A hepatologist is a physician who has received specialized training to address problems with the liver. To become a hepatologist, a physician must first graduate from medical school and complete a residency in internal medicine. Since the liver is part of the gastrointestinal system, he then completes additional training in the form of a fellowship in gastroenterology. Following that, there is additional fellowship training focusing solely upon the liver. With such specialized training, hepatologists serve mainly as consultants dealing with the most challenging liver problems, such as hepatitis and follow-up care of liver transplant patients.

Consulting

According to "Harrison’s Principles of Internal Medicine," hepatologists are usually called in when internal medicine doctors and gastroenterologists are faced with difficult liver problems. In less urgent cases, a doctor may refer a patient to a hepatologist, and the hepatologist will see the patient in the office. Liver issues sometimes arise in seriously ill patients who are hospitalized. In such cases, the primary treatment team that has been caring for the patient will ask for a hepatology consult. A hepatologist will then examine the patient and make her recommendations. The primary treatment team then decides, based upon other medical problems the patient may have, which of the recommendations it wishes to follow and is responsible for actually implementing them.

Hepatitis

One area where the expertise of a hepatologist is needed is hepatitis. According to the Centers for Disease Control and Prevention, hepatitis refers to any inflammation of the liver and can have a number of causes, including autoimmune disease, alcoholism and infection. Two of the most challenging types of hepatitis are hepatitis B and hepatitis C, both caused by viruses. These two types of hepatitis can turn into chronic diseases, requiring complex treatments over an extended period of time. Hepatologists are often called upon to help with the long-term care of patients with hepatitis B and hepatitis C.

Liver Transplant Follow-Up

Another area where hepatologists are often employed is the long-term care of liver transplant patients. Hepatologists do not perform liver transplants, since they are not trained as surgeons. After the surgery has been performed, liver transplant patients require careful management to ensure that the body does not reject the transplant and that the new liver is functioning properly.

Salaries

Hepatology is more specialized than general gastroenterology and requires more training, yet hepatologists in the United States are usually paid less than general gastroenterologists. In 2020, the median annual salary for all physicians and surgeons was more than $208,000, with internal medicine specialists averaging around $224,000

Physicians and Surgeons salary

• Median Annual Salary: $208,000 or more ($100/hour)