Dr. Smith performs operation on out-of-town patients on Wednesdays. A typical itinerary for an out of patient would look like this: Monday or early Tuesday Arrive in Atlanta. Tuesday Office visit with Dr. Smith where the plan made during a virtual visit would be reviewed. A preoperative visit at Piedmont Atlanta Hospital with the anesthesia team. Wednesday Admit to the hospital for surgery some time that day. Possible discharge later that day, or admitted for an overnight stay. Thursday If overnight stay, discharge late morning or early afternoon. Friday or Into Weekend Travel home. First follow-up visit is typically at one month from the day of surgery and is a virtual visit, no need to travel back to Atlanta.

Yes, a significant part of Dr. Smith's practice is seeing patients who live throughout the US and even internationally. Patient can send their records to Dr. Smith, including recent testing, and during a virtual appointment decisions can be made about traveling to Atlanta for surgery with Dr. Smith.

Yes, we provide virtual visits using Doxy.me. You will need to be connected to a high speed internet network, and not be riding in a car or moving. The office staff will instruct you on how to connect for the visit. IT IS VERY IMPORTANT THAT YOU TEST YOUR INTERNET CONNECTION AND DEVICE BEFORE THE APPOINTMENT TIME. If too much of the time is spent getting the connection to work the appointment will need to be rescheduled.

Yes, Dr. Smith does see Medicare patients, but Medicare patients will not be able to use their Medicare benefits to pay Dr. Smith's professional fees. They can use their Medicare benefits to pay for all the other costs related to the care Dr. Smith provides. Statement on Medicare. For example, if a Medicare patient chooses Dr. Smith for their care, this how their Medicare benefit can be used: Any and all testing not performed by Dr Smith - YES Hospital fees for any care Dr. Smith provides including testing and surgery - YES Anesthesia fees for any care provided including testing and surgery by Dr. Smith - YES Dr. Smith's professional fee for care he provides including office visits, testing and surgery - NO For his Medicare patients, Dr. Smith will do everything he can to get all of the testing done by doctors who accept Medicare, and minimize the number of office visits with Dr. Smith, thereby helping a Medicare patient optimize the use of their benefits, and only have to pay for Dr. Smith's professional fees. Please contact the office to get an estimate of what your out-of-pocket cost will be for an office visits and surgery.

EIA accepts insurance form most Anthem, United Healthcare, Aetna, Cigna, Ambetter and Tricare plans*. There may be some special plans that these companies offer that are not accepted. Call the office to learn more, or check with your insurance company to see if Dr. Smith is covered and in-network. NOTE: Dr. Smith does not accept Medicare or any Medicare supplemental plan for payment of his service. See FAQ on Medicare. *EIA is contracted through the Piedmont Clinic, and therefore is in network with most insurance plans that are accepted and in-network with Piedmont Clinic.

POEM (per-oral endoscopic myotomy) is a newer technique for treating POEM. It is a way to cut the lower esophageal sphincter (LES) by going through the mouth in stead of going through the abdomen to cut the LES. You can learn more about treatments for achalasia here. POEM has been promoted primarily by GI doctors as the best way to treat achalasia, highlighting that is is "less invasive". This is because GI doctors can not offer the traditional surgical approach. Surgeons who do not offer POEM (most don't) claim POEM is not a good idea because of the resulting GERD that occurs in up to 40% of POEM patients, and instead promote the traditional surgical approach where the risk of GERD can be addressed during the procedure by creating a "stomach wrap" around the newly opened LES and thereby decrease the chance of GERD. What these two different opinions represent is the fact that doctors will promote what they can offer, and may not acknowledge or even know details about other techniques. Doctors who can offer all treatments will use POEM selectively for cases where POEM is proven to be better. There are three types of achalasia. POEM has been proven to be the best technique for Type III achalasia (learn more here). Dr. Smith will use POEM primarily for Type III achalasia, and the traditional Heller myotomy with Toupet fundoplication (stomach wrap) for all others. Type III achalasia is the rarest form, and patients with Type III suffer primarily with severe chest pain.

This is a very complicated question, and Dr. Smith will have a tutorial on this available soon. Some general principles: Do your own research on any surgeon who has been recommended, either by your PCP, GI or a friend Remember, the internet a huge digital marketing tool, so watch out for websites and surgeon claims that can't be validated through others (independent reviews or publications confirming claims). When narrowing your search, look to see what the surgeon's practice area of focus is. For example, Bariatric surgeon practices do primarily weight loss surgery, general surgery practices do a little bit of everything, and thoracic surgery practices primary operate on anything in the chest. All of these surgeon practices will offer esophageal surgery, but it is not their primary focus. It has been shown that to gain and maintain skills in esophageal surgery a surgeon should be doing 25+ esophageal operation each year. This requires a primary focus on esophageal surgery. Ask the surgeon you are considering how many primary esophageal operations they do each year. For example, a bariatric surgeon may do a hiatal hernia repair as part of their weight loss operation, but this is not primarily an esophageal operation. If you are considering a revision or REDO surgery, specifically ask them how many of these operation they have performed overall, and how many in the last 1-2 years. To do these operations well, you need to get good and stay good through experience. Ask the surgeon you see if there is anyone else in the area who also does the surgery your considering. They should know this and be comfortable sharing with you those other names. Finally, if at any time during your interview of a surgeon they are not willing to answer your questions, that is probably an indication that they don't want you to know the answer. A surgeon who won't answer a question during an initial visit should alert you to either lack of transparency or time to answer your questions. Their willingness to tell you other moper important things later in the relationship should come to mind.

YES! If a surgeon has told you that a revision or REDO can not be done laparoscopically, what they are really saying is "I can't do that operation laparoscopically". Regrettably, Dr. Smith sees patients who have undergone and open operation to revise or REDO a failed prior operation because they were told it was not possible to do it laparoscopically. These patients have suffered needlessly with the more painful and prolonged recovery after an open operation. Also, surgeons who can only do such an operation open are typically inexperienced with revision or REDO surgery and will be more likely to have a complication or poor outcome from surgery. The claim that it can not be done laparoscopically is most frequently made by thoracic surgeons, and again, what they are saying is that they can not do it using laparoscopy. This is because they operate primarily in the chest and do not routinely perform laparoscopy. An open operation through the chest is rarely needed to manage a failed prior operation, and when done is very morbid with a higher risk of complications and a long and painful recovery. Before accepting a surgeon's claim that such an operation can only be done open, take the following steps: Ask them how many revision or REDO esophageal operations they perform annually? Ask the surgeon if there are other surgeons who can do it laparoscopically? Contact EIA and get a virtual appointment with Dr. Smith. He will help you determine if that claim is true and help find someone who can help you without an open operation.