthSystem, an academic medical center. We have a 40,000-square-foot freestanding pediatricambulatory facility that includes general academic pediatrics, medical and surgical subspecialty pediatrics with pediatric radiology, laboratory, and pharmacy facilities.In addition, we have a state-of-the-art, 18-bedPICU, three new pediatric wards, and a 36-bed NICU. We are dedicating a totallycomputerized pediatric emergency room.

Ochsner Health System (www.ochsner.org) is a non-profit, academic, multi-specialty,healthcare delivery system dedicated to patient care, research, and education. The system includes 7 hospitals and 40 health centers throughout Southeast Louisiana.Ochsner employs over 600 physicians in 80medical specialties and subspecialties and conducts over 300 ongoing clinical researchtrials annually. We offer a generous and comprehensive benefits package. We alsoenjoy the advantage of practicing in a favorable malpractice environment in Louisiana. EOE

Phone: 800.488.2240 Fax: 225.761.5441E-Mail CV: profrecruiting@ochsner.orgRef #APGA3

• Maryland –The Division of Pediatric Gastroenterologyand Nutrition, Department of Pediatrics,Johns Hopkins University School of Medicine, seeks two to three full-time BC/BEpediatric gastroenterologists for tenure-trackpositions at either the assistant or associateprofessor level. We are looking for individualswith outstanding clinical and procedural skills,a commitment to education, and clinical, translational or laboratory research interests in gastroenterology, and particularly, nutritionand hepatology. Johns Hopkins Hospital is adynamic institution that has topped U.S.News & World Report's annual rankings ofAmerican hospitals for 15 years in a row.

Baltimore, established in 1729, is Maryland'slargest city and a top tourist destination. From its famous Inner Harbor to its thrivingbusiness district to its renowned academic centers to its charming neighborhoods, Baltimore has a vast array of metropolitan attractions.

Johns Hopkins University School of Medicineis an affirmative action, equal opportunity employer. Women and minorities are encouraged to apply.

Interested applicants should send or e-mailletters of interest and curriculum vitae to:

Maria Oliva-Hemker, MDPediatric Gastroenterology and NutritionBrady 320600 N. Wolfe StreetBaltimore, MD 21287–2631Phone: 410.955.8765E-Mail: moliva@jhmi.edu

• Missouri –St. John’s Mercy Children’s Hospital, a member of Sister’s of Mercy Health System, isseeking a BC/BE pediatric gastroenterologistto join an existing and thriving practice in St.Louis, Missouri.St. John’s Mercy Medical Center offers: • 859-bed, fully accredited not- for-profit

teaching hospital• Children’s Hospital new patient tower

under construction• Associate member of NACHRI• Level 1 trauma center with 17,000

pediatric emergency visits annually• 34-bed pediatric unit, 10-bed PICU

and a 70-bed Level III NICU• More than 200 primary care pediatricians

on staff• Excellent 24 hour in-house neonatology

and pediatric coverage• Excellent subspecialty support• Opportunity for research

The successful candidate will: • Work in a comprehensive gastrointestinal

endoscopy laboratory with the latest in advanced diagnostic equipment

• Have outpatient responsibilities in a gastroenterology clinic

• Have full practice management services• Share call with the other gastroenterologists

on staff• Be employed by the hospital with a highly

competitive income guarantee• Receive benefits including health, dental,

vacation and CME• Receive relocation assistance and

malpractice insurance

St. Louis offers urban amenities in an attractive and affordable living environment.The four-season climate and abundance ofcultural and outdoor activities, along withfive-star restaurants, major league sporting attractions, outstanding schools, and a diverse economy make St. Louis an attractiveplace to live, work and play.

The successful candidate will be BE/BC pediatric gastroenterology.

