Collaborative Culture (Part 1)

Creating success with attentive care and a dynamic management style.


Founding partner Dr. John Spivey left a multispecialty practice to begin Gastroenterology Associates of Fredericksburg (GAF) in 1990. With an unusually attentive style of patient care, the new practice soon outgrew its original 700-square-foot rental unit with three staffers to its current 20,000-square-foot location with eight physicians, five midlevel providers and numerous staff. They are now the largest practice in Fredericksburg, Virginia. GAF entered into a partnership with Physicians Endoscopy (PE) in 2018. PE Senior Vice President Carol Stopa spoke with three of the key players in the group: Chet Pai, DO, Managing Partner; Frank DeTrane, MD, Senior Partner; and Cheryl Leite, Practice Administrator, to learn how they have been able to maintain and grow a thriving GI practice.

Carol Stopa (CS): How would you define your leadership style?

Dr. Chet Pai (CP): I believe in adaptive leadership. I want people to have a similar vision for the practice and similar goals—staff, partners and board members—to make the work environment better.

Dr. Frank DeTrane (FD): Historically, I always strived to have a positive outlook and be very inclusive of all of the partners and associates, promoting mutual respect and appreciation for what each individual had to contribute to the success of the practice. GAF still has weekly physician meetings to promote open communication and to try to solve problems before they fester. It is also very important to remain focused and see every challenge as a potential opportunity to improve the quality of care and access for our patients. I would not hesitate to seek professional guidance, either locally or at national meetings, for the more complicated issues such as developing ancillary services.

Cheryl Leite (CL): A key element to my leadership style and what I think makes us successful is communication. I know it sounds a little cliché, but effective communication skills are essential to any leadership role. Over the years of my career, working with different providers, I’ve learned that people have different ways of delivering and receiving messages. Being the person who makes sure important messages are delivered and received is a key part of my role.

In addition to managing communication with and between the providers, it is important to keep the staff informed about what is going on, so I send out regular updates to the team. They appreciate that someone is cluing them in as to what is going on with the practice. I would also say I’m extremely collaborative. Staff on every level have great insights and good opinions, so I solicit input from people and ask them, “What do you see? What do you think we should be doing differently?” Our culture supports this. People are very respectful of your questions or suggestions, even if they don’t agree.

Collaborative Culture

CS: What challenges have you successfully overcome when it comes to ongoing growth? Have you faced hurdles in staffing, equipment, facilities or management?

CP: We are working on all of those challenges. In terms of staff, finding the right providers is one big challenge. We are very selective about who will join our practice; we are trying to find the right partners and associates who have the same vision for the practice.

It’s not hard to attract people—but attracting the right person is hard. Each has to go through our vetting process, which involves all board members. We start with a phone call from one of the senior members of the practice to see if we should invite them for an interview. If that goes well, we invite them to visit the practice, along with their significant other. We don’t present an offer until everyone is comfortable. It’s a rather drawn-out engagement!

FD: Over the last 25 years, GAF has successfully overcome many challenges. We outgrew our office space twice, and in 2008 made a major investment in our future by building and owning our current 20,000-square-foot digestive center, which houses our two-room AAAHC-certified office endoscopy center and 21 exam rooms, allowing the physicians to be more efficient and productive. Our staff has grown exponentially as well, so we successfully recruited Cheryl in 2015 as our Practice Administrator. With her vast experience, she was able to restructure our outdated management system and assumed many of the responsibilities that the managing partner did not have time to address while working clinically full-time. Subsequently, we now rotate the managing partner position to interested partners to provide new energy and different perspectives to the future growth of GAF.CL: Staff recruitment and retention is a challenge for our group, as with many practices. Most resumes I receive are from people who change jobs roughly every two years. Finding the right candidate who is the right fit for the practice but who is also prepared to commit for years to come is very difficult. I think we offer a very good, supportive, collegial work environment and  competitive compensation and benefits. When recruiting, we really try to focus on fit and not just rush to fill a  position with the first seemingly qualified candidate.

CS: As managing partner, what is your vision for the practice over the next several years?

CP: As a provider, I recently did my MBA at George Washington University, and I focused on healthcare in the U.S., and how to curtail the extraordinary costs. Traditionally, we have looked at healthcare through three prisms, one each belonging to the payer, the hospital and the provider. There has always been a struggle between hospital and payer, the provider and the payer, and so forth. I’m hoping we can all work together to create a system that could decrease costs while providing excellent service at the same time.


To continue reading, click here. 

Subscribe to EndoEconomics

EndoEconomics™ is a journal focused on issues faced by the GI medical community. The blog offers journal content and the latest GI news and information.

• Print: only qualified recipients will receive
• Digital: all subscribers will receive