This post is an informational reference for current patients of mine. While the general public is welcome to read it, the specifics of the following applies only to my current patients:
One of my goals in starting Dr. Fischer, MD, was to be able to break free of the restrictions of insurance driven medicine and offer my patients what I believe is the best care. In this vein, I am excited to announce that we will be holding a screening clinic for esophageal cancer on the afternoon of Tuesday, October 28th.
Esophageal cancer has become much more common over the past few decades, and is often deadly. Now a new technology, called Esoguard, has been developed and approved by the FDA. Esoguard is able to detect pre-cancerous changes in the esophagus years before they would go on to be a problem. I believe that in the future this technology will be widely used in the American medical system, but right now most insurers have not gotten around to approving it, and it will be a long time before this technology is standardized and deployed widely at more traditional medical offices.
However, I am excited to announce that – for my patients who qualify – this technology is available now, at no out of pocket cost.
If you are a current patient of mine who is interested in learning more, please read the rest of this very carefully.
Who qualifies to have this testing?
To sign up for testing, you must meet the following criteria:
Be a current patient of Dr. Fischer, MD
Not already have a known diagnosis of esophageal cancer or Barrett’s esophagus
Not have already had an endoscopy (sometimes called an EGD, or an “upper scope”) within the past two years
Be willing to follow up any abnormal result by being referred to a gastroenterologist for an endoscopy
Meet at least three of the seven criteria for which the FDA has approved the test, which are:
At least 50 years old
Caucasian race
Male
Heartburn/acid reflux and/or take any medication for heartburn/acid reflux
Overweight (BMI of 30 or higher)
Current or former smoker
Family member with esophageal cancer or Barrett’s esophagus
What does the testing entail?
At your appointment time you will arrive here at my office. The entire visit will last about 15 minutes, most of which will be filling out paperwork with a representative from Esoguard. Then a nurse from Esoguard will perform a brief procedure (which typically only takes 2-3 minutes) in which you swallow a small capsule with a catheter attached to it. They will use the catheter to retrieve the capsule after a moment, and then your visit will be done.
The capsule will be sent to a lab and about two weeks later I will get a report with your results, which I will then call you to discuss.
Here’s a video that shows an example of the procedure being done, if you’d like to see more:
What are the significances of a positive or negative test result?
While there are never 100% guarantees in medicine, studies have shown that a negative result is extremely reassuring. Very few people who have this will go on to develop esophageal cancer over the coming decade.
By contrast, a positive result DOES NOT MEAN that you have esophageal cancer or pre-cancerous changes. It does however mean that the possibility cannot be excluded, and therefore you will be referred to a gastroenterologist to have a procedure called an endoscopy performed for further evaluation. This is a very important concept: false positives are possible with this test, and if you are not willing to follow up an abnormal result by going for an endoscopy procedure, then you should not have Esoguard testing.
How is this available at no cost?
When you check in for your appointment, the representative from Esoguard will take your insurance information. They will then attempt to bill your insurance for the procedure. However, they understand that many insurers will deny payment, and they have assured me that in those cases, they will write off the cost of the procedure rather than billing my patients for it. (Technically, due to legal regulations, they will have to send you a bill, but they will advise you to ignore it and not pay it). This type of practice is common for new medical technologies who are working to become more widely known and increase market share. As in many business models, a loss of money that helps to increase market share now can lead to a big profit later on.
I meet all of the above criteria and am interested in being tested. What do I need to do next?
Call or text the office to schedule an appointment on the afternoon of Tuesday, October 28th. Appointments will be in 15 minute increments between the hours of 1:00pm and 3:45 pm (e.g. 1:00, 1:15, 1:30, etc).
If you are interested and meet the criteria for screening, but cannot make that date, please let me know. I anticipate running another event like this in the future. There may also be opportunities to have you screened at another location sometime in the next few months.