If you are interested in learning more about

this opportunity with St John’s MercyHealth Care, please contact:Lisa KuesPhone: 800.851.2382 or 314.364.3840E-Mail: lisa.kues@mercy.net For more information, visit our website at(www.stjohnsmercy.org)

• Missouri –Saint Louis University is seeking faculty candidates to join an active division of Pediatric Gastroenterologists, clinical PNP,dedicated GI clinical nurses and dedicatedprocedure staff. The division has busy outpatient and inpatient services based at Cardinal Glennon Children’s Medical Center, a 165 bed, free-standing children’shospital affiliated with the Saint Louis University School of Medicine. The divisionserves an active liver transplant program, a nutritional support team, a multidisciplinaryobesity clinic, and interacts with the CF center. Pediatric gastroenterology and hepatology also has ongoing, NIH-fundedclinical and basic science research projectswithin the division, and a working relationshipwith the St. Louis University School of PublicHealth. Close clinical and research ties aremaintained with the St. Louis University LiverCenter. Excellent opportunities for teachingin both didactic and clinical settings are available at the medical student and postgraduate levels. Candidates must beBC/BE in Pediatric Gastroenterology. The institution is open to working with manytypes of foreign visa holders, as well as greencard holders and US citizens.

Saint Louis University is a Catholic, Jesuit institution dedicated to student learning, research, health care, and service. Saint LouisUniversity is an Affirmative Action, EqualOpportunity Employer, and encourages nominations of, and applications from women and minorities.

Interested candidates must submit a cover letter, application, and current CV tohttp:/jobs.slu.edu. Other correspondence regarding this positioncan be sent to:Jeffrey Teckman, MDDirector, Division of Gastroenterology Department of PediatricsSaint Louis University School of Medicine1465 S. Grand BlvdSaint Louis, MO 63104Phone: 314.577.5647Fax: 314.268.2775E-Mail: teckmanj@slu.edu

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• New York –

The Division of Gastroenterology, Hepatologyand Nutrition in the Department of Pediatrics,State University of New York (SUNY)Downstate Medical Center is seeking an additional BC/BE pediatric gastroenterologistat the assistant professor level, to join fourmembers in our growing division. The successful candidate will possess excellent clinical and procedural skills, a commitmentto teaching medical students, residents and fellows, and a strong interest in pursuing aclinical, translational or laboratory researchprogram. For the individual engaged in basicor translational research, we have establishedstrong relationships with the basic science faculty at SUNY-Downstate, leading torecently funded initiatives in lipid metabolismand in the pathogenesis of gastrointestinal inflammation. We offer ample protected timeto pursue academic interests, along with acomprehensive and competitive salary andbenefits package.

The Division of Pediatric Gastroenterology,Hepatology and Nutrition at SUNY-Downstate sponsors the only ACGME-accredited fellowship training program and is the only medical school-centered PediatricGI program in Brooklyn, New York, a “city” of almost 3 million. The myriad cultural,recreational ‘and educational opportunities of the New York metropolitan area are at ourdoorstep.

SUNY-Downstate Medical Center is an affirmative action, equal opportunity employer. Women and minorities are encouraged to apply.

Contact:William R. Treem, MDVice-Chair for Clinical DevelopmentDepartment of PediatricsDirector, Division of Pediatric Gastroenterology, Hepatology, and NutritionChildren’s Hospital at DownstateSUNY Downstate Medical Center445 Lenox Rd., Box 49Brooklyn, NY, 11203-2098Phone: 718.270.3090E-Mail: william.treem@downstate.edu

• North Carolina–

The Division of Pediatric Gastroenterology atDuke University Medical Center has immediate openings for junior, mid-career, or senior level academic clinician-educatorsand clinical investigators interested in generalpediatric gastroenterology and pediatric hepatology. Our active, growing division,

which includes pediatric gastroenterology, hepatology, and nutrition, is complementedby a great team of endoscopy nurses, a technician, experienced nurse clinicians, and a dedicated nutritionist. Our busy inpatient and consultative service includes a wide variety of patients, including liver transplant, bone marrow transplant, and otherimmunocompromised patients. Excellent collegial support is available from pediatricsurgery, radiology, and pathology. Our world-class, academic institution offers a highcommitment to clinical research, teaching,and patient care.

Durham, along with Raleigh and Chapel Hillis the “Triangle” area and is noted as one of thebest places to live in the South due to its highgrowth, quality schools, and limitless “metro”amenities.

