Sameer K. Berry, MD, MBA, comes from a family of GI doctors. As a child, he used to accompany his father when he made rounds at the local county hospital.
Oshi Health
Dr. Sameer K. Berry
“I was a little kid, so I wasn’t helping him,” but he said he learned a great deal by sitting in the hallways and listening to his father talk to patients. “I could clearly hear the human suffering on the other side.”
This experience had a big impact on Dr. Berry, who continues the family trade. Like his father, talking with patients about their condition is his favorite part of the job, but especially talking about the role of diet, lifestyle, and stress on GI health, said Dr. Berry, who is a gastroenterologist and clinical assistant professor of medicine at New York University’s Grossman School of Medicine.
In addition to his clinical practice, Dr.Berry serves as the co-founder & chief medical officer at Oshi Health. Oshi is an integrative healthcare clinic that is entirely virtual and entirely and solely about GI health. The clinic works with GI clinicians and other healthcare providers, allowing patients access to multidisciplinary care that has proven to reduce healthcare costs and improve patient outcomes. The company was recently named a recipient of funding through the American College of Gastroenterology and the American Gastroenterological Association’s Center for GI Innovation & Technology’s GI Opportunity Fund.
The Oshi model is a whole-person, multidisciplinary GI care model, which includes traditional medical care for GI conditions but also provides access to health coaching, nutrition and diet support, and behavioral and mental health services. Research shows the approach is effective in mitigating symptoms. A 2020 randomized controlled trial published in Lancet Gastroenterology and Hepatology demonstrated that integrated multidisciplinary care led to improvement in symptoms, quality of life, and cost of care for complex GI conditions, as compared with the traditional GI specialist care model. Numerous similar studies have found that integrated care teams were better equipped to meet the needs of patients with inflammatory bowel disease (IBD) and patients with disorders of gut-brain interaction (DGBIs), patient outcomes and satisfaction were better, overall direct and indirect costs were lower and psychological health needs better addressed.
Q: What was the inspiration behind Oshi Health?
Dr. Berry: Gastroenterologists continue to witness unnecessary patient suffering due to antiquated care delivery models and perverse incentives in our healthcare system. Oshi’s care model was designed to align incentives and provide patients with access to clinicians who are traditionally not reimbursed in fee-for-service healthcare while also helping GI practices provide this care to their patients. During my clinical training it was easy for me to order expensive and invasive testing for my patients, but very difficult for me to get them the multidisciplinary care they needed. Many of the patients I would see didn’t need more MRIs, CT scans, or expensive medications. They needed access to a team of clinicians to help with all the aspects of GI care, including diet, behavioral, and medical.
Q: Why is multidisciplinary care the right approach?
Dr. Berry: GI is a very complex field with many nuances that can impact a patient’s symptoms. As physicians, our role is now evolving to oversee a team of clinicians working together to maximize expertise in nutrition and the gut-brain axis. With these new multidisciplinary care models, GI practices can expand their capabilities. At Oshi Health, every single patient has access to a nurse practitioner, dietician, psychologist, and health coach — all overseen by a gastroenterologist — as a covered benefit through their health plan. Providing multidisciplinary care through a virtual-first model solves some of the scalability challenges of these intensive care models and can significantly improve access to care.
Q: What grant-funded clinical research are you doing right now?
Dr. Berry: Most of my research focuses on evaluating the impact of novel care delivery models in GI and the evaluation of digital technologies in GI and how we can incorporate those digital technologies into clinical practice. How can we determine what type of care can be done remotely via video visits? What can be done on the phone or via text messaging? How can we get these new services paid for so patients can reap the benefits of seeing their doctor more frequently?
Q: What teacher or mentor had the greatest impact on you?
Dr. Berry: Dr. John Allen, MD, MBA has had an incredible impact on my career. He’s the former president of the American Gastroenterological Association, and was the chief clinical officer and a professor at the University of Michigan. He’s one of the rare GI doctors that has both a strong clinical and leadership role in GI. I can’t thank him enough for planting the seeds to encourage me to focus on improving the ways we deliver care to patients.
Q: Describe how you would spend a free Saturday afternoon.
Dr. Berry: Roaming around and exploring a new neighborhood either in New York City or anywhere in the world. If I wasn’t going to be a doctor, I’d probably be an anthropologist. I love observing people in their element, and exploring new neighborhoods that are off the beaten path is a great way to do that.
Lightning round! Do you prefer texting or talking?
Texting
What’s high on your list of travel destinations?
Antarctica
Where was your most memorable vacation?
Patagonia
How many cups of coffee do you drink daily?
Four
What’s your favorite holiday?
Halloween
What’s your favorite junk food?
In-N-Out Burger
If you weren’t a gastroenterologist, what would you be?
Anthropologist
Summary content
7 Key Takeaways
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Developed a paper-based colorimetric sensor array for chemical threat detection.
