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Dr. Robert D. Fusco, Medical Director    
What is Gastroenterology?

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Gastroenterology is a branch of medicine concerned with digestive diseases. The practice of gastroenterology concentrates on the diagnosis and treatment of diseases involving the esophagus, stomach, small intestine and large intestine (colon), liver, gallbladder, and pancreas. This medical field is really a subspecialty of Internal Medicine, as is, for example, Cardiology, which deals with diseases of the heart.

A Gastroenterologist is a specialist who is first broadly trained in Internal Medicine and subsequently in diagnosing and treating disease of the digestive system. Frequently, a Gastroenterologist is called in cases of abdominal pain, rectal bleeding, or change in bowel habits when the diagnosis is unclear or where specialized diagnostic procedures are necessary. Most Gastroenterologists are certified by the American Board of Internal Medicine and then receive additional training in Gastroenterology. To qualify for Board certification, an individual must have completed four years of college, four years of medical school and have received a degree in medicine. Then he/she must complete an additional four to six years of specialty training in Internal Medicine and Gastroenterology. After several years of clinical practice, the doctor must successfully complete an extensive series of examinations. All of our doctors are Board Certified in Gastroenterology.

Frequently, a Gastroenterologist is called in cases when the diagnosis is unclear or where specialized diagnostic procedures are necessary. A Gastroenterologist treats a broad range of conditions, including, but not limited to:

  • Abdominal Pain
  • Abnormal Xray findings
  • Colon Cancer
  • Colon Polyps
  • Colon Screening Exams
  • Constipation
  • Crohn's Disease
  • Diarrhea
  • Difficulty Swallowing
  • Diverticulosis
  • Esophageal Reflux
  • Gastritis
  • GERD
  • Heartburn
  • Hemorrhoids
 
  • Hepatitis
  • Hiatal Hernia
  • Indigestion
  • Irritable Bowel Syndrome
  • Jaundice
  • Liver Disease
  • Malabsorption
  • Nausea Diarrhea
  • Post-OperativeColon Tests
  • Rectal Bleeding
  • Spastic Colon
  • Ulcers
  • Ulcerative Colitis
  • Unexplained Weight Loss
  • Vomiting
DOES A GASTROENTEROLOGIST PERFORM SURGERY?

A Gastroenterologist does not perform surgery. His work is limited to diagnosis and medical treatment. However, under the broad classification of surgery, Gastroenterologists do perform such procedures as liver biopsy and endoscopic ("scope") examinations of the esophagus, stomach, small and large bowel. Also, the Gastroenterologist frequently works with surgeons before and after an operation in helping select the best operation for a particular patient, and in providing follow-up care relevant to the particular digestive disorder.

INITIAL VISIT

Whether you have been referred to us by your personal physician or have made the decision to consult a Gastroenterologist on your own, your initial visit will begin with a discussion of your general health and previous medical history. You should be aware of any past operations or major illnesses that you may have had. Bring a list of any current medications and drug allergies. The doctor will then ask you the reason for your visit in more detail and then perform a complete general physical examination.

Additional diagnostic procedures such as blood tests, x-rays, or endoscopic examinations of the stomach (gastroscopy) or large intestine (colonoscopy) will be performed on most patients undergoing a complete evaluation in a Gastroenterologist's office. To prevent discomfort, most scope tests are done using intravenous sedation and require special preparation. Our staff will explain any special preparation that will be necessary. If you are a diabetic or on Coumadin, please let them know. If sedation is used, you must bring a companion to drive you directly home and plan to take the rest of the day off work.

After the studies are completed, the doctor will explain your situation and recommend a specific treatment. Your questions are encouraged. It is very important that you understand your situation fully and are comfortable with the treatment prescribed.

WILL I STILL NEED MY FAMILY DOCTOR?

