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Telemedicine Consult - Dr. Gish
Schedule Telemedicine Consult with Dr. Gish
Telemedicine Consult Services via Folsom Gastromed
Telemedicine Consult Services
WHO:
Dr. Gish is a Hepatologist specializing in all forms of liver disease, liver cancer and liver transplant. Dr. Gish has partnered with TeleMed2U to provide telemedicine consultative services for patients with liver disease.
WHAT:TeleMed2U is a telemedicine-based multi-specialty clinical practice increasing access to specialist providers providing, “healthcare anywhere and everywhere.” The telemedicine consultation will be conducted through our HIPAA and HITECH compliant platform. Connectivity testing will be done in advance to ensure you can connect via our telemedicine platform. Following the consultation, a clinical note will be provided including a summary of your liver consultation with Dr. Gish and his consultative recommendations.
COST:Payment will be processed through an online secure transaction portal. The fees for consultative services are:
- Initial 60 minute consultation per patient: $500.00
- Follow Up 30 minute consultation per patient: $300.00
If you’d like to continue, please click Next to complete the form and we will contact you to schedule connectivity testing. During the test you will have the opportunity to determine the method of providing medical records, discuss appointment availability as well as discuss any additional questions that you have. If you are a healthcare facility interested in services, please complete the form and we can discuss the options that are right for you and your patients.
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Recorded Podcasts
When Do I Use Resmetirom for Nonalcoholic Steatohepatitis (NASH)
March 14th, 2025
With the recent renaming of NASH to MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and the evolving landscape of treatment, when is the right time to use resmetirom? In this episode, we explore how this thyroid hormone receptor-β agonist is changing the management of MASLD, particularly in patients with significant fibrosis. We also break down non-invasive testing methods—for instance, elastography, CAP scores, (FibroScan), ELF score, and FIB4—to help stage patients and guide treatment decisions.
Tune in as we discuss the science, clinical guidelines, and real-world considerations for incorporating resmetirom into patient care!
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Primary Biliary Cholangitis & Second Line Therapy
February 27th, 2025
In this episode, Dr. Robert Gish, a leading expert in liver diseases, dives deep into second-line therapies for Primary Biliary Cholangitis (PBC), a chronic autoimmune liver disease. Dr. Gish explores key treatment options, including Ursodeoxycholic Acid (UDCA/"Urso" first-line), obeticholic acid (OCA/Ocaliva), elafibranor, and eeladelpar, discussing their mechanisms, benefits, and how they can be used to manage PBC. He also addresses the persistent challenge of managing pruritus (itch), a common symptom for patients. With a variety of treatment options available, Dr. Gish emphasizes that no PBC patient, in our ideal patient management world, should be progressing to the point of needing a liver transplant, and discusses how careful management can prevent disease progression. This episode provides valuable insights for both patients and healthcare providers looking to improve outcomes in PBC treatment.
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Exploring HepQuant DuO - Liver Function Test
February 14th, 2025
Join Dr. Robert Gish, a leading expert in liver health and diagnostics, in this deep dive into HepQuant DuO, a groundbreaking tool for assessing liver function. Dr. Gish will discuss how HepQuant DuO works, its significance in clinical practice, and the impact it has on patient care. Whether you're a healthcare professional, a student, or simply curious about liver health, this podcast promises to enhance your understanding of modern diagnostics and the future of liver disease management. Tune in to discover how HepQuant DuO is revolutionizing the way we approach liver assessment!
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When and How to Use the Direct Bilirubin
January 16th, 2025
In this episode, Dr. Robert Gish explores liver function tests (bilirubin, albumin and INR), with a focus on total and more importantly on direct bilirubin. He explains how these tests help doctors assess liver health and clarifies the difference between liver function tests and liver enzyme tests.
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Hepatitis Delta
January 2nd, 2025
In this enlightening episode, Dr. Robert Gish, a renowned expert in hepatology, explores the complexities of Hepatitis Delta (HDV), a deadly form of viral hepatitis. Dr. Gish emphasizes why all Hepatitis B (HBV) patients must be tested for HDV total antibodies, and if positive, further tested for HDV RNA quantification. He explains the significant risks HDV poses to liver health, its interaction with HBV, and the urgent need for proper diagnosis and management.
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Statins in Chronic Liver Disease
December 21st, 2024
In this episode Dr. Gish takes a deep dive into statins—one of the most widely prescribed medications for managing cholesterol and preventing heart disease. Dr. Gish breaks down the risks and benefits of statins for chronic liver disease, offering clear, evidence-based insights on how to effectively incorporate them into patient care.
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Cuvrior: A New Treatment for Wilson Disease
December 5th, 2024
Join Dr. Robert Gish in this insightful episode as he discusses the latest breakthrough in Wilson disease treatment: Cuvrior. This innovative medication offers a new option for patients with Wilson disease, featuring a remarkable safety profile, the convenience of no refrigeration, and future possibility of once-a-day dosing (research in progress). Dr. Gish explores how Cuvrior is revolutionizing care with its potential to be more affordable than traditional treatments like trientine, depending on insurance and contracts. Listen in for an in-depth discussion on how Cuvrior is setting a new standard in the management of Wilson disease, providing hope for patients seeking effective, accessible, and safe treatment options. There is also a new assay in development for nonceruloplasmin copper concentration that will help with patient management (research update to follow).
