Paving the Way in Colon & Rectal Surgery - Adrienne Forstner-Barthell, MD
By Edward Araujo, Managing Editor, Arizona Physician
Photography by Noble Pictures, jeffnoblepictures.com
Seeing sheer gratitude on her patients’ faces post-surgery truly makes Dr. Forstner-Barthell feel like she’s making a difference in their lives. She understands how hard it is for her colon and rectal surgery patients to even discuss the issues that ail them, let alone actual surgery. So, guiding them through those hard times makes a successful surgery that is much more rewarding for her.
Adrienne Forstner-Barthell, MD, FACS, FSCRS, is a board-certified colon and rectal surgeon at Arizona Advanced Surgery—Colon and Rectal Center of Arizona. She completed both medical school and residency at Mayo Clinic and completed her fellowship at the Colon and Rectal Clinic of Orlando. She’s been practicing now for over 18 years and specializes in treating colon & rectal problems.
THE COLON AND RECTAL SURGEON JOURNEY
Dr. Adrienne Forstner-Barthell’s journey into colon and rectal surgery began in medical school at Mayo Clinic in Rochester, MN and continued here at Mayo Clinic in Scottsdale. She states, “I knew I wanted to do something that incorporated advanced laparoscopic and potentially robotics at the time I was in training, and we had just done the first robotic procedure in the state of Arizona,” so naturally she was intrigued by the specialty. Yet, she was still swimming in many ideas on what she wanted to specialize in.
She would go on to poll her peers and find that only the colorectal surgeons would even go back to medicine if they had to do it all over again, meaning they felt they had the best job satisfaction, in her point of view. As a colorectal surgeon she performs many procedures including colonoscopies and anything hemorrhoid related plus all cancers including colon, rectal, and anal.
Even though Trans anal Endoscopic Microsurgery (TEM), which is a procedure that treats rectal tumors and other rectal problems without making any incisions wasn’t new to the U.S., it was being performed in limited areas outside of Arizona. Dr. Forstner-Barthell was one of the first to bring it here. It is now used less often as there are now some very advanced endoscopic resections, which are minimally invasive and are done by both gastrointestinal and colorectal surgeons using a colonoscope. Other less well-known procedures she performs are interstim or sacral nerve placement and surgical treatment of pilonidal cysts, which include surgical treatment of anal dysplasia.
Dr. Forstner-Barthell prides herself on building relationships with her patients. She goes above and beyond to ensure their health and wellbeing. For example, she will conduct a colonoscopy on a patient and see them again for any colon or rectal issues they may experience. Should they develop diverticulitis or cancer she will walk them through the next steps to help support their health success. Over the years, Dr. Forstner-Barthell has built a level of trust amongst many generations of patients and their family members. These longitudinal relationships help bring joy to the invaluable treatment she provides and gives her purpose.
ARIZONA ADVANCED SURGERY
Arizona Advanced Surgery is a unique business model with a corporate structure that allows physicians like Dr. Forstner-Barthell to run their own individual practice locations. AAS has two large locations throughout Arizona where multiple physicians work.
Additionally, AAS gives autonomy to each physician partner to decide how many patients they see. Initially, Dr. Forstner-Barthell partnered with 1 of the 6 founding physician members of Arizona Associated Surgeons, the precursor to AAS. They started with 6 and quickly grew to twenty-one surgeons in western and southern Phoenix metro. Over the years they would merge with another surgical group that had locations throughout the central and eastern Phoenix metro and Scottsdale. From that merger of surgeons, the group would be renamed Arizona Advanced Surgery. AAS was not done yet, during the middle of the pandemic, growth opportunity arose, and they grew to forty-seven surgeons and 8 allied practitioners.
Arizona Advanced Surgery is unique in that it has a corporate structure but allows physicians like Dr. Forstner-Barthell to run their own individual practice locations should they have one. AAS also has two larger locations in which multiple physicians work. AAS allows enough autonomy to each physician partner to decide how many patients they see. The AAS has many advantages, according to Dr. Forstner-Barthell.
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AAS is patient centric, which means the patient always comes first, getting back to patients quickly and transparent billing is prioritized through knowledgeable and efficient staff.
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The ability to negotiate better vendor contracts is another advantage that helps with curtailing costs.
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The company chooses which insurance they take, making things easier for physicians and staff.
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AAS allows more autonomy for physicians to be successful. AAS has fourteen locations and forty-five physicians and more opportunities for growth.
So, what makes AAS unique? One word, leadership. Dr. Forstner Barthell shares that leadership doesn’t micromanage its physicians nor the number of patients they have. Along with incredible management, AAS has a great billing system in place that takes the authorization burden off the physicians’ offices, which is a game-changer to her. She cannot stress the importance of having autonomy in decision-making and having great partnerships with each of the forty-five physicians and her colleagues.
WHAT THE FUTURE HOLDS IN STORE
Dr. Forstner Barthell shares that the biggest obstacles that AAS and her own practice face are decreasing healthcare reimbursement and increased costs. Costs like increased rents, increased medical supply costs, and employee salaries. As reimbursement is slashed, she fears the next generation of surgeons may really feel that effect. That could turn surgery practices into concierge medicine where it’s all cash pay, or they could end up at conglomerates where they may be miserable and forced to see patients too quickly to really access their problems. So, what’s the solution?
Dr. Forstner-Barthell shares that her current group is one of the answers as it continues to grow. She also sees physicians may at one point need to own surgery centers, maybe even own hospitals, or at least become investors in them. Currently there are many restrictions and rules that don’t easily allow doctors to do. Yet, she believes using scale to combat the insurance companies’ impact on medicine to allow for better doctor-patient relationships and better gains for surgeons is a good path.
Dr. Forstner-Barthell believes it is important for her to be a positive role model for other women looking to get into medicine and are in medicine. More so, for women getting into surgery…as historically it has been a difficult specialty for women to get in to and stay. She is beyond grateful to the many mentors she’s had along the way and hopes to do the same for others. Being a colorectal surgeon has allowed Dr. Forstner Barthell a lot of balance in her life. Her career choice has produced flexibility to allow her to pick the procedures she can do, spend time with her family, and teach in conjunction with running her own practice.
She travels regularly and donates time to her charity in Nicaragua, “Por Ellos.” She is beyond grateful to the many mentors she’s had along the way and hopes to do the same for others. “I think it’s important as a physician to be approachable to young people. I think it’s important to encourage them with what is exciting in medicine. I think it’s important for women physicians to be vocal, to teach and to encourage,” states Dr. Forstner-Barthell. â–
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ABOUT THE AUTHOR
Edward Araujo is the Managing Editor of Arizona Physician magazine and puts together Arizona Physician media. He is also Director of Marketing and Communications for the Maricopa County Medical Society (MCMS). Edward has over 20 years of marketing, operational, donor relations, volunteer management, and board development experience. He is highly skilled and experienced as a creator of print, digital, & audio media and social media.