With a new spin on old tech, Bridgewater doctor seeks to improve patient care
Michael Gorman | CBC News | Posted: November 21, 2018 10:00 AM | Last Updated: November 22, 2018
Dr. Hughie Fraser uses ultrasound to help diagnose, treat patients with bowel disorders
A Nova Scotia doctor is using a common piece of medical equipment in a different way — and the generosity of his community — to help improve care for patients dealing with gastrointestinal issues.
In the last year, Dr. Hughie Fraser, a gastroenterologist at the South Shore Regional Hospital in Bridgewater, spent time training in Calgary, Germany and Austria to become qualified to do intestinal ultrasounds.
While the practice is common in Europe, it's less so here in Canada. Fraser said he is the only gastroenterologist qualified to do it in Atlantic Canada.
"Basically, we're measuring bowel wall thickness," said Fraser. "We're measuring how thick is the gut, how inflamed is the gut. And that helps us differentiate irritable bowel syndrome from inflammatory bowel disease."
A non-invasive approach
While it's not appropriate for every patient, Fraser said ultrasound can be a good way to diagnose or rule out inflammatory bowel disease, including Crohn's, and track the health of patients who have the condition.
Gastroenterologists are doctors specially trained in diagnosing and treating diseases of the gastrointestinal tract and liver.
For Fraser, who first learned about intestinal ultrasounds during his residency at the University of Calgary, a particular draw is that it's non-invasive, allows immediate results and better communication with patients, particularly when compared to more traditional tests such as colonoscopy or CT scans.
It doesn't replace other tests, but it provides a far more detailed picture than if Fraser were doing a more traditional exam using only his hands on a patient's abdomen.
"I think you're getting a much fuller history while you're examining them," he said. "There's a better connection between the patient and the physician while you're doing this."
Fraser said the ability for patients to see what's going on inside them in real time and talk with the doctor about what's happening improves patient engagement.
"In a lot of disease aspects we're trying to bring the patient on board and say, 'Take your disease into control for yourself.'"
Emily Oickle appreciates all those aspects of the practice.
The Liverpool resident had a perforation of the bowel during a colonoscopy, which led to surgery to remove part of her bowel. Ultrasound, however, would have shown colonoscopy wasn't a good option for her.
A community steps up
Being able to have access to the device at her doctor's office during an exam and not have to wait for test results is a big deal, said Oickle.
"It's amazing," she said. "You just instantly see."
Getting the technology to Fraser's office wasn't cheap.
At $117,000, it's unlikely doctors are going to be rushing out to buy their own ultrasound machine. That's where the community stepped up.
Big picture system benefits
Fraser made a pitch to the South Shore Regional Hospital Auxiliary, which fully funded the purchase. The auxiliary's mandate is patient comfort and care, and Sharon Ritcey said the group was immediately swayed by Fraser's presentation.
"It's the fact that the auxiliary could be a part of something as innovative as this is," she said. "We're very proud to play a part in that."
Fraser now has his own dedicated ultrasound machine for patients who visit him at his office off hospital grounds in Bridgewater.
Besides what it means for patients, Fraser also sees the effort as a way to help the health-care system.
Interest in training
Financially, ultrasound is a far cheaper and faster option than the more common tests and procedures he might use. There are educational and potential recruiting benefits, too.
Already he's getting calls from doctors who would like to do training and, as someone who regularly takes medical residents, Fraser is exposing future gastroenterologists to the technique early in their careers.
"For them to see this technology and use this technology and have hands-on experience, it really plants the seed with them and piques their interest."