Yes, you will. Following consultation, you will usually be referred back to your family doctor for follow-up unless your case requires the continued attention of the Gastroenterologist. Even if you have a problem which requires continuing treatment by a Gastroenterologist, your family doctor will still advise and/or treat you for all other non related medical problems. Your family doctor will continue your treatment if and when your problem no longer requires the attention of a Gastroenterologist. Your family doctor and Gastroenterologist often consult each other about your problems and care.

WHAT ABOUT MY CARE WHEN MY GASTROENTEROLOGIST IS AWAY FOR A WEEKEND OR MEETING?

The answer to this question varies with circumstances. If you are being treated by a Gastroenterologist as well as your personal physician, the latter can handle your case in the absence of the former. However, if the Gastroenterologist has been treating you exclusively, you should call the office for direction. One of our three Gastroenterologists is available for emergencies 24 hours a day 365 days a year.

WHAT ABOUT PHONE CALLS?

Many telephone calls can be avoided by having a member of the family come in with the patient on the initial visit, to be a party to the information and instructions given. Subsequent calls can often be handled by our medical assistants. Our staff is trained to obtain the proper information and either relay an answer from the doctor or arrange for the doctor to call you back. Not all problems can be handled by phone. Many diseases have similar symptoms. If you have developed a complication or a new problem, please understand that it may be necessary to schedule an examination in the office.

When you call during office hours, our staff will help you with appointments, insurance, and other administrative matters. When the office is closed, you may leave a message with the answering service. When the office reopens, our staff will promptly return your call.

In cases of an emergency nature, it is best to go directly to your local Hospital Emergency Room and ask the physician on duty to call us.

REFILLS

The fastest way for you to get authorization to refill your prescriptions is to use our new automated phone system. This system is available to you 24 hours a day every day of the week. Simply call 412 262-1000 and select option 5. Have your prescription bottle in hand and be ready to suppy the following information:
  • your name
  • date of birth
  • name of medication
  • how often taken
  • name of pharmacy
  • pharmacy phone number (with area code)
  • Do you need written prescription mailed to you to send away?
Most prescriptions will be ready the next business day, but call your pharmacy to confirm before pickup.

CANCELING AN APPOINTMENT

If you are unable to keep your appointment, or are going to be late, please call our office as soon as possible. This courtesy allows us to be of service to other patients.

WILL MY INSURANCE COVER ALL THIS?

Fees will vary with the individual case, but generally reflect the specialized ability and time devoted to each problem. Insurance coverage also varies and each case must be handled individually. As you know, the rules are constantly changing, so it is not possible to predetermine the exact amount of coverage. In some circumstances, routine office visits and consultations are not covered by insurance. That includes your initial visit and routine follow-up visits. In those situations, we request payment of your office visit at the time of service. Many HMO cover authorized office visits, but may request that a small co-pay be paid at the time of service. Most medical procedures are at least partially covered by your insurance plan. Pre-authorized HMO procedures are usually covered in full. It is important that you bring the necessary insurance forms with you. Our staff will prepare and submit most forms on your behalf, and bill you for any amount not covered by your insurance carrier. Please keep all receipts for your records and Major Medical.

If you are a member of an HMO, please ask you primary care doctor for a referral slip or authorization number as soon as you make your appointment. Otherwise, your visit or procedure may have to be rescheduled for another day

Your care is important to all of us. If finances are a problem, we can arrange a payment plan for you. If you have any questions, the office assistant will be glad to discuss this further with you.

DOCTOR-PATIENT RELATIONS

These are best when based on a mutual understanding. We make a special effort to explain everything to you regarding your condition. If ever you have any questions, or if something is not clear to you, please do not hesitate to ask.

We have chosen our personnel, office procedures, and medical equipment with much thought and care to provide quality medical services in a pleasant, efficient, and friendly atmosphere. Your medical record is strictly private. We will not give out information regarding your condition to your employer, friends, or relatives without your permission.

If you have any suggestions or complaints regarding our services or fees, please tell us so that we may better serve you and your friends.

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