The History of Lowcountry GI

Lowcountry Gastroenterology Celebrates the Legacy of its Founding Physicians

From left: Drs. Yantis, Joyner and Marsh.

All East Cooper residents have witnessed the recent changes in our community, but few are more qualified to talk about those changes than Drs. Paul Yantis and Bill Marsh. After more than fifty years combined in Mount Pleasant, these local gastroenterologists have decided to put down their stethoscopes and pick up their fishing rods. Their legacy at Lowcountry Gastroenterology will be carried forward by the next generation of physicians, but their story shares the origins of healthcare in East Cooper and is worth recounting.

In 1984, Mount Pleasant was a sleepy little town compared to the present day hustle and bustle. There were only about 15,000 people and the closest hospital was across the rickety 2-lane Cooper River Bridge in downtown Charleston. Most physicians would stay away from a community such as this, but when a deal to move to Charlotte fell through, Dr. Yantis decided to “hang a shingle” in Mount Pleasant.

He was fresh out of his training at MUSC and didn’t have any money, so he made a deal with Dr. Billy Wingfield Sr., one of the local internists. In exchange for free rent, Dr. Yantis taught Dr. Wingfield how to perform flexible sigmoidoscopy, a procedure that allows the physician to examine the last parts of the large intestine.

There were only a few doctors East of the Cooper at the time; Jim Ward was the pediatrician, Bill Stroud the surgeon, Mary Baker and Dee Terry were the obstetricians, and George Durst Sr. had his internal medicine practice on Sullivan’s Island. Paul Yantis established the first gastroenterology practice in town. Known more for his social nature and business acumen than his creativity, he named it Paul Yantis M.D., P.A.

Paul was eager and ambitious. He told everyone he met, “Don’t hesitate to contact me, I’ll be happy to help out.” The emergency departments were happy to honor such a request from the greenhorn doctor, and Paul started receiving phone calls at all hours from Roper and St. Francis downtown, and the now closed Baker Hospital in North Charleston. 

Imagine a life where every time the phone rings you may have to go back to work. There were a lot of sleepless nights, crossing the rickety old bridge under moonlight to take care of patients on the peninsula, then crossing back as the sun rises and having a full day of patients scheduled at the office.

The good news is that the strategy worked and business was booming. The bad news is that Paul was getting burnt out. “I was busy and getting beat up. Within a year, I was looking for some help.”

His first call was to Dr. Bill Marsh. Bill was a few years ahead of Paul at MUSC and had been his junior attending, meaning that he was responsible for teaching Paul the intricacies of gastroenterology. Paul describes Bill as the greatest teacher he ever met. “Bill was super. A great guy to work with.” But Bill loved his job as a teacher downtown and was unwilling to give it up.

Fortunately, help was on the way. In June 1985, Paul hired Jewel Clifton as his medical assistant. Paul describes Jewel as extremely talented. She was able to do a little bit of everything: field phone calls, assist with patients in the office, transcribe dictations, and send bills to the insurance companies. “From day 1, I took over and started purchasing the equipment that we needed. I bought a typewriter. I tried to buy a fax machine and he said, “We will never use that.” I said, “Yes we will!” We didn’t have a fax line, so we would have to unplug the phone to plug in the fax when we heard the high-pitched transmission noise.” Jewel was Paul’s only employee for several years, and continues to work part time for the practice, now 30 years later. With Jewel’s help, Paul was able to keep his head above the water.

Then in January 1986, East Cooper Hospital opened as the first inpatient medical facility in Mount Pleasant. Paul’s philosophy remained the same. According to Jewel, “It didn’t matter who called or when, we would see the patient whenever we could.” But the burden of being a solo practitioner weighed heavy on Paul as his business continued to grow and he was now taking daily call at four different hospitals across the region.

Paul actually considered a job in Williamsburg, VA, but he loved Mt. Pleasant too much to leave. Finally, in 1987 came some relief. An endoscopy rep gave Paul the name of a gifted young GI doctor who had trained under Dr. Peter Cotton up at Duke. His name was Jeffrey R. Joyner, M.D, and his arrival heralded a new era for the practice. The call burden was reduced by a whopping 50%, so Dr. Yantis could finally go out for a much-needed cold beer. It also sparked the transformation from Paul Yantis M.D., P.A. to the modern name, Lowcountry Gastroenterology Associates.

Things were going well until September 21, 1989, a day of infamy in the lowcountry. That is the day that Hurricane Hugo struck South Carolina. East Cooper Hospital remained open, but nearly all of the patients were discharged or transferred out. Drs. Yantis and Joyner evacuated their families but remained in town to continue providing their services.

Jewel describes the aftermath as “a total mess.” The roads were flooded, giant trees were toppled, and the power was out. Paul remembers being called out to both Baker and St. Francis Hospitals during this time, and having to wind his way through the obstacle course and cross the rickety bridge to see the patients. For about a year, business was down dramatically while East Cooper residents invested in rebuilding their homes rather than on medical care.

In the years that followed, both Mount Pleasant and the practice continued to grow. They soon added a third physician, Dr. David Ingraham, who remained with the practice for 3 years before deciding to move closer to family. This left a hole in the practice that had to be filled. It was eleven years since his first recruitment effort, and Paul decided to reach out again to his old friend, Dr. Bill Marsh.

 
By this point, Bill had received numerous teaching awards and had accomplished his goals as an educator. He recounts, “It was time for something new for me. I felt the urge to be a true clinician and spend all of my time taking care of patients.”
 

On January 1st, 1995, Bill Marsh brought his well-recognized clinical skills East of the Cooper. Bill’s assistant from day one was Lisa Welch. She would remain his assistant until the day he retired, and has now moved on to a new phase in her career as the Office Manager. But she will always have fond memories of her time with Bill. “We were together for more than 20 years, and not once did he raise his voice at me or become angry with me. He is a great and kind man.”

From that point forward, it was a group of three. They navigated a rapidly evolving healthcare system together. They also supported each other through times of personal challenge, such as the loss of loved ones or treatment for cancer. It certainly was not always easy, but despite outside influences they managed to maintain their focus on high quality care with a personal touch. They took the time necessary to listen, to educate, and to connect with their patients even if it meant they didn’t make as much money. They were the first, and to this day remain the only gastroenterology practice that is in Mount Pleasant full time.

When Drs. Yantis and Marsh decided to hang up their white coats for the last time, it ushered in a new era for Lowcountry GI. The first arrival was Joshua T. Watson, M.D, an 11-year veteran of the Army, a Bronze Star recipient, and the former Chief of the Gastroenterology Clinic at Dwight D. Eisenhower Army Medical Center. Josh was a graduate of MUSC and eager to return to the area with his wife, Theresa (also an MUSC grad), and four children. He was followed by William J. Bulsiewicz, MD, MSCI, the former chief medical resident at Northwestern and chief gastroenterology fellow at UNC. Dr. B's wife is a native of Charleston, raised on Sullivan's Island and with a family history dating back over 5 centuries in the lowcountry.

Change is inevitable in today’s healthcare climate. While some things at Lowcountry GI will change, the legacy of Drs. Yantis and Marsh will live on as we continue to listen, to educate, and to connect with our patients in the way that they did during their combined 70 years in the lowcountry.

From left: Drs. Yantis, Watson, Marsh, Bulsiewicz and Joyner