HI! I’m Dr. Keith Berger, M.D., an internist and gastroenterologist, and if you will be visiting my office, I’m the one who will be doing your procedure. I’ve been in medical practice in Virginia Beach continuously for the past 32 years (since 1981) and formed the current Center for Health and Cancer Prevention in 2001.
I was a product of Norfolk public schools (Granby), attended Harvard University for undergraduate work where I received a BS in Biology with honors then attended Duke Medical school for 4 years, subsequently taking a residency at Duke in Internal Medicine for 3 years. After that, my final 2 years of specialized GI training were at Yale under the tutorage of Dr. Howard Spiro and Dr. Pierluigi Marignani.
Dr. Spiro wrote one of the major textbooks of gastroenterology–he was one of the most well read and erudite people I have ever met. Dr. Marignani was probably the most talented, educated and brilliant people (let alone doctors) I have ever known. He loved teaching, medicine, art and culture and I owe him a huge debt for the many medical and life lessons he taught me.
I also owe a huge debt to my Dad, Dr. James Berger, who practiced general surgery right here in Virgina Beach for over 43 years. My Dad taught me what was of most importance in practice—treating people with respect and love.
Dad really knew how to talk to people. He sat on the edge of their hospital beds and listened. Although he often didn’t say much, he was always very related. empathetic and reassuring. My Dad was always there for me too, personally and particularly during the first years of my practice. His dad was an ENT specialist in Brooklyn, NY.
Incidentally, my younger brother Jeff Berger, who trained here at EVMS with the famed Dr. Britt, took over my Dad’s practice several years ago and Jeff is a very respected doctor. Finally, while I’m on the subject, my older son is a 3rd year student at EVMS, so we are up to 4 generations of doctors in our family at this point!
I started a solo practice in GI here in Virginia Beach in 1981, building it into a several physician, multiple office practice. Then in 2001 I started the Center for Health and Cancer Prevention, where I have practiced since. My reason for starting CHCP and leaving my old practice was that I wanted to simplify my practice and my life, and have a great environment for my patients and staff. The CHCP model has allowed me to do that.
Since our practice is limited to elective screening and non-emergent diagnostic evaluations, we have a ‘quieter’ practice without emergencies, multiple offices, multiple physicians and all the hustle & bustle. The vast majority of our patients are well and just need cancer screening or a straightforward evaluation. All of us, the staff and myself, really feel like we can ‘be there’ for the patients and make the experience really pleasant, if not fun (we also do joke around a lot, if you’re up for it!).
My current practice reflects several of my commitments. First, as I have said, I wanted a pleasant, caring, respectful environment for patient and the staff. Second, I wanted people to be at ease. People generally have a lot of concerns coming to the doctor, and I am very aware of them.
Colonoscopy itself is a bit intimidating—even for me (speaking from my own personal experience!), someone who has done thousands of them. So we’ve designed everything including having a nurse anesthetist there to make the procedure a breeze.
Back in the early 1980’s, I was the first gastroenterologist in the Tidewater area to do endoscopy and colonoscopy right in the office, instead of taking people to the hospital where they all used to be (and some still are) done. I thought—‘you know, these could be done in the office where it’s much friendlier and cost effective.’ As it turned out, after we started that trend, office based colonoscopy is now a standard practice.
Another area I promoted in the early 80’s was colorectal cancer screening in Tidewater. I served for several years on the American Cancer Society steering committee, giving countless public and professional lectures on colon cancer screening, and training family practice residents to do sigmoidoscopy (a limited for of colonoscopy done without sedation by primary care doctors).
11 years ago when I started CHCP, I wanted to have nurse anesthetists doing the anesthesia. The way it is ordinarily done is that the GI doctor does both the sedation and the procedure at the same time. Because gastroenterologists aren’t trained anesthesia specialists, they can only give sedatives (where the patient is partially awake) but they can’t administer true anesthetics, where the patient is really asleep. Also, when you are doing both the procedure and the sedation, it is somewhat distracting because you have to do both. Having a nurse anesthetist (CRNA) solves this problem, and results in quicker, safer, more comfortable and better quality examinations. Finally, with sedation, a few patients may wind up being uncomfortable, or an occassional patient may have pain during a colonoscopy. When I started using CRNA’s for colonoscopy 15 years ago, I had to answer the question, “why would I want anyone not to have the best possible experience, even if it’s only a rare patient?” How would you like it if you were that patient? The ’bottom line’ is that CRNA administered anesthesia is quicker, safer, more pleasent/never even uncomfortable, plus you recover faster with little or no grogginess for the remainder of the day. Why would anyone NOT use it?
CRNA anestesia is, coming from someone who has done ten’s of thousands of colonoscopies both ways, a huge upgrade. By the way, most research studies support the superiority of anesthesia over sedation. Over the past year or so, other gastroenterologists have begun to adopt using CRNA’s, but we are veterans at it.
One final thing I’d like you to know is that I’m committed to people’s overall well-being, not just their colon’s well-being. I’m very practiced at what I do (colonoscopy, e.g.) so the medical side of my practice is really very routine for me. Over the years of practice, I’ve come to personally appreciate my patients and their lives, their challenges, health issues, problems and so on.
It’s rare that a patient and I don’t strike up a conversation about something that has nothing to do with the state of their colon, although that’s important too. I like to feel like I make a difference with people, and strive to do that in every way, even if they just came in for a colon screening.