Overcoming The Odds

North Carolina Gastroenterologists Overcome the Odds to Open an Endoscopy Center

It began as a slow trickle, recalls gastroenterologist Austin Osemeka, MD, of Carolina digestive diseases in Gastonia, N.C. He watched as a few of his patients left Gastonia and traveled to the neighboring city of Charlotte to undergo their screening colonoscopy.

This was in the mid-2000s. Several endoscopy centers had opened in Charlotte, but Gastonia — located in Gaston County — had none.

“Patients would go get their screening done in Charlotte and then come back to Gastonia for the rest of their care,” Dr. Osemeka recalls. “Initially there were just a few patients doing this, but it soon became a pattern. They were getting their screening done at these endoscopy centers because they could have the procedure at a lower cost than what we could provide to them by performing the procedure at the local hospital.”

Gastroenterologist Sam Drake, MD, of Gaston Digestive Disease Clinic in Gastonia, recalls a similar change happening with his practice. “We started seeing patients leaving our county and going to Charlotte. It was strictly from an economic standpoint. Considering their insurance, they were able to get their indicated procedure done financially better than what we could do.”

Over the years, the number of patients leaving Gaston County for their procedures grew significantly, says gastroenterologist William Watkins, MD, of Gaston Gastroenterology in Gastonia. “We were losing about 1,400 colonoscopies a year to endoscopy centers in Charlotte because patients could get their procedure for a co-pay, which was lower than what they needed to pay at the hospital.”

Dr. Osemeka adds, “Many patients are unwilling to pay what the hospital charges, especially those with no medical problems, a high deductible and private North Carolina Gastroenterologists insurance.”

Greater Gaston Endoscopy Center

A PE Partner since 2011. Started by Neville Forbes, MD; Sam Drake, MD; William Watkins, MD; and Austin Osemeka, MD.

920 Cox Road, Suite 201
Gastonia, NC 28054

(704) 772-4455


“They are being asked to pay a lot out-of-pocket for a preventive procedure at a time when many cannot afford the expense.”

Austin Osemeka, MD

Pursuing A Solution

As soon as they observed patients leaving Gastonia County for treatment elsewhere, a group of gastroenterologists approached the local hospital about the need for the county to develop its own endoscopy center, says gastroenterologist Neville Forbes, MD, of Gaston Medical Associates in Gastonia. “We thought we could open a center through a joint venture with the hospital. This would help prevent further exodus of patients and hopefully allow us to recapture our patients that were leaving.”

Gaston County was the largest county in North Carolina without a dedicated endoscopy center, Dr. Drake notes. “We approached the hospital about opening an endoscopy center because we were trying to get the people who wanted to stay here for their care back. Most of these were people we had seen for years and had done their procedures before, but now with the way things were being designated by the insurance, it was more advantageous for them to get their care across the river.”

“Opening a center in Gastonia was truly about providing economic access to the residents of our community.”

Sam Drake, MD

Tired of Waiting

The hospital applied for a certificate of need to build an endoscopy center and received it in late 2008. But over the next two years, little progress on the center was made. “They said that, economically, it wasn’t the right time for the project,” Dr. Drake recalls. “But we knew there was an alternative to the joint venture model, and that was complete physician ownership.”

In late October 2010, a group of Gastonia gastroenterologists successfully petitioned the state to open the center. “We just got tired of waiting,” says Dr. Osemeka. “We decided that if the hospital wouldn’t do it, we would try to do it ourselves. If we wanted to practice for another 10-20 years in this area, we knew we needed to be able to keep up with the times by opening a center rather than just keep doing the same thing at the hospital.

“If we just continued doing what we were doing, we would end up losing too many patients.”

Austin Osemeka, MD

Blocking the Center

But the hospital did not view this action positively, and took legal action to try to block the center from opening. After a three year legal battle, the court struck down the hospital’s claims. Even after the ruling, the physicians approached the hospital about partnering on a center, but the hospital declined. “We really tried to do a joint venture, but it just didn’t materialize,” Dr. Drake says.

So the group of gastroenterologists, working with Physicians Endoscopy, began building the Greater Gaston Endoscopy Center in Gastonia.

“Not only was opening the center about providing better access to care to our local patients, but we thought that it might help all of us who are in separate practices,” Dr. Drake says.

“We really felt like this partnership might allow us to become more of a functioning group than individual physicians.”

Sam Drake, MD

The Goal Achieved

Greater Gaston Endoscopy Center (GGEC) opened and began seeing patients in early February. GGEC features two procedure rooms. Drs. Drake and Watkins serve as co-medical directors, with Drs. Osemeka and Forbes also performing procedures at the center. Physicians Endoscopy provides management of the facility, with Lara Jordan, a vice president of operations for Physicians Endoscopy, assisting the center with ongoing operations.

It’s been a long, difficult process, but Jordan says she is not surprised that this group of physicians stayed true to their vision. “It just shows they have a tremendous commitment to the community. What I’ve heard, time and time again from all of them, is they just want better for their patients. They want their patients to have options, and to see them persevere through the legal battle and all the time that’s passed, it’s apparent they really just want this project to be successful for the patients.”

No Alternative

Dr. Forbes says the alternative to not opening an endoscopy center was one that he wasn’t willing to accept. “We had to stick with the center, otherwise the cost to receive care here would become so prohibitive for patients. Once that happened, there would be no patients for us.”

“The other option to opening the center was closing up and leaving, and we weren’t willing to do that.”

Neville Forbes, MD

A New Experience

“For patients who have never been to a surgery center of any type, the experience they will have at the endoscopy center will likely change their perception of what it can mean to receive exceptional care”, Jordan says.

“In this county, specifically, many patients don’t have the knowledge of surgery centers,” she says. “If you go to a hospital, it can be an all-day process for an endoscopy type procedure. But at an endoscopy center, everything is meant to be easy. There’s the ease of the scheduling process; the ease of parking right in front of the building, walking in and being exactly where you need to be; the ease of being in and out of the building in just a few hours. It’s such a drastically different experience for patients.”

It’s also a different experience for the physicians, Dr. Watkins notes. “It’s difficult to get things scheduled at the hospital in a timely fashion because you have about eight gastroenterologist plus the surgeons all trying to get their procedures done there. The hospital recently told me I could no longer schedule procedures on Tuesday mornings. We were at the whims of the hospital, but at the center we will control our own scheduling.”

“The center makes us more independent, and allows us to make our own decisions about what we feel are the best ways to meet the needs of our patients.”

William Watkins, MD

Cost-effective care, Done Right

Ultimately it’s the residents of Gastonia and Gaston County that Dr. Osemeka hopes will benefit the most from the new facility. “We are finally able to provide our patients with the care they need at a very cost-effective rate, and do so right here. These are our patients. These are people who have come to us and asked us to take care of them. I think we have an obligation to do just that.”

Dr. Drake adds, “To stay the course the way we have and finally see our efforts come together is a real statement to people trying to do what’s right for patients. We hope that we will do things in such a way that this will be an extremely positive step for healthcare within our county.”