Onsite with Mount Sinai's Newly Launched IBD Center

Issue: November 2015

With the launch of the Susan and Leonard Feinstein IBD Clinical Center in May 2015, Mount Sinai Hospital and the Icahn School of Medicine pledged to care for patients of all ages who are diagnosed with inflammatory bowel disease. By integrating pediatric care with adult care, the team at Mount Sinai can easily transition patients throughout their lives, as IBD impacts many aspects of life.

Marla C. Dubinsky

James F. Marion

Healio Gastroenterology had the opportunity to visit the newly minted center in New York City and speak with Marla C. Dubinsky, MD, chief of pediatric gastroenterology and hepatology, professor of pediatrics, and co-director of the center, and James F. Marion, MD, professor of medicine and director of education and outreach at the center, about the ongoing project (pictured).

“The history of IBD, here at Mount Sinai, stretches back to the early 1900s. Burrill B. Crohn, MD, after getting out of medical school, opened up a private practice out of Mount Sinai and was the first to describe IBD in the early 1930s,” Marion said. “That was the beginning of Mount Sinai’s history as a center for treating these conditions. And, over the years, other giants such as Leon Ginzburg, MD, Gordon D. Oppenheimer, MD, Henry D. Janowitz, MD, who was my mentor, Daniel H. Present, MD, who was one of my partners in practice, all worked in trying to understand these diseases.”

Still today, Marion continued, his more recent practice has focused on further uncovering and implementing better treatments for his patients.

Jean-Frederic Colombel

“We don’t understand the essential nature of these conditions. And, as a result, it has been an area of great interest and enormous effort, both with clinical research, but also increasingly basic research here at Mount Sinai,” Marion said. “Having brought my practice up here to the Susan and Leonard Feinstein IBD Clinical Center and working side by side with Dubinsky and Jean-Frederic Colombel, MD, and Bruce Sands, MD, and the GI division here, we are in a new era that I think is going to be another landmark era in understanding these diseases.”

Full Life Spectrum: “When somebody comes here, there will not be a scenario around their IBD that we’re not ready to handle. I always tell my patients that IBD is one of the most inconvenient conditions one can have. It interferes with the most critical stages of life: the birth of your child, starting college, starting your first relationship, getting married. There’s just not a time when it’s a good time to have it. But, I think now that we have this full spectrum — the full life spectrum — in terms of managing IBD at every stage, there are no surprises. We’re ready for it. And, we can help navigate these moments with the patients more mindfully,” Marion said.

Integrative Care: “It’s a safe place so that if they were walking down the halls from the age of 8 to 18 years and then transfer care to an adult IBD provider, … it’s the same halls, the same safe people that have always managed them,” Dubinsky said. “One of the unique things that I think really differentiates us from most IBD centers of excellence around the world is that we can provide, under one roof, seamless integrative care through the entire life cycle.”

Transition: “Transition is many things. Transition is not just transitioning from pediatric oriented care to adult oriented care. There is transition to child bearing, … being able to get pregnant or consider pregnancy. We have a preconception clinic here, where we work with the maternal fetal medicine team to offer really consultative care,” Dubinsky said.

Continuity of Care: “I really don’t think there are many places that have the capability to offer the complete care team within the same physical space — pediatric care providers, adult care providers, nutritionists, social workers, nurse practitioners, colorectal surgeons, research coordinators and administrative support,” Dubinsky said. “Essentially, we are all here for the patient, meaning the patient has the same address, same phone number, the continuity of care is there.” (Nutritionists and social workers pictured to the right.).

Research: “We feel very strongly that we need to offer patients novel therapeutic targets and have a very robust clinical trials program,” Dubinsky said. “We’re pretty well doing the majority of clinical trials, new targets, existing targets, learning how to use them better. So, we offer a full range of clinical trials here and people can reach us through our website.” (Administrative support pictured above.)

Fireworks: “The most exciting thing for me in this transition, since we’ve opened, is when we were in a conference or in some sort of a meeting and, somebody with whom I would typically not have much contact asked that question that I never would have thought of asking about these diseases. And, that starts the conversation. And, that starts these initiatives,” Marion said. “We’re all here under one roof. And, we’re all talking to each other. And, sometimes it’s like fireworks go off in these meetings. It is that exciting. So, I think it’s an amazing moment right now for the system and for the center.”.

Opportunity for Understanding: “The most exciting aspect of the Feinstein IBD Clinical Center, in my opinion, is the opportunity for pushing back the borders of ignorance about these diseases. We are toiling in a specialty where we do not understand the essential nature of Crohn’s disease or ulcerative colitis. So, as you can imagine, the opportunities for greater understanding are immense. And, to do that, it requires basic research, it requires clinical research, and it requires involving our patients in the community in trying to understand these diseases,” Marion said.