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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 Webinars
Hepatitis B: Update 2025 and beyond
March 28th, 2025
- Describe the epidemiology and virology of hepatitis B and how this links to testing and linkage to care
- Summarize the natural history of hepatitis B
- Recommend screening for HBV: Test all adults with triple panel
- Facts and Fictions of HBV:
- HBV is blood transmitted
- Clarity of anti-HBc test interpretation and linkage to care
- Treatment options for HBV: Consider to treat all HBV DNA+
- Pregnancy
- Liver Transplant
- New Treatments
- Vaccination: Current discussions
- 5 line guidelines
Open in YouTube Download Slides
How to use motivational interviewing in a Hepatology/GI practice for Alcohol Use Disorder (AUD)
October 9th, 2024
The goal of MI is to facilitate:
- Fully informed about the dangers of AUD AALD
- Deeply thought out pathway to liver and body health
- Internally motivated choices about drinking vs non drinking behavior
- Not to change AUD behavior….. directly
Open in YouTube Download Slides
MAFLD MASLD NASH ......
September 5th, 2024
- NAFLD
- Nonalcoholic Fatty Liver Disease
- MASLD, MetALD, (AALSD and EASL) and MAFLD (APASL/70 countries) {is more expansive}, inclusive and non-stigmatizing
- Metabolic Associated Steatotic Liver Disease
- Metabolic Associated Fatty Liver Disease
- Lean MAFLD, normal BMI fatty liver
- OLD NAMES NASH NAFL NAFLD
- NonAlcoholic SteatoHepatitis........
- Steatosis/Steatotic
- Fatty changes
- Hepatitis
- Inflammation
- ASH, AALD/ALD, AUD, AH
- Alcohol induced steatohepatitis, Alcohol Associated Liver Disease, Alcohol Use Disorder, Alcoholic
- CASH/BASH combined/both: ASH + NASH old terms - out of date
Open in YouTube Download Slides
"Hepatitis B: 2024 and Beyond" by Prof. Robert Gish
March 21st, 2024
- Describe he epidemiology and virology of hepatitis B and how this links to testing and linkage to care
- Summarize the natural history of hepatitis B
- Recommend screening for HBV: Test all adults with triple panel
- Facts and Fictions of HBV:
- HBV is blood transmitted
- Clarity of anti-HBc test interpretation and linkage to care
- Treatment options for HBV: Consider to treat all HBV DNA+
- Pregnancy
- Liver Transplant
- New Treatments
- Vaccination: Current discussions
- 5 line guidelines
Open in YouTube
Screening for Liver Disease: The Work-up and Diagnosis of Acute and Chronic Liver Disease - 2023
October 21st, 2023
Who should be tested for liver disease?
- Symptom based
- Risk based
- Referral due to elevated liver tests on blood tests
- Referral due to abnormal liver imaging
Open in YouTube Download Slides
Drug, Supplement and Herbal Induced Liver Disease
June 5th, 2023
At the end of this lecture you will:
- Be able to classify DILI by mechanism and histology
- Be familiar with the good and bad of biotransformation
- Understand the structural basis of DILI
- Recognize hypersensitivity as a mechanism of DILI
- Be familiar with some drugs that commonly cause DILI
Open in YouTube Download Slides
HCC Biomarkers Current and Future Use
December 20th, 2022
HBV 5 Line Guideline (Proposed):
- Test all adults for Hepatitis B with the triple panel: HBsAg, AntiHBc total, AntiHBs
- Vaccinate all adults for HBV who are HBV triple panel negative
- If HB surface antigen positive, link to HBV DNA quant and Hep delta total antibody
- Treat all individuals who are HBV DNA positive
- Stage liver disease and start surveillance for liver cancer and other forms of Liver Disease
Open in YouTube Download Slides
Witte Lecture 2022
November 9th, 2022
The 2022 Bruce Witte Lecture, "HBV: expanding treatments guidelines: where are we and where are we going?
