Who Can Treat Hepatitis?

If you have hepatitis, a hepatitis specialist can help

Male nurse using digital tablet at window
Getty Images/Hero Images

If you have hepatitis, you may be wondering who can treat your hepatitis. Well, a hepatitis specialist can help. But do you understand the difference between the different kinds of clinicians who can treat your hepatitis? To help you understand who does what, here's a short description of the different professionals who might work at your health care setting.

Types of Clinicians

The next time you visit a hospital, clinic or office, take a moment to view the lobby directory.

In the past, someone might only see one or two types of clinicians listed. Today, however, there are many types, each with different levels of training that provide a valued part of your healthcare needs.

  • Physicians who earn the doctor of medicine degree (MD) or doctor of osteopathic medicine (DO) degree can be licensed to practice medicine and surgery by a state medical board. These doctors complete four years of training in medical school and then complete an additional training program of at least three years duration (called a residency program) in preparation for a specialty. Each specialty program requires different durations of study. For example, most of the primary care specialties, such as family medicine or internal medicine, are three or four years in length. Surgical specialties require at least five years of training. Physicians have the training to completely manage your hepatitis, whether acute or chronic, whether viral or non-viral.
  • Nurses are a crucial part of the healthcare system and are frequently described as being the eyes and arms of physicians. They implement treatment plans and alert the doctor of any problems. With this said, the profession is incredibly diverse and people with nursing degrees are found in many different settings, not just clinical. Nurses complete several levels of training, but the standard is earning a four-year bachelor's of science in nursing (BSN) followed by extensive testing and licensing as a RN. Nurses at this level of training would neither diagnose illnesses nor prescribe medications, but would have significant patient care experience.
  • are nurses who receive advance clinical training (NP) and are licensed to diagnose some illnesses and prescribe some medication. These clinicians are trained for primary care, and depending on their practice, could have significant experience diagnosing and treating various forms of hepatitis.
  • (also called PAs) are trained to work under the supervision of a licensed physician. With this arrangement, PAs are able to handle the less-complicated cases which free up the physicians to handle the more complicated cases. In a way, PAs are physician extenders, giving the physician the ability to see more patients in a given time.
  • Alternative medicine, in its many forms, is becoming more prominent but it's still not embraced by everyone. Many of the therapies that are considered alternative often lack convincing evidence of their usefulness. Examples of clinicians who practice in this area are chiropractic (DC) and naturopathic (ND) physicians, and physicians trained in traditional Asian medicine (OMD). While these clinicians may be well-trained and provide a helpful treatment, it is good to remember that if an alternative therapy works and has scientific supports, it will eventually be incorporated into conventional medicine.

    Primary Care Clinicians

    Most people will probably learn of their hepatitis diagnosis from their primary care clinician. Primary care is usually described as the type of routine head-to-toe medical care that everybody needs throughout their lives such as annual check-ups, health education and on-going care of chronic illnesses, but it is often the first level of health care to identify health problems, such as hepatitis. In one sense, primary care is simply where you get your main medical care -- but it is also the first level of entry to the American health care system.

    Primary care providers are physicians who usually specialize in family medicine or internal medicine. These providers will have the necessary training to manage most cases of viral and chronic hepatitis. Other clinicians, like nurse practitioners and physician assistants, also provide primary care services, and may have significant experience managing hepatitis depending on their levels of training.

    Specialists Who Treat Hepatitis

    Not everyone who has hepatitis needs to see a specialist. However, while many patients can be treated by their primary care doctor or nurse practitioner, sometimes a specialist needs to be involved in very complicated or unusual hepatitis cases. There are three physician specialties with training in managing hepatitis. All three begin their training as either an internist or pediatrician. From this broad training, they further specialize into specific areas of medicine.

    • Infectious Disease: The infectious disease physician treats illness caused by microorganisms, such as viruses and bacteria. Acute viral hepatitis caused by the hepatotrophic viruses (for example hepatitis A, B and C viruses) is expertly treated by these physicians. Hepatitis not caused by viruses, such as alcoholic hepatitis, are best treated by other specialists.
    • Gastroenterologist: Gastroenterology is a subspecialty of internal medicine. These specialists focus on all of the digestive organs and processes of the body. Since the liver is an important part of metabolism and digestion, gastroenterologists are very knowledgeable in treating hepatitis.
    • Hepatologist: A gastroenterologist with extensive training in liver disease is a hepatologist. These physicians are subspecialists with many years of training and are experts in all the diseases that affect the liver, especially hepatitis.

    Which Specialist Do I Choose?

    Treating hepatitis, whether it be from viral, chronic autoimmune disease or another source, often requires a multi-specialty approach. This means that several types of physicians come together to provide expert care. It may be that in your care, you will be treated by several different sub-specialists physicians. For example, one specialist might perform a liver biopsy but another will manage the long-term therapy with drugs that have significant side-effects.

    While these can be managed at the primary care level, often hepatitis treatment is best served at the subspecialty level, especially treatment for viral hepatitis.

    Internists or Pediatricians

    Each of the specialists described above can focus on either adults or children. For example, a physician could be an adult gastroenterologist or a pediatric gastroenterologist. The difference in focus comes from the choice of residency after medical school. Usually, a physician enters a residency program immediately after graduating from medical school. If the physician is interested in treating only children and teenagers, he or she will complete a pediatric residency program, which is three years of supervised medical practice. After this program, the physician can sub-specialize in a particular type of medicine, such as gastroenterology.

    If the physician is only interested in treating adults, the doctor will complete a residency program in internal medicine.

    Afterwards, he or she can also sub-specialize in a particular type of medicine.

    Though it's easy to think that children are just "little adults" when it comes to medical care, this is not really true. Since children have specific medical concerns and require different medical treatments, it's always a good idea for children or teenagers to see a pediatric specialist.

    Unfortunately, this level of care may not be available in all places, especially in smaller cities or rural areas.

    Sources:

    American Academy of Family Physicians. http://www.aafp.org/online/en/home/policy/policies/p/primarycare.html

    Bureau of Labor Statistics Registered Nurses. December, 2007. http://www.bls.gov/oes/current/oes291141.htm

    The Gastroenterology Core Curriculum, pages 29-31. May, 2007. http://www.acg.gi.org/physicians/trainees/pdfs/GICoreCurriculum.pdf

    Continue Reading