Below are a selection of frequently asked questions.
It is standard practice to have a referral from your GP or another specialist to see Dr Pavey. Your referral ideally provides Dr Pavey with essential information about you and your health history which is important to him providing you with the right care.
You also need a valid referral in order to claim your eligible rebate(s) from Medicare or your private health fund.
Yes. You may schedule a consultation or screening colonoscopy with the practice without a referral from a GP or Specialist. Just be aware that you will not be able to claim a rebate through Medicare or your private health fund.
If you would like to self-refer and are not concerned about claiming rebates through Medicare or a private health fund, please contact our helpful staff to discuss your options and provide your health profile.
Even if you choose to self-refer, we can provide any doctor you designate with a copy of your report(s) and summary of your care with Dr Pavey or his colleagues.
A Gastroenterologist is a physician with dedicated training and unique and extensive experience in the management of diseases of the gastrointestinal tract and liver.
Gastroenterology is the study of the normal function and diseases of the esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts and liver. It involves a detailed understanding of the normal action (physiology) of the gastrointestinal organs including the movement of material through the stomach and intestine (motility), the digestion and absorption of nutrients into the body, removal of waste from the system, and the function of the liver as a digestive organ. It includes common and important conditions such as colon polyps and cancer, hepatitis, gastroesophageal reflux (heartburn), peptic ulcer disease, colitis, gallbladder and biliary tract disease, nutritional problems, Irritable Bowel Syndrome (IBS), and pancreatitis. In essence, all normal activity and disease of the digestive organs are part of the study of Gastroenterology.
A Gastroenterologist must first complete a three-year Internal Medicine residency and is then eligible for additional specialized training (fellowship) in Gastroenterology. This fellowship is generally 3 years long so by the time Gastroenterologists have completed their training, they have had at least 7 years of additional specialized education following medical school. In some cases, a Gastroenterologist will go on to do additional Advanced Fellowship training to hone specific technical skills which can range in length up to 2 years.
Gastroenterology fellowship training is an intense, rigorous program where future Gastroenterologists learn directly from nationally recognized experts in the field and develop a detailed understanding of gastrointestinal diseases. They learn how to evaluate patients with gastrointestinal complaints, treat a broad range of conditions, and provide recommendations to maintain health and prevent disease. They learn to care for patients in the office as well as in the hospital.
Gastroenterologists also receive dedicated training in endoscopy (upper endoscopy, sigmoidoscopy, and colonoscopy) by expert instructors. Endoscopy is the use of narrow, flexible lighted tubes with built-in video cameras, to visualize the inside of the intestinal tract. This specialized training includes detailed and intensive study of how and when to perform endoscopy, optimal methods to complete these tests safely and effectively, and the use of sedating medications to ensure the comfort and safety of patients. Gastroenterology trainees also learn how to perform advanced endoscopic procedures such as polypectomy (removal of colon polyps), esophageal and intestinal dilation (stretching of narrowed areas), and hemostasis (injection or cautery to stop bleeding). Importantly, 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.
Some Gastroenterologists also receive directed training in advanced procedures using endoscopes such as endoscopic biliary examination (endoscopic retrograde cholangiopancreatography or ERCP), removal of tumours without surgery (endoscopic mucosal resection or EMR), placement of internal drainage tubes (stents) and endoscopic ultrasound (EUS). This provides them with the training necessary to non-surgically remove stones in the bile ducts, evaluate and treat tumours of the gastrointestinal tract and liver, and provide minimally invasive alternatives to surgery for some patients.
The most critical emphasis during the training period is attention to detail and incorporation of their comprehensive knowledge of the entire gastrointestinal tract to provide the highest quality endoscopy and consultative services. The final product is a highly trained specialist with a unique combination of broad scientific knowledge, general Internal Medicine training, superior endoscopic skills and experience, and the ability to integrate these elements to provide optimal health care for patients. This advanced fellowship training is overseen by national societies committed to ensuring high quality and uniform education. These groups include the Royal Australasian College of Physicians (RACP).
