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Choosing a GI
How do you know if your Gastroenterologist has the right qualifications and expertise? Here are 10 questions every patient should ask before meeting with a Gastroenterologist or scheduling a colonoscopy or endoscopy:
1. Is Your Doctor a Gastroenterologist?
Gastroenterologists are considered experts in performing endoscopic procedures (Endoscopy, Colonoscopy, and Flexible Sigmoidoscopy). Studies have shown that Gastroenterologists perform higher quality endoscopic examinations when compared to other physicians. This translates into the more accurate detection of polyps and fewer complications from procedures.
2. Where Did Your Doctor Complete His or Her Training?
Gastroenterologists must first complete a three-year residency in Internal Medicine and are then eligible for additional specialized training called a fellowship in Gastroenterology. This fellowship is generally 3 years long. During their training, fellows receive dedicated training in colonoscopy by expert instructors. This specialized training includes detailed and intensive study of how and when to perform colonoscopies, and optimal methods to complete endoscopic procedures safely and effectively.
Gastroenterologists also learn how to perform advanced endoscopic procedures such as polypectomy (removal of colon polyps), dilation (stretching of narrowed areas) and hemostasis (procedures to control bleeding). Additionally, Gastroenterologists learn how to properly interpret the findings and biopsy results of these studies in order to make appropriate recommendations to treat conditions and/or prevent cancer.
Dr. Marc Edelstein completed his residency and fellowship at UCLA Medical Center. UCLA is consistently rated one of America’s best hospitals (#3 in the country) and it ranks #5 in the United States for the treatment of gastrointestinal disorders (US News and World Report’s 2009 Best Hospital Rankings).
3. Is Your Doctor Board Certified?
Once fellows complete their training, they are then qualified to take the Gastroenterology Board Certification Test administered by the American Board of Internal Medicine. Once they have successfully completed this examination, they are considered “Board Certified.”
Dr. Marc Edelstein is Board Certified in both Internal Medicine and Gastroenterology. Find out if your doctor is Board Certified by contacting the American Board of Internal Medicine at http://www.abim.org/.
4. Is Your Doctor a “Fellow”?
Some Gastroenterologists receive special recognition from national societies when they demonstrate extraordinary achievements in the field of Internal Medicine or Gastroenterology. The American College of Physicians and the American College of Gastroenterology designate these physicians as “fellows” and the suffixes FACP and FACG are added to denote these honors. This means that these physicians have fulfilled the respective organizations’ rigorous requirements to gain these added distinctions.
Dr. Marc Edelstein has been elected a Fellow of the American College of Physicians and the American College of Gastroenterology.
5. Is Your Doctor Affiliated with Any Hospitals?
Experienced and qualified physicians hold attending and admitting privileges at accredited, quality, hospitals and surgical centers.
Dr. Marc Edelstein has full attending and admitting privileges at Cedars-Sinai Medical Center. Dr. Edelstein has been teaching medical students, residents, and fellows at Cedars-Sinai Medical Center for the past 5 years. He is a member of the Digestive Diseases Center of Excellence as well as the Colorectal Cancer Center of Excellence.
Cedars-Sinai is consistently rated one of America’s best hospitals, and it ranks #10 in the United States for the treatment of gastrointestinal disorders (US News and World Report’s 2009 Best Hospital Rankings).
6. Where Will My Procedure Be Performed?
Patients are usually offered a choice of where they can have their colonoscopy performed. Choices may include an ambulatory surgical center (ASC) or a hospital. If you plan to have your procedure performed at an ASC, make sure that the center is accredited by a national organization such as AAAHC (Accreditation Association for Ambulatory Health Care) and certified by Medicare. AAAHC certification requires demonstrated commitment to providing high-quality health care by meeting or exceeding the Accreditation Association's meticulous standards. Additionally, all outpatient centers are mandated to have a transfer agreement with a local hospital in case of an emergency. This is usually the closest hospital to the center. Always make sure that the center you choose is affiliated with a major medical center and make sure your doctor has active privileges there as well.
Dr. Marc Edelstein has active privileges at a number of outstanding, fully credentialed surgical centers for outpatient procedures, including Robertson Surgical Center and Cedars-Sinai Medical Center. Dr. Marc Edelstein is the founder and Medical Director of Robertson Surgical Center, a state-of the-art endoscopy center credentialed by AAAHC and certified by Medicare. Robertson Surgical Center has a transfer agreement with Cedars-Sinai Medical Center in case of an emergency. Read more
7. How Often Does Your Doctor Complete the Colonoscopy?
Quality evaluation of the colon during Colonosocpy consists of evaluating the entire colon and is defined as the passage of the colonoscope to the most proximal portion of the colon called the cecum. The term for this is called the “Cecal Intubation Rate.” Experienced Gastroenterologists should be able to intubate the cecum in >90% of all cases and in >95% of cases when the indication is “screening” in a healthy adult.
Dr. Marc Edelstein is considered an expert in performing colonoscopies. Cecal Intubation Rates are routinely measured, and are nearly 100%.
8. How Long Does Your Doctor Take to Examine Your Colon?
Studies have demonstrated increased detection of significant lesions within the colon in Colonoscopies where the withdrawal time (the time is takes a Gastroenterologist to withdraw the colonoscope while examining the inside lining of the colon) is 6 minutes or more.
Dr. Marc Edelstein is considered an expert in performing colonoscopies. Withdrawal time for his procedures is routinely measured and is always greater than 6 minutes.
9. How Often Are Polyps Found by Your Doctor?
Gastroenterologists may have variable skill levels for finding and removing precancerous growths of tissue called adenomas during a colonoscopy. Among healthy asymptomatic patients undergoing a screening colonoscopy, adenomas should be detected in >25% of men and >15% of women more than 50 years old.
Dr. Marc Edelstein is considered an expert in performing colonoscopies. Adenoma detection rates are routinely measured for his patients and are well above the national standards of care.
10. How Many Perforations Has Your Doctor Had?
Perforation is the most serious complication in the short term during or after a colonoscopy. The rates of colonoscopic perforation vary widely in the medical literature. Considering all of the available data, perforation rates should be less than 1 in 500 cases overall, or less than 1 in 1000 in screening patients.
Dr. Marc Edelstein is considered an expert in performing colonoscopies. His rate of complications is well below the national standards of care.
Does your baby cry or fuss excessively, without apparent cause? Many babies labeled "colicky" actually suffer from treatable gastrointestinal disorders like infant GERD. Dr. Susan Edelstein can help.…Read more
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