Open in YouTube Download Slides
MAFLD 2022 Updates
October 18th, 2022
Updates on the name change and management of metabolic –associated steatotic fatty liver disease (MASLD - MAFLD 2023)
Open in YouTube Download Slides (Updated 2023)
How to move to global elimination of HBV
August 1st, 2022
Test all adults & Vaccinate all patients who are triple panel negative, treat all who are HBV DNA+
Open in YouTube Download Slides
NASH and Cardiovascular Lecture
February 26th, 2022
Dr. Gish - La Maestra
NASH and Cardiovascular Lecture
Recorded on Oct 18, 2021 12:03 PM
Open in YouTube
Evaluation of a Patient for Cirrrhosis and Subsequent Medical Management
February 26th, 2022
Dr. Gish - La Maestra
Evaluation of a Patient for Cirrrhosis and Subsequent Medical Management
Recorded on Nov 8, 2021 12:19 PM
Open in YouTube
Drug, Supplement and Herbal Induced Liver Disease
January 25th, 2022
At the end of this lecture you will:
- Be able to classify DILI by mechanism and histology
- Be familiar with the good and bad of biotransformation
- Understand the structural basis of DILI
- Recognize hypersensitivity as a mechanism of DILI
- Be familiar with some drugs that commonly cause DILI
Open in YouTube Download Slides
NASH ASH vs. MAFLD: Diagnostic and Treatment Implications
January 13th, 2022
- MAFLD is part of a systemic inflammatory process and other diseases (cardiovascular) are associated
- More prevalent than previously estimated
- Hispanics and diabetics at particular risk
- Biopsy is required for research studies not practical in clinical practice, steatosis benign from hepatic point of view, NASH can progress to cirrhosis
- Smoking and excess alcohol are bad, but coffee, tea and sleep likely good
Open in YouTube Download Slides
ICU care of the liver patient:Also : When to Transfer Liver Patients to the ICU and to a LT center
January 5th, 2022
Overview of the Care of the LIVER Patient in the Hospital“when to consider a transfer" - The Simple Rules and Guidelines
Open in YouTube Download Slides
Hepatitis B: Update 2021
November 22nd, 2021
- Describe the epidemiology and virology of hepatitis B and how this links to testing
- Summarize the natural history of hepatitis B
- Recommend screening for HBV
- Facts and Fictions of HBV
- Treatment options for HBV
Open in YouTube Download Slides
PBC Q&A | Dr Robert Gish and our CEO Collette Thain
September 23rd, 2021
Topics covered in this Q&A include: How to manage fatigue. Talking to pharmacists about drug interactions. PBC and diet. PBC and Covid-19 vaccinations.
Open in YouTube
The Role of Next-Gen Noninvasive Tests (NITs)in NAFLD/NASH
March 17th, 2021
- NITS use and thinking in real life
- NAFLD/NASH and NITS
- Identifying Fibrosis
- Growing Importance of Steatosis
- NITs: Simultaneous v. Sequential Us
- Conclusions
Download Slides
Metabolic and Genetic Liver Diseases - A focus on Wilson Disease
March 9th, 2021
- Autosomal recessive disorder of copper metabolism
- Excess copper accumulation in hepatocytes and release of excess copper into other tissues, particularly the brain
- Liver Disease includes
- autoimmune type hepatitis
- fulminant hepatic failure
- chronic liver disease
- Rare Condition; 1:30,000 and carrier state of 1:90
- Higher in China (2-3 fold) and Asian Countries than in the West
Open in YouTube Download Slides
Hepatitis B Virus
February 9th, 2021
- Replication of HBV
- More information is needed about use of clotting tests in cirrhosis
- The Incidence and 5-Year Survival of HCC in United States
- Global Prevalence of Chronic Hepatitis B
- Screening for HBV infection
- Hepatitis B vaccine and impacts
- Natural History of Chronic HBV
Download Slides
NITS and NASH - What We Know in 2021
February 2nd, 2021
- Accurate noninvasive tests are strongly needed to identify patients with advanced fibrosis.
- ALT or AST are not sensitive for NAFLD/NASH alone.
- Alone, AST, FIB-4, NFS, VCTE lack sufficient PPV to predict NASH and fibrosis.
- Thus, we need to use combination testing:
- Sequential (best for primary care) or
- Simultaneous
- Many noninvasive tests, alone or in combination, being studied for:
- Diagnosis of NASH patients with NAS ≥ 4 and fibrosis ≥ F2
- Assessment of therapeutic response(for drug therapy in near future)
- Assessment of long-term patient outcomes (for drug therapy in near future)
Open in YouTube Download Slides
Liver Disease, Liver Failure, Cirrhosis and Coagulation - A Paradigm of Awareness
January 29th, 2021
- Coagulation in chronic liver disease is a complex, “balanced” process
- More information is needed about use of clotting tests in cirrhosis
- Risk of thrombosis may be present even in setting of apparent mild, moderate or severe coagulopathy
- Recognize superimposed conditions: sepsis, uremia, hyperfibrinolysis
- Start the use of TEG at your institution to help decrease factor use
- Don’t treat the INR: treat the patient
Open in YouTube Download Slides
When to Transfer Liver Patients to the ICU and to a LT Center
December 18th, 2020
Overview of the Care of the LIVER Patient in the Hospital“when to consider a transfer”
Open in YouTube Download Slides
Screening for Liver Disease: The Work-up and Diagnosis of Acute and Chronic Liver Disease
October 14th, 2020
Open in YouTube Download Slides
New and Advanced Treatment Strategies for Hepatitis B
October 14th, 2020
Presented at the 17th Vietnam National Congress of Cardiology
Open in YouTube Download Slides
When to Transfer Liver Patients to the ICU and to a LT Center
September 24th, 2020
Overview of the Care of the LIVER Patient in the Hospital“when to consider a transfer”
Open in YouTube Download Slides
NASH ASH vs. MAFLD
September 23rd, 2020
NASH ASH vs. MAFLD: Diagnostic and Treatment Implications
Open in YouTube Download Slides
Primary Biliary Cholangitis
September 21st, 2020
Diagnosis and Management of PBC Liver Disease and Other Complications
Open in YouTube Download Slides
Contact Dr. Robert Gish
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