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How To Use Noninvasive Testing (NITs) in Your Practice Today
November 22nd, 2024
In this episode, Dr. Robert Gish discussed the evolving world of Noninvasive Testing (NITs) for liver disease, focusing on their critical role in diagnosing and staging liver conditions. Dr. Gish breaks down the latest Noninvasive Liver Disease Assessment (NILDA), with an emphasis on fibrosis staging, and explores how these cutting-edge tools can also assess liver fat, inflammation, and disease activity. He explains why NITs are a cornerstone in providing optimal care for liver patients, how these tools should be part of your toolchest and are foundational for the best care of your liver patients.
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When to Order a Gamma-Glutamyl Transferase (GGT)
November 7th, 2024
In this episode, Dr. Robert Gish, a renowned expert in hepatology, examines the critical role of the Gamma-Glutamyl Transferase (GGT) test in assessing liver health. Dr. Gish explains why GGT is an essential part of the liver enzyme panel and how it provides vital insights into a patient's inflammatory status, especially when alkaline phosphatase (ALP) alone may not be sufficient due to its limited sensitivity and specificity.
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Thromboelastography (TEG)
October 24th, 2024
In this latest episode of "Everything Liver," Dr. Robert Gish delves into the intricacies of thromboelastography (TEG) and its pivotal role in patient care. Join Dr. Gish as he breaks down how to interpret TEG test results, emphasizing its importance in the clinical setting. With an engaging analogy, he compares TEG to the cutting-edge F-35 jet, showcasing its precision and versatility, while likening the traditional INR test to a Model T—valuable but limited in scope. Discover why understanding TEG is essential for optimizing treatment plans and improving patient outcomes in liver health. Tune in for insights that could revolutionize your approach to coagulation testing!
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Hepatitis B Virus - Treat All Approach
October 10th, 2024
Join Dr. Gish, a leading expert in infectious diseases, as he delves into the complexities of Hepatitis B Virus (HBV) and the innovative "Treat All" approach. In this episode, Dr. Gish explores the 10 important reasons why we propose to treat all patient with HBV who are HBV DNA+
- HBV DNA+ correlates with risk: risk of HCC, cirrhosis, liver transplant and death
- Treatment decreases risk: 70% less HCC and 90% decrease in cirrhosis and liver transplant
- Decrease Risk of Transmission U=U
- Treatment to prevent infection
- Reduce Stigma
- Improve QOL
- Reduce HBV related extrahepatic disease
- Decrease other HBV related cancers (bile duct cancer is an example)
- Reduce Discrimination
- Partner with Patients who request treatment
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When and how do you use phosphatidylethanol (PETH) testing in your clinical practice
September 26th, 2024
In this episode, Dr. Gish delves into the crucial role of phosphatidylethanol (PETH) testing in detecting alcohol use among patients in your general clinic, for those who have undergone liver transplants or individuals being evaluated for liver transplantation. Understanding alcohol consumption quantity is vital for patient safety and optimal outcomes, and PETH serves as an invaluable tool in this process.
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Progressive familial intrahepatic cholestasis (PFIC) and genetic testing for cholestatic liver disease
September 12th, 2024
Welcome back to Dr. Robert Gish's podcast series! In this episode, he's diving deep into the world of Cholestasis with a focus on Progressive Familial Intrahepatic Cholestasis, or PFIC. Dr. Gish will unravel the complexities of this rare and challenging liver condition, exploring its genetic underpinnings and the latest advancements in genetic testing for many other forms of cholestasis as well.
PFIC is a group of genetic disorders that impair bile flow, leading to progressive liver damage. Understanding its genetic basis is crucial for accurate diagnosis, prognosis, and treatment planning. There are 77 mutations that can now be detected using the Prevention Genetics Panel that have or may have a link to various forms of cholestasis. Dr. Gish will shed light on the latest developments in genetic testing for cholestatic liver diseases, discussing how these advancements can improve patient outcomes and tailor personalized treatment strategies.
Whether you're a healthcare professional, a patient, or simply curious about liver health, this episode promises valuable insights and perspectives. Don’t miss it as we continue our journey into the cutting-edge world of liver disease research and treatment with one of the leading experts in the field.
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HCC Screening And Surveillance Risk Biomarkers
August 29th, 2024
In his first podcast, Dr. Robert Gish discusses Hepatocellular carcinoma (HCC) Screening And Surveillance Risk Biomarkers, how to use and what to order.
Learn more about Dr. Gish at his website www.robertgish.com and send any questions or feedback to him at rgish@robertgish.com
Dr. Gish will be releasing new podcasts every other week so tune in for more.
Thank you for listening!
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Contact Dr. Robert Gish
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