
Elizabeth Goacher
PA-C
Location : Raleigh, NC, USA

BIO
Elizabeth Goacher is a Physician Assistant with Duke University Medical Center, Department of Medicine, Gastroenterology Division, Duke Liver Center, April 2001 to the present. Her pronouns are she/her. She is currently engaged in full time clinical practice in Hepatology. Her clinical work encompasses the full spectrum of liver disease patient population, from early stage disease to end of life, with a particular interest in portal hypertension. She served as Team Lead for the Duke Division of Gastroenterology Advanced Practice group of 25 Advanced Practice Providers 2014-2023. She is also lecturer and preceptor at Duke University School of Medicine Physician Assistant Program. Elizabeth graduated from the Duke University School of Medicine Physician Assistant Program in 1998 after earning her Bachelor of Arts from University of North Carolina at Chapel Hill in 1991. She is past Chair of the Hepatology Associates Committee of the American Association for the Study of Liver Diseases and was a member of the inaugural class of Associate Fellows of AASLD in 2020. When she is not at work, she maintains a health boundary from technology (aka EPIC) and spends as much time outdoors as possible. When asked to design and implement her dream job, she would own and operate a cocktail and tapas venue while instructing fitness classes on a large piece of lakeside property in North Carolina alongside her canine rescue, foster and retraining agency.
MASLD-MASH Content Featuring Elizabeth