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Can detect 12 chemical agents, including industrial toxins.
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Production cost is under 20 cents per chip.
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Utilizes dye-loaded silica particles on self-adhesive paper.
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Provides rapid, simultaneous identification through image analysis.
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Inspired by the mammalian olfactory system for pattern recognition.
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Future developments include a machine learning-enabled reader device.
The guidelines emphasize four-hour gastric emptying studies over two-hour testing. How do you see this affecting diagnostic workflows in practice?
Dr. Staller: Moving to a four-hour solid-meal scintigraphy will actually simplify decision-making. The two-hour reads miss a meaningful proportion of delayed emptying; standardizing on four hours reduces false negatives and the “maybe gastroparesis” purgatory that leads to repeat testing. Practically, it means closer coordination with nuclear medicine (longer slots, consistent standardized meal), updating order sets to default to a four-hour protocol, and educating front-line teams so patients arrive appropriately prepped. The payoff is fewer equivocal studies and more confident treatment plans.
Metoclopramide and erythromycin are the only agents conditionally recommended for initial therapy. How does this align with what is being currently prescribed?
Dr. Staller: This largely mirrors real-world practice. Metoclopramide remains the only FDA-approved prokinetic for gastroparesis, and short “pulsed” erythromycin courses are familiar to many of us—recognizing tachyphylaxis limits durability. Our recommendation is “conditional” because the underlying evidence is modest and patient responses are heterogeneous, but it formalizes what many clinicians already do: start with metoclopramide (lowest effective dose, limited duration, counsel on neurologic adverse effects) and reserve erythromycin for targeted use (exacerbations, bridging).
Several agents, including domperidone and prucalopride, received recommendations against first-line use. How will that influence discussions with patients who ask about these therapies?
Dr. Staller: Two points I share with patients: evidence and access/safety. For domperidone, the data quality is mixed, and US access is through an FDA IND mechanism; you’re committing patients to EKG monitoring and a non-trivial administrative lift. For prucalopride, the gastroparesis-specific evidence isn’t strong enough yet to justify first-line use. So, our stance is not “never,” it’s just “not first.” If someone fails or cannot tolerate initial therapy, we can revisit these options through shared decision-making, setting expectations about benefit, monitoring, and off-label use. The guideline language helps clinicians have a transparent, evidence-based conversation at the first visit.
The guidelines suggest reserving procedures like G-POEM and gastric electrical stimulation for refractory cases. In your practice, how do you decide when a patient is “refractory” to medical therapy?
Dr. Staller: I define “refractory” with three anchors.
1. Adequate trials of foundational care: dietary optimization and glycemic control; an antiemetic; and at least one prokinetic at appropriate dose/duration (with intolerance documented if stopped early).
2. Persistent, function-limiting symptoms: ongoing nausea/vomiting, weight loss, dehydration, ER visits/hospitalizations, or malnutrition despite the above—ideally tracked with a validated instrument (e.g., GCSI) plus nutritional metrics.
3. Objective correlation: delayed emptying on a standardized 4-hour solid-meal study that aligns with the clinical picture (and medications that slow emptying addressed).
At that point, referral to a center with procedural expertise for G-POEM or consideration of gastric electrical stimulation becomes appropriate, with multidisciplinary evaluation (GI, nutrition, psychology, and, when needed, surgery).
What role do you see dietary modification and glycemic control playing alongside pharmacologic therapy in light of these recommendations?
Dr. Staller: They’re the bedrock. A small-particle, lower-fat, calorie-dense diet—often leaning on nutrient-rich liquids—can meaningfully reduce symptom burden. Partnering with dietitians early pays dividends. For diabetes, tighter glycemic control can improve gastric emptying and symptoms; I explicitly review medications that can slow emptying (e.g., opioids; consider timing/necessity of GLP-1 receptor agonists) and encourage continuous glucose monitor-informed adjustments. Pharmacotherapy sits on top of those pillars; without them, medications will likely underperform.
The guideline notes “considerable unmet need” in gastroparesis treatment. Where do you think future therapies or research are most urgently needed?
Dr. Staller: I see three major areas.
1. Truly durable prokinetics: agents that improve emptying and symptoms over months, with better safety than legacy options (e.g., next-gen motilin/ghrelin agonists, better-studied 5-HT4 strategies).
2. Endotyping and biomarkers: we need to stop treating all gastroparesis as one disease. Clinical, physiologic, and microbiome/omic signatures that predict who benefits from which therapy (drug vs G-POEM vs GES) would transform care.
3. Patient-centered trials: larger, longer RCTs that prioritize validated symptom and quality-of-life outcomes, include nutritional endpoints, and reflect real-world medication confounders.
Our guideline intentionally highlights these gaps to hopefully catalyze better trials and smarter referral pathways.
Dr. Staller is with the Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston.