Digestive Disease Center at MUSC

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Digestive Disease Center at MUSC


Guest: Dr. Mark DeLegge – Gastroenterology & Hepatology

Host: Dr. Linda Austin – Psychiatry

Dr. Mark DeLegge: I am Mark DeLegge. I am the director of Digestive Disease Center at the Medical University of South Carolina. I am a gastroenterologist, meaning, I take care of patients with diseases of the GI tract, esophagus, stomach, small intestine and the colon. My job at the DDC is, really, to set the stage for all the other physicians and all the other colleagues, meaning, secretaries, nurse practitioners, physicians’ assistants, and down the line, to take care of patients. My primary mission is to make sure that when someone comes to see us at the Digestive Disease Center, they walk away with all their questions answered, they walk away happy, and they walk away wanting to come back again.

Dr. Linda Austin: How is a center different from the traditional model for giving digestive healthcare?

Dr. Mark DeLegge: A center concept is very different than the traditional model of getting medical care. For example, I would go see a doctor about, perhaps, abdominal pain, my gastroenterologist. That gastroenterologist would say, boy, I wonder if this is gall bladder disease or, I wonder if this is appendicitis. Then, they would try to set up an appointment with another doctor, a surgeon, perhaps in a different building or on a different street, or somewhere different in the city. You go to see that person and they would see you there, then send a letter back to your gastroenterologist and try to put the whole package together.

With the Digestive Disease Center, all the physicians, the gastroenterologists and a surgeon, work side by side. So, you may come to see the gastroenterologist and they may decide you need a surgeon. They may get you over to see a surgeon that day or they may arrange for an appointment to be seen in the same area, and those two physicians talk on a daily basis. If you got admitted to the hospital, you would see me up there as a gastroenterologist or, perhaps, you would see Dr. David Adams as the surgeon. We are seeing the same patients, working side by side on the same floor, conversing everyday. That results in better patient care. That results in better patient communication. That results in less error.

Dr. Linda Austin: Who are the other members of the healthcare team?

Dr. Mark DeLegge: The other members of the healthcare team, most importantly, are the nurses. The nurses at the Digestive Disease Center are, frankly, stupendous. They are friendly. They are very knowledgeable. Most of them have years of experience in digestive diseases. In addition to that, we have some very good physician extenders. What I mean by a physician extender is like a nurse practitioner or a physician’s assistant. These are people who could see you preliminarily before the physician. A physician would come in to see you as well. It allows us to see a lot more patients. It also allows the patient to ask a lot more questions because they have time with the physician’s assistant and then they have time with the physician.

Dr. Linda Austin: Are there students and residents at the DDC, what role do they play?

Dr. Mark DeLegge: There are almost always students and residents at the Medical University of South Carolina, in the Digestive Disease Center, because we are a teaching institution. That does not mean that you are going to come to the university and be seen by a student or resident doctor alone or that you are going to be asked the same question 400 times, or you are going to be examined 400 times. That is not going to happen. The students and the residents are there to observe, to listen, to understand, to develop the ability to provide compassionate care. That will involve being involved with patients on a day to day basis. I think that is the only way we can really pass down medical school training today. Residency training is with direct patient contact.

Dr. Linda Austin: And, what is the value of that to the patient?

Dr. Mark DeLegge: The value of seeing a resident, or a medical student, in the hospital has many advantages. First of all, what I have learned is, when the patient gives their history, like what is bothering them, when they give it, perhaps twice, there are things that turn up in a second version that did not turn up in the first version, which gives us tremendous insight. Secondly, you know as well as I do, that four eyes are better than two, and eight eyes are certainly better than two. So, we look at, perhaps, a team where we will have myself, a fellow, who is someone training in gastroenterology, a resident in internal medicine, and a medical student. We all put our heads together. We discuss you. We formulate a plan and we enact that plan. It is not just me sitting in an office by myself wondering what is going on or struggling to put things down on paper. This is a team effort that allows you to receive the best care that you will ever receive in medicine.

Dr. Linda Austin: Any new developments in terms of technology at the DDC?

Dr. Mark DeLegge: The Digestive Disease Center, as it stands today, is set up to evaluate and to use new technologies in patient care. What do I mean by that? Well, there is a new area of gastroenterology where we are doing surgery not through your abdominal wall and into your abdominal cavity. We actually go through your mouth, into your stomach, make a little incision in the stomach, go out into the abdominal cavity and, perhaps, remove your gallbladder or your appendix, come back up, sew that hole up, and essentially you have no scars. In that area, we are working very hard. In our labs and in the not too distant future, we will be able to roll that out. The FDA is monitoring the situation and making sure that everyone is safe and well taken care of.

In addition to that, our surgeons at the Digestive Disease Center, meaning, those surgeons who do digestive disease surgery, such as gastric bypass surgery or, perhaps, they are going to remove your whole colon or part of your small intestine, or part of your pancreas, are well trained, and becoming better trained, in a number of areas including mini-incisional surgery, or they are going in through very small incisions, or what we may call ports, and surgeries that save a lot time. What I mean by that is, it was not unusual, perhaps, a few years ago to go in and have your gall bladder removed and it may have taken and hour and a half. It would not be unusual now for you to go in and have your gall bladder removed and to be in there for perhaps 20 to 30 minutes.

The difference is you are not under anesthesia as long. Your recovery time is shorter, and the risk to the patient is much less.

Dr. Linda Austin: It sounds as if the Digestive Disease Center will really be a premier institution in the Southeast.

Dr. Mark DeLegge: Yes, the Digestive Disease Center, for the future, will be a premier institution in the Southeast. We are engaged in a collaborative effort right now with Clemson University and also with the University of South Carolina for bioengineering development. What I mean by that is we have bioengineers and physicians talking to one another. The physicians say, we need this. The bioengineers say, this is how you have to solve that problem, and we work together to make that a reality. So, if I was looking for a place to receive my medical care in the Southeast, perhaps even in the United States, I would really focus on Charleston, South Carolina. It is a dynamic university. The Digestive Disease Center has a tremendous reputation, some very solid physicians, and an eye toward the future.

If you have any questions about the services or programs offered at the Medical University of South Carolina or if you would like to schedule an appointment with one of our physicians, please call MUSC Health Connection: (843) 792-1414.

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