Management of Life Style Modification
January 2025
This video focuses on the comprehensive management of patients with metabolic-associated steatohepatitis (MASH), emphasizing lifestyle modifications, dietary adjustments, and exercise strategies. Key topics include the importance of addressing risk factors like diet, exercise habits, and alcohol intake, as well as referrals to medically supervised weight loss clinics or bariatric surgery for advanced cases. The speaker highlights the benefits of the Mediterranean diet, intermittent fasting, and avoiding ultra-processed foods while discussing the role of resistance training to combat sarcopenia and maintain muscle mass. Practical advice and tailored recommendations ensure a holistic approach to managing MASH and improving patient outcomes.
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Third Step of Life Style Management
January 2025
This video provides a comprehensive overview of emerging pharmacologic treatments for metabolic-associated steatohepatitis (MASH) and their tailored applications based on patient profiles. Topics include FDA-approved therapies, drugs in advanced clinical trials (such as semaglutide and lanifibranor), and the potential for combination treatments targeting both steatohepatitis and fibrosis. The speaker emphasizes the importance of patient-specific approaches considering metabolic profiles, obesity, and diabetes status, alongside lifestyle interventions. Additionally, the video discusses the evolving interdisciplinary care model and highlights the exciting progress in non-invasive testing and treatment advancements for F2-F3 fibrosis.
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Approved Medication for MASH/NASH
January 2025
This video provides detailed guidance on selecting and monitoring patients for emerging therapies targeting advanced fibrosis (F2-F3) in NASH. Key topics include contraindications for patients with cirrhosis, considerations for concomitant medications, and dose adjustments for statins. The video outlines ideal candidates based on specific thresholds for VCTE, MRE, ELF scores, and other non-invasive tests while emphasizing the importance of ruling out portal hypertension and other liver diseases. It also reviews a stepwise monitoring approach, focusing on tolerability at three months and efficacy assessments at six and twelve months, with an emphasis on histologic and non-invasive test improvements.
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Types of Diet for the Treatment of MASLD
January 2025
This video explores comprehensive strategies for managing metabolic-associated steatohepatitis (MASH), focusing on fibrosis risk stratification, lifestyle modifications, and pharmacologic interventions. Learn about dietary recommendations like the Mediterranean diet, exercise guidelines emphasizing resistance training, and the role of intermittent fasting and processed food avoidance. The video also highlights weight loss targets, diabetes management, and emerging therapies such as GLP-1 receptor agonists and bariatric surgery, all aimed at improving liver health and patient outcomes.
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NITs to Identify High Risk MASH Patients
January 2025
Explore advancements in non-invasive diagnostics and risk stratification for liver fibrosis and MASH. This video highlights tools like FIB-4, transient elastography, and innovative scoring systems (e.g., FAST and Agile) to identify and predict outcomes for high-risk patients. Learn about serum biomarkers, updated guidelines, and the role of lifestyle interventions alongside targeted therapies for managing metabolic risks and advancing care in hepatology.
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MASH Bootcamp Q&A
March 2025
In this interactive Q&A session, a panel of liver disease experts discusses key challenges in diagnosing and treating metabolic dysfunction-associated steatohepatitis (MASH) using non-invasive testing and the latest therapeutic advancements. The panel explores the role of FibroScan, ELF scores, and cardiometabolic risk factors in diagnosing fibrosis, especially in patients with limited access to MRI or VCTE-based assessments. They also discuss how serologic testing can be a viable alternative in resource-limited settings and when a liver biopsy may not be necessary for diagnosis. The discussion highlights the FDA approval criteria for Resmetirom, its limitations in F4 patients, and practical strategies for determining treatment eligibility. The experts address real-world challenges, including diagnosing MASH in rural areas, evaluating confounding factors in fibrosis assessment, and ensuring comprehensive liver disease workups to rule out autoimmune conditions.
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Misconceptions About Liver Health
September 2025
Elizabeth Goacher, PA-C at Duke University in Durham, North Carolina, addresses a common misconception about Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)—that it’s a “death sentence.” While early screening and awareness are critical, Elizabeth emphasizes the importance of balanced messaging: most patients with MASLD, especially those without advanced fibrosis, will not experience liver failure or require a transplant. Instead, their greatest health risks are often from cardiovascular disease and all-cause malignancy, making lifestyle changes, metabolic health management, and cardiovascular risk reduction key priorities. This discussion encourages both patients and referring providers to focus on evidence-based care, clear communication, and realistic risk assessment, ensuring that awareness doesn’t translate into unnecessary fear.
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Lifestyle Management With Elizabeth Goacher
September 2025
Elizabeth Goacher, PA-C, Duke University, leads a practical, peer-to-peer session on lifestyle management for MASLD/MASH, translating evidence into clear, clinic-ready advice for APPs and primary care. She covers how to identify at-risk patients, use a simple FIB-4→VCTE/ELF pathway to rule out advanced fibrosis, and then center treatment on sustainable weight loss (goal 7–10%), calorie restriction, and a Mediterranean-style diet (more plants, whole grains, lean seafood, fewer added sugars and saturated fats). Elizabeth explains why fructose and highly processed foods drive hepatic fat and inflammation, how to tailor nutrition to culture and access, and how to turn “exercise” into an achievable plan—progressing from walking to 150–200 minutes/week of moderate aerobic activity or 75–125 minutes of vigorous exercise, plus resistance training for central adiposity and insulin resistance. She shares motivational interviewing tips (small, specific goals; non-stigmatizing language; frequent follow-up) and reminds clinicians that lifestyle therapy improves not just liver outcomes, but also diabetes, hypertension, and cardiovascular risk—making it the foundation of MASLD/MASH care.
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MASLD Pharmacotherapy With Elizabeth Goacher
September 2025
Elizabeth Goacher, PA-C from Duke Medical Center in Durham, NC, delivers an in-depth discussion on pharmacotherapy for MASLD/MASH, highlighting both current treatment options and emerging therapies. She reviews the role of GLP-1 receptor agonists in managing obesity and type 2 diabetes while offering secondary benefits for liver health, and addresses key considerations for procedural planning due to delayed gastric emptying. Elizabeth also explores the ongoing debate around vitamin E and pioglitazone, summarizing data from pivotal trials and guideline recommendations. The session emphasizes the groundbreaking approval of resmetirom, the first FDA-approved medication for MASH with F2–F3 fibrosis, detailing its mechanism as a thyroid hormone receptor beta agonist, trial outcomes, safety profile, and practical prescribing considerations, including payer coverage and drug interactions. This presentation provides hepatology and GI providers with practical insights on staging, non-invasive testing strategies (FIB-4, FibroScan, ELF, MRE), treatment sequencing, and how to integrate pharmacotherapy with lifestyle and multidisciplinary care to optimize outcomes in metabolic liver disease.
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MASLD vs MetALD With Elizabeth Goacher
September 2025
Elizabeth Goacher, PA-C, explains MASLD vs MetALD within the broader Steatotic Liver Disease (SLD) spectrum—and why separating metabolic dysfunction alone (MASLD) from metabolic dysfunction + alcohol exposure (MetALD) changes risk stratification and management. Through a real case, Elizabeth shows how to assess fibrosis risk, interpret CAP/Liver Stiffness, and recognize factors that can inflate stiffness. She reviews practical alcohol quantification, the limits of self-report, and when an objective biomarker like PEth can clarify true exposure—especially for patients with borderline metabolic criteria (e.g., isolated hypertension or hypertriglyceridemia). You’ll learn a stepwise approach for: confirming SLD etiology (exclude DILI, viral hepatitis, monogenic disease), choosing FIB-4, VCTE/FibroScan, or ELF for secondary assessment, deciding when to refer or biopsy for discordant results, and prioritizing therapy (alcohol reduction/cessation, cardiometabolic risk control, lifestyle intervention, and when targeted MASLD pharmacotherapy may be appropriate). She also discusses progression risk (MetALD accelerates vs MASLD), and thoughtful use of HCC surveillance in higher-risk patients. Perfect for APPs, GI/hepatology clinicians, and primary care optimizing real-world MASLD/MetALD care.
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Addressing Health Disparities: Equity Considerations in MASH/MASLD Care
August 2025
Join Elizabeth Goacher, PA-C from Duke University Medical Center, for an in-depth discussion on addressing healthcare disparities in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD). As part of the MASLD Community Network, supported by Madrigal, Elizabeth explores how social determinants of health—including race, ethnicity, socioeconomic status, geography, and access to nutritious food—impact MASLD prevalence and outcomes. She highlights the higher rates of MASLD in Hispanic populations, individuals with obesity, diabetes, cardiovascular disease, and hypertension, and emphasizes actionable strategies clinicians can use in everyday practice to mitigate bias, improve screening, and provide equitable care. This episode underscores the importance of starting with the individual patient, asking the right questions, and tailoring recommendations based on access and resources to help reduce disparities and improve liver and metabolic health.
Watch NowHighlighted Events

