Behind the scenes: Highest caliber, fellowship-trained pathologists examine all patient specimens in GIA’s on-premises laboratory

Patients are accustomed to developing face-to-face relationships with their physician, the practice nurses and even the front desk staff. Delivering health care is a very personal endeavor.

Conversely, laboratory services can be very impersonal, with many giant commercial labs located thousands of miles away from physician practices and patients.

Have you ever wondered who the person is behind the microscope, making what could be a life-changing decision about whether tissue is malignant or benign, or indicates the presence of disease?

GIA patients don’t have to wonder because two top-notch, gastrointestinal fellowship trained physicians run its in-house laboratory and make every biopsy determination or diagnosis. Dr. Trevor Ingeneri and Dr. Jay Alan Gates not only collaborate on difficult cases, but can easily discuss a patient’s medical history with his/her physician – who in some cases is just outside their office doors in GIA’s Powell practice.

It’s extremely unusual for an independent medical practice to establish its own in-house laboratory, and even more so to staff it with two physicians of Dr. Ingeneri and Dr. Gate’s caliber.

Dr. Ingeneri

In 2010, GIA decided to undertake what was then a novel experiment. Dr. Ingeneri contacted me with the idea to establish such an on-premises lab to offer patients not only quick turnaround and efficiency, but also highly specialized, personalized and informed lab results.

“I knew of GIA’s reputation for quality and felt that I could make a significant contribution,” recalled Dr. Ingeneri, who had worked in a large commercial lab in the Northeast. “Open communication leads to the best possible results, for patients and doctors. My gastroenterologist colleagues are often right outside the door, so I can easily get additional patient history or discuss findings on a case.”

Dr. Ingeneri earned his medical degree from the University of Miami School of Medicine and completed his internship at the Naval Medical Center in Portsmouth, Va. He served his residency at University of Tennessee Medical Center in Knoxville and completed his GI fellowship training in Memphis.

Within two years, increased demand on the lab necessitated expanding its staff by adding a second physician. Dr. Gates, who was hired in 2012, earned his medical degree at Yale University School of Medicine where he also completed both his residency and fellowship.

“Medicine has become so specialized these days,” Dr. Gates said. “There’s so much to know about each specialty. You wouldn’t want a urologist interpreting a cardio stress test. Having us in-house and having us highly trained is critical. We don’t want a mystery out there. We want a hard diagnosis, so the patient can receive the proper treatment.”

Dr. Gates

The biopsies they examine come from endoscopies of the esophagus and stomach as well colonoscopies of the colorectal area. They look for signs of cancer, pre cancer, lesions, inflammation, auto immune disorders and infections.

Dr. Gates thinks what distinguishes them from average pathologists is specialized GI training.

“With our experience and expertise, we see subtleties and entities that most people won’t see,” he said.

Because they examine only GIA specimens, Drs. Ingeneri and Gates develop physician relationships with patients as well.

“I see patients over time. That’s as close as you can get in pathology,” Dr. Ingeneri said. “It’s the best possible situation for GIA patients.”

While only in its fourth year, I have no hesitation in deeming our experiment a resounding success, and am proud that it means better care and outcomes for our patients.