Qualified candidates of all genders, races, and religions are encouraged to apply. Duke University is an equal opportunity/affirmativeaction employer.

Please send a CV and a letter describing your career interests to:Martin H. Ulshen, MDChief, Division of Pediatric Gastroenterology, Hepatology and NutritionPO Box 3009Duke University Medical Center Durham, NC 27710E-Mail: martin.ulshen@duke.edu

• Ohio – The Division of Gastroenterology, Hepatology and Nutrition of CincinnatiChildren’s Hospital Medical Center(CCHMC) is continuing to expand to meetour goal to improve child health through better diagnosis, treatments and outcomes.

We are recruiting faculty who will primarilyprovide outpatient clinical care while contributing to one of our program areasthrough teaching, clinical research and/orquality improvement.

The Division is a vibrant part of CCHMCand is ranked 3rd nationally in Digestive Disorders by U.S. News and World Report.Our vision is to improve digestive health forchildren by integrating research into patientcare and to provide high quality, timely andfamily-centered care. Clinical and researchteams with national leaders and outstandingmentors are in place to help advance newknowledge. It is important to have health careproviders as part of our team who can translatethis new knowledge into patient care. These

opportunities, combined with our commitment to and support of junior faculty, make this is a great place to launchyour career and change children’s outcomes.

CCHMC is ranked 3rd nationally in generalpediatrics by U.S. News and World Report’srankings of best children’s hospitals.Children’s Hospital Research Foundation isone of the largest pediatric research programsin the nation and ranks 2nd among pediatricinstitutions in direct funding from the National Institutes of Health. The Divisionhas an NIH-funded training program, participates in 6 NIH-funded TranslationalResearch Consortia and is home to an NIH-funded Digestive Disease Research CoreCenter (Digestive Health Center) devoted to pediatric digestive diseases.

Women and minorities are encouraged toapply. CCHMC is an affirmative action/equal opportunity employer.

Interested candidates should contact:Mitchell B. Cohen, MD Director, Division of Gastroenterology, Hepatology and NutritionCincinnati Children’s Hospital Medical Center3333 Burnet Avenue, ML 2010Cincinnati, Ohio 45229–3039Phone: 513.636.4953E-Mail: mitchell.cohen@cchmc.org

• Ohio –The Division of Gastroenterology, Hepatology and Nutrition and ColumbusChildren’s Research Institute invite applications for tenure-track laboratory and clinical investigators based at ColumbusChildren’s Hospital. Faculty appointments atour academic affiliate, The Ohio State Collegeof Medicine, will be at the rank of assistant, associate or full professor on the tenure track.

Candidates must have the background and experience to establish a successful basic, clinical or translational research program relevant to pediatric gastroenterology. Outstanding research programs with expertcollaborators and mentors are currently inplace in the following areas of gastroenterological research: functional disorders, motility disturbances, inflammatorybowel disease, hepatitis C, hepatic fibrosis andgrowth factor biology. The Division currentlyhas 11 faculty members, ensuring adequateprotected time for research activities.

Columbus Children’s Hospital is a Childmagazine top-ten children’s hospital and

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a top ranked US News and World Report pediatric center. The 300,000-square-footColumbus Children’s Research Institute isranked among the top-ten free-standing pediatric research facilities in NIH researchdollars received. The institute is housed instate-of-the-art dedicated research spacecontiguous with the hospital and the divisionwill move into newly constructed outpatient,academic and procedure space in 2008.Substantial start-up resources, excellent sharedresources, and programmatic support are available to successful candidates.

For more information about research and clinical programs at Columbus Children’s,please visit our website at (www.ccri.net).

Address correspondence with a curriculum vitae to: Carlo Di Lorenzo, MD 700 Children’s Drive Columbus, OH 43205 E-Mail: dilorenc@pediatrics.ohio-state.edu

• Pennsylvania –The Division of Pediatric Gastroenterologyand Nutrition at the Milton S. Hershey Medical Center, Penn State Hershey Children’s Hospital seeks two additional faculty members at the assistant/associateprofessor level. We would consider a candidatewho would be interested primarily in directingour inpatient services and teaching residents.All candidates should have excellent clinicaland procedural skills and a strong interest in medical student and resident education. Interests in nutrition and intestinal failure are desirable.

