Clinical Component

Navigating the Clinical Component

A Practice Designed Around Procedures

At Lake Charles Memorial Health System, the Gastroenterology program is intentionally structured so physicians spend the majority of each day in the Endoscopy Center. Physicians spend approximately 80% of their professional time performing endoscopic procedures and approximately 20% in the outpatient clinic, which functions primarily as the entry point for procedural evaluation, consultation, and follow-up care.

This model has produced one of the busiest Gastroenterology practices in the region, with routine procedures scheduled 2 to 3 months in advance and continued growth creating the need for additional physicians. Notably, no general surgeons perform endoscopy at the hospital, so procedural volume belongs to the Gastroenterology team.

Daily Workflow

Individual schedules vary, but physicians typically rotate between:

  • Dedicated endoscopy blocks
  • Outpatient clinic
  • Hospital consults
  • Inpatient rounding
  • Shared call responsibilities

Extensive APP support, experienced nursing staff, AI-assisted documentation, and centralized scheduling minimize administrative burden so physicians can focus on patient care.

Outpatient Clinic

The Digestive Health Clinic is located on the hospital campus in the Medical Office Building, allowing physicians to move easily between clinic, inpatient consultations, and the Endoscopy Center throughout the day.

Clinic Highlights

  • Approximately 30 to 35 patients during a full clinic day
  • 3 to 5 exam rooms per physician
  • Epic EMR with AI-assisted documentation
  • Onsite laboratory, imaging, and infusion services
  • 5 dedicated schedulers
  • Referral relationships with Primary Care and specialty physicians throughout southwest Louisiana and southeast Texas

Routine screening procedures are generally scheduled 2 to 3 months in advance, while urgent consultations are accommodated within approximately one week when clinically appropriate.

Endoscopy Center

The hospital-based Endoscopy Center is the operational core of the program, designed for procedural efficiency.

Endoscopy Suite Highlights

  • 4 dedicated procedure suites
  • Olympus endoscopy equipment
  • Ability to work two procedure rooms simultaneously
  • Approximately 10-minute room turnover
  • Dedicated GI nursing staff and experienced GI technicians
  • CRNA anesthesia coverage, with physician anesthesia available when needed

Procedural Practice

Physicians perform a broad range of diagnostic and therapeutic procedures.

Diagnostic Endoscopy

  • Colonoscopy
  • Upper endoscopy (EGD)
  • Surveillance examinations

Advanced Endoscopy

  • ERCP
  • Endoscopic ultrasound (EUS)
  • Capsule endoscopy
  • Bravo pH monitoring

Therapeutic Procedures

  • PEG placement
  • Polypectomy
  • Hemostasis and GI bleed management
  • Esophageal obstruction management

There is no separate ERCP or EUS call schedule.

Patient Demand

  • Colonoscopy schedules extending 2 to 3 months
  • Immediate access to new patients
  • Significant referral volume from community physicians
  • Continued population growth throughout the service area

Leadership believes the community could support several additional Gastroenterologists if physician availability allowed, creating immediate productivity for the incoming physician with no referral base to build.

Advanced Practice Provider Support

The practice employs 9 dedicated Advanced Practice Providers: 8 Nurse Practitioners and 1 Physician Assistant. APPs practice with a high degree of autonomy while remaining closely integrated with physician partners.

APP responsibilities include:

  • Independent outpatient clinics focused on established patients
  • New referral evaluations
  • Follow-up visits
  • Inpatient rounding support
  • First-line call triage
  • Patient education and care coordination

Call Structure

Call Overview

Frequency 1:3 currently; approximately 1:4 with the incoming physician
Type Home call, paid
Rotation Full week, Thursday 5:00 PM to Thursday 5:00 PM
Volume Approximately 20 patient calls per week of call
Coverage One hospital
Triage APPs field incoming calls first

When a patient presents to the ER with a GI bleed or esophageal obstruction, the ER physician consults the on-call Gastroenterologist, and response timing depends on severity. Physicians generally return to the hospital only when a procedure is required. Hospitalists manage admissions and discharges and phone consult the GI team, and providers rarely need to come in overnight.

Hospital Relationships

Collaboration is a recurring theme at Lake Charles Memorial. The Gastroenterology team works closely with:

  • Primary Care
  • Hospital Medicine
  • Emergency Medicine
  • General Surgery
  • Colorectal Surgery
  • Radiology
  • Critical Care

Communication is direct and physician-to-physician, with providers routinely reaching each other by personal cell phone rather than working through administrative messaging layers.

Technology and Clinical Resources

  • Epic EMR
  • AI-assisted documentation
  • Olympus endoscopy systems
  • Hospital-based laboratory with satellite locations
  • Onsite imaging and infusion services

Leadership and Professional Growth

  • Medical Directorships
  • Participation in departmental decision-making
  • Quality and EMR/Technology Committees
  • Future Digestive Health program expansion

Clinical research is in early stages with plans to grow, and medical students shadow the practice for physicians who enjoy informal teaching.

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