Dr Pavey is one of eight doctors on the Conjoint Committee for the Recognition of Training of Gastrointestinal Endoscopy (CCRTGE) which assesses and recognises the ERCP training for Gastroenterologists and Surgeons in Australia.
MBBS stands for Bachelor of Medicine, Bachelor of Surgery, and is awarded to medical practitioners upon graduation from university.
FRACP stands for “Fellow of the Royal Australasian College of Physicians”.
Fellowship is a highly regarded qualification, given the extended and rigorous training program, the wide experience & knowledge base, and general commitment required for its attainment.
Fellowship of the Royal Australasian College of Physicians (or its recognised equivalent) is a requirement to be recognised as a Specialist or Consultant Physician, in General (Internal) Medicine or the relevant subspecialty, in Australia and New Zealand.
The unique training that Gastroenterologists complete provides them with the ability to provide high quality, comprehensive care for patients with a wide variety of gastrointestinal ailments. Gastroenterologists perform the bulk of research involving gastrointestinal endoscopic procedures as well as the interpretation of results, and are considered experts in the field. Studies have shown that Gastroenterologists perform higher quality colonoscopy examinations and comprehensive consultative services when compared to other physicians. This translates into more accurate detection of polyps and cancer by colonoscopy when performed by Gastroenterologists, fewer complications from procedures and fewer days in the hospital for many gastrointestinal conditions managed by trained gastroenterology specialists. It is this ability to provide more complete, accurate, and thorough care for patients with gastrointestinal conditions, which distinguishes Gastroenterologists from other physicians or surgeons that provide some similar services.
After an endoscopy, the patient is observed and monitored by a qualified individual in the endoscopy room or a recovery area until a significant portion of the medication has worn off. Occasionally the patient is left with a mild sore throat, which may respond to saline gargles, or chamomile tea. It may last for weeks or not happen at all. The patient may have a feeling of distention from the insufflated air that was used during the procedure. Both problems are mild and fleeting. When fully recovered, the patient will be instructed when to resume their usual diet (probably within a few hours) and will be allowed to be taken home. You may experience some irritation or discomfort in the vein area where the IV sedation was introduced. You will be alert and physically functional, but please note that sedation will affect your judgement. Because of the use of sedation, most facilities mandate that the patient be taken home by another person and that he or she not sign any legal documents, drive or handle machinery for the remainder of the day.
Interventional Endoscopy is used to diagnose and treat diseases. Interventional Endoscopy encompasses a variety of endoscopic procedures and is used when a more comprehensive or complex technical approach is needed, beyond what regular endoscopic techniques can achieve. By combining advanced imaging and device technology with technical expertise, physicians like Dr Pavey are helping patients to avoid more invasive traditional treatment approaches such as surgery. Endoscopy procedures are minimally invasive, meaning they are performed using thin flexible tubes advanced through the body’s natural orifices such as the mouth and rectum – thus avoiding the complications associated with surgery and providing faster recovery times. Interventional endoscopy is utilized in the treatment of bile duct stones, stenting of the gastrointestinal tract, treatment of gastrointestinal bleeding, and the diagnosis and treatment of tumours involving the esophagus, stomach, biliary system, pancreas, small bowel and colon.
Dr Pavey typically conducts procedures on an outpatient basis, and patients often return home the same day.
The human gastrointestinal tract, or GI tract, or GIT, is an organ system responsible for consuming and digesting foodstuffs, absorbing nutrients, and expelling waste.
The tract consists of the stomach and intestines, and is divided into the upper and lower gastrointestinal tracts. However, by the broadest definition, the GI tract includes all structures between the mouth and the anus. On the other hand, the digestive system is a broader term that includes other structures, including the digestive organs and their accessories. The tract may also be divided into foregut, midgut, and hindgut, reflecting the embryological origin of each segment.
The whole digestive tract is about nine metres (30 feet) long.
The GI tract releases hormones from enzymes to help regulate the digestive process. These hormones, including gastrin, secretin, cholecystokinin, and ghrelin, are mediated through either intracrine or autocrine mechanisms.