RGA’s Founding Fathers Talk 40 Years of History

Among the most crucial aspects of our history and 40th anniversary celebration this year are three physicians: Dr. Roger Greenlaw, Dr. William Baskin and Dr. James Frakes.

Together, they established an independent group practice in 1980 named Rockford Gastroenterology Associates (RGA). Their forethought, diverse expertise, and dedication to helping people with gastrointestinal (GI) conditions created the foundation that made RGA the nationally recognized leader in digestive health care that we are today.

Though they retired together in 2010, the three doctors still keep in touch with the current medical team and staff. We sat down with them earlier this year to talk about RGA's beginnings, growth and cultural foundations.

Designing a GI Practice

Dr. Greenlaw was an intern at the University of Missouri in 1971 when he first met Dr. Baskin. They lost touch after their training ended, reconnecting when Dr. Greenlaw started a solo gastroenterology practice in 1975 at SwedishAmerican Hospital and recruited Dr. Baskin to come to Rockford.

Dr. Frakes joined the group in 1980 as the decision was being made to establish RGA as an office-based private practice, serving more than just one hospital. They had identified the growing demand for GI work and wanted to specialize solely in gastroenterology to provide one-on-one patient care and perform procedures to provide state-of-the-art diagnosis and treatment for patients.

Dr. Greenlaw wanted to establish a different way to create incentives for a healthy group practice to maximize internal group cooperation and ensure all patients had access to care, regardless of their social, economic, or medical status. All partners worked equal hours, seeing all patients in rotation as they were referred. No patients were turned away regardless of ability to pay. In the RGA model, partners would be able to refer patients to each other within the practice to take advantage of individual expertise with certain GI conditions or procedures.

"Gastroenterology fit for the three of us because it's internal medicine, and we all liked the intellectual discipline of internal medicine, which is diagnosis-based and involves puzzle solving. We're very much problem solvers and have a lot of pride in intellect," Dr. Frakes said. "Secondly, the field involved endoscopy. That gives one way to diagnose and in some cases treat a problem. The combination of the intellectual and procedural just makes for a really interesting branch of medicine."

During those early days, the founders ended up working with doctors and patients at local hospitals and clinics across all specialties, including pediatrics, obstetrics/gynecology, even behavioral health. "We got to work with all the doctors and nurses throughout the hospital and a great variety of patients and diseases – it was really remarkable," Dr. Greenlaw said.

Developing a Successful Surgery Center

RGA's first building was at 1345 Charles St. (across from SwedishAmerican) and was one of the first office-based diagnostic endoscopy labs in the U.S.

"Over the next 10 years, GI just exploded," Dr. Baskin recalled.

Technology and GI instruments were improving to make both patients and physicians more comfortable during procedures. Even medications – like those to manage common conditions such as heartburn – were becoming more effective and more readily available.

"Endoscopy techniques changed dramatically. Colonoscopies were once a two-person procedure that would take an hour or 90 minutes to do," Dr. Frakes said. "Now, it's a one-person procedure that takes much less time.

"Part of that need for more and more GI came from the fact that there was so much more one could do and find with endoscopy. Drugs got better, instruments got better, and you could see GI care moving to an outpatient setting."

RGA was one of the first practices in the country at that time doing outpatient endoscopy procedures. They were writing their own GI practice roadmap and even doing their own landscaping – Drs. Baskin and Frakes fondly recalled bringing their lawnmowers to trim the grass at the clinic during those early days.

By 1988, the partners started looking for a bigger location as they outgrew the Charles Street building. RGA moved to its current location at 401 Roxbury Road (by OSF Saint Anthony Medical Center) in 1990.

During the next several years, they worked to become a state-licensed, Medicare-certified, and Joint Commission Accreditation of Health Care Organizations-accredited ambulatory surgery center. RGA's surgery center was just the second such facility in the U.S. dedicated to GI care at the time, Dr. Frakes said.

As the role of colonoscopy in colorectal cancer screening increased in the outpatient setting, opportunities evolved for quality assessment research. As part of its burgeoning research effort, RGA completed a landmark study of polyp and cancer detection related to colonoscopy withdrawal time. This highly acclaimed study was successfully published in the New England Journal of Medicine and all of the group, as well as much of the country, adopted this new quality standard.

Prioritizing Education and the Next Generation

A big reason why Rockford appealed to all three founders was the close connection to the University of Illinois College of Medicine Rockford. The partnership was ideal for clinical teaching opportunities and filling the pipeline of future doctors.

"The three of us were the first full clinical professors over time," Dr. Greenlaw said. "That made RGA a model practice in terms of teaching – it helped us recruit partners because most coming out of their GI fellowship had been teaching and wanted to continue that."

RGA quickly became recognized for leading efforts in the clinic setting and the surgery center. Dr. Frakes traveled across the county teaching outpatient endoscopy techniques and served as national president of the American Society for Gastrointestinal Endoscopy.

Carving this niche for providers – allowing them to pursue their passions, be that procedures, research, teaching or speaking – helped build RGA's culture and is a still a priority today for the current medical staff.

"We'd seen so many ways not to run a practice, so we wanted to build the structure, the culture, and the balance the right way, from the beginning," Dr. Greenlaw said.

"We had people interested in different directions," Dr. Frakes said. "Roger always had an interest in disease prevention and health promotion, as well as the role of patient 'self-care' and lifestyle medicine. Bill's forte was nutrition and teaching, and he has a bushel basket full of Golden Apple Awards to reflect that. I had an interest in endoscopy, implementing things, being managing partner and doing that outreach on the national stage. We could do those things because we got support from each other and the other partners.

"What we had in common was always the same: We were good doctors who took good care of people. That was a given and is the connection still today."

Drs. Greenlaw, Baskin, and Frakes spent 30 years helping RGA become a leader in GI care with their innovative practice design and dedication to patient care, continuing education, and community outreach. We are grateful for their dedication and their impact on our organization, and we are committed to carrying on those principles of exceptional care and exceptional caring for the next 40 years – and beyond.