Our division consists of 3 physicians, 2 experienced nurse practitioners, 1RN, 1 LPN, 1behavioral psychologist and 11/2

administrative assistants. Divisional interestsinclude inflammatory bowel disease, feedingproblems and basic science research. Wehouse a nationally and internationally recognized feeding program. A newChildren’s Hospital is finishing architecturalplanning and should be completed in 2011.

We have 24/7 pediatric hospitalist coverage,endoscopy block-time with all proceduresbeing performed with pediatric anesthesiologyand close working relationships with excellentpediatric surgery, pediatric radiology, pathologyand adult gastroenterology divisions.As partof the Penn State College of Medicine, there isample opportunity for teaching and clinicaland basic science research.

Hershey, located in beautiful central Pennsylvania, is a wonderful place to raise

a family and has excellent “Blue Ribbon”schools. We are located within 15 minutes of the State Capital, 90 minutes fromBaltimore and Philadelphia and 3 hours fromthe New Jersey shore.

Penn State Milton S. Hershey Medical Center is an equal opportunity/affirmativeaction employer and encourages applicationsfrom women and members of minority groups.

Interested candidates should contact:Douglas Field, MDChief, Division of Pediatric GI/Nutrition500 University DriveHershey, PA 17033Phone: 717.531.5901E-Mail: dfield@psu.edu

• Texas –Driscoll Children’s Hospital, a nonprofit, freestanding 189-bed tertiary care children’shospital, in Corpus Christi, Texas is seekinga BC/BE pediatric gastroenterologist. Thegastroenterology department has two BC/BEpediatric gastroenterologists, a well-trainednursing staff, nutrition support and a fully-equipped endoscopic gastroenterologylab. Driscoll Children’s Hospital serves 33South Texas counties. The hospital provides comprehensive pediatric services includingNICU, PICU and more than 45 pediatricsubspecialties. The hospital maintains a teaching affiliation with Texas A&M University Health Science Center and has its own pediatric residency and pediatric anesthesia fellowship programs.

Texas is a wonderful place to work, live, playand invest. Tort reform has made Texas an attractive practice location because of the lownumber of lawsuits and reduced cost of malpractice insurance. Texas is the secondfastest growing state in the union and boastsyearly growth rates of up to 20–25% per year. Corpus Christi is a dynamic coastal citywith miles of beautiful beaches, world-classhunting, fishing, sailing and wind surfing, and the mild climate allows for year-roundoutdoor family activities such as golf, cyclingand tennis. Additionally, cost of living is low and there is no state income tax.

Successful applicants will enjoy an excellentcompensation package including coverage ofall overhead expenses (including malpractice),medical, dental and vision, disability and lifeinsurance and retirement plans.

In short, our division needs to grow to providegastroenterology services to our rapidly growingpopulation. The combination of location,population growth and compensation make

this an excellent opportunity. Please share thisopportunity with your fellows and other interested colleagues. Thank you.

Viable candidates, please contact:Annette Shook3533 South Alameda StreetCorpus Christi, Texas 78411Phone: 361.694.6807Fax: 361.694.5010E-Mail: annette.shook@dchstx.orgOr visit: (www.driscollchildrens.org)

• Vancouver, British Columbia –BC Children’s Hospital (BCCH) is seekingtwo pediatric gastroenterologists who willprovide clinical service, education andresearch with a focus in one or more areas ofnutrition, hepatology or endoscopy.

The Division of Gastroenterology is a provincial resource serving a total populationbase of approximately 1.0 million children.The Division provides a broad range of consultation services and inpatient care. The Division currently has 6 full-time facultymembers with planned expansion to 8 over thenext year. The Division has a strong researchprogram with strengths in inflammatorybowel disease, liver disease and acid peptic disease with excellent opportunity for growthwith newly completed research facilities. The Division has a Royal College accredited residency program.

Applications are invited from clinician-scientists, clinician-investigators and clinicians teachers with potential to thrive in a busy clinical and academic environment.As the successful candidate, you will havedemonstrated a commitment to pediatric gastroenterology and excellence in providing a high level of quality clinical care. You willhave sub-specialty training in pediatric gastroenterology and be a Fellow or be eligible for Fellowship in the Royal College of Physicians and Surgeons of Canada.

You will hold an appointment in the Department of Pediatrics, University ofBritish Columbia. Your income will be commensurate with qualifications and experience within a department alternativefunding plan.

We invite you to apply online for this positionat (http://careers.phsa.ca). Applications willbe accepted to January 16, 2009 or until filled.For more information about the Agency,please visit: (www.bcchildrens.ca).

For further information, please contact:Dr. Kevan Jacobson

Acting Division HeadDivision of Pediatric GastroenterologyBC Children’s HospitalRoom K4-1814480 Oak StreetVancouver, B.C. V6H 3V4 Canada E-Mail: kjacobson@cw.bc.ca

• Washington –Providence Health & Services is seeking aBC/BE pediatric gastroenterologist to join itsteam at Sacred Heart Medical Center &Children's Hospital in Spokane, Washington.The new physician will join another pediatricgastroenterologist with an established pediatric gastroenterology and nutrition team.• 161-bed Children's Hospital serving

population of 1.5 million• Excellent subspecialty support including

Peds Hospitalists• Procedural sedation provided by Peds

Intensivists• World-class research department• Competitive compensation and benefits

Sacred Heart Medical Center & Children'sHospital has 623 beds, a medical staff of morethan 900 and a service area population ofabout 1.5 million. The children's hospitalalone includes more than 90 pediatric

subspecialists. Sacred Heart has a world-classresearch department and offers some of theNorthwest's most advanced services, includingminimally invasive cardiac surgery proceduresand robotic surgery.

Spokane, about halfway between the Rockyand Cascade Mountain Ranges, is a regionalmedical hub with an abundance of quality oflife features: • Four seasons with 250-plus days of sun• Strong, diversified economy• Excellent K-12 & higher education,

including Gonzaga University• Close to prime skiing, hiking, rafting

and more

Sacred Heart is part of Providence Health & Services, a not-for-profit network of hospitals, clinics and physician partners inAlaska, California, Montana, Oregon andWashington. Providence has a proud 152-yearhistory in the West and continues to growwith the communities we serve. With morethan 300 physician opportunities in virtuallyall specialties, we offer physicians diverselifestyle choices, flexible work arrangementsand robust practice support.

For details, contact:Pat Isakson Phone: 509.474.6604E-Mail: Isaksop@psew.orgOr visit our website:(www.providence.org/physicianopportunities)

• Wisconsin –Marshfield Clinic has a 90-year history as oneof the most well respected 100% physician-directed private medical group practices in thenation, with over 750 physicians at 42 centersin Wisconsin. The pediatric gastroenterologygroup is expanding services at the MarshfieldCenter in a department that includes all subspecialties.• System-wide EMR accessed with mobile

PC at point of service• Clinical research support• Teaching (on-site residency programs and

medical student rotations)• Adjoining children’s hospital features

Level I PICU and Level III NICU• Generous two-year guaranteed salary

followed by RVU production-based income• Four weeks vacation to start, 10 days CME

plus $5,800 allowance, occurrence-based malpractice, life, health dental and disability insurance, fully funded retirement plan plus matching 401K plan, generous relocation, and more

• Outstanding schools, no long commutes, easy access to metro areas and plentiful outdoor recreation

Please contact:Mary TreichelPhysician RecruiterPhone: 800.782.8581 (ext 19774)E-Mail: treichel.mary@marshfieldclinic.org

www.naspghan.org

Podcasts of selected abstracts from the

January 2009, November/December 2008,

and October 2008 issues of the

Journal of Pediatric

Gastroenterology & Nutrition

are now available on the JPGN website.

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www.jpgn.org