4th Annual GI & Liver Summit
September 12 @ 07:00 pm - September 13 @ 04:30 pm CST
The GI and Liver Summit will deliver focused, educational updates highlighting clinically relevant advances in the management of patients with chr..

GHAPP Regional
October 09 @ 12:00 pm - 12:00 pm EST
Speakers: TBD..

GHAPP Regional
November 13 @ 12:00 pm - 12:00 pm CST
Speakers: TBD Location: New Orleans Marriott Metairie at Lakeway..

GHAPP Eighth Annual Conference
September 04 @ 12:00 pm - September 06 @ 12:00 pm PST
About the 2025 GHAPP Conference The GHAPP conference is the only conference specifically designed by advanced practice providers (APPs) for the pur..
Latest News & Blogs

Wegovy® approved in the US for the treatment of MASH
At Aug 20, 2025
Check out the prescribing information here: https://bit.ly/novo-pi-wegovy
Read MoreRelated Content

Clinical Deep Dive: Unlocking the Treatment Potential of Rezdiffra
March 2025
This educational discussion dives into Rezdiffra, the first and only FDA-approved therapy for non-cirrhotic metabolic-associated steatohepatitis (MASH) with moderate to advanced fibrosis. The talk provides a clinical deep dive into the progression of MASH and fibrosis, highlighting the risks of untreated disease and the importance of early intervention. A key focus is the thyroid hormone receptor beta mechanism, explaining how Rezdiffra directly targets liver-specific pathways to reduce hepatic fat accumulation and fibrosis. Additionally, the discussion covers the rigorous FDA approval process and dual efficacy endpoints, detailing how Rezdiffra achieved significant fibrosis improvement and steatohepatitis resolution in the MAESTRO-NASH trial. The session also provides practical insights into patient access, prescribing considerations, and managing common side effects. With over 2,000 patients studied, Rezdiffra has demonstrated a strong safety profile and offers a once-daily oral treatment option that represents a major advancement in MASH management. This discussion is essential for gastroenterologists, hepatologists, and endocrinologists managing patients with MASH, as well as primary care providers and cardiologists who play a role in identifying at-risk individuals. If you are a healthcare professional looking to stay updated on the latest MASH research and treatment strategies, this session provides the insights you need.
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Liver Model Overview
July 2025
Join Alison Moe, PA-C with United Digestive, as she walks through a hands-on demonstration using a life-sized liver model to help patients better understand fibrosis and liver disease progression. In this engaging and practical overview, Allison explains how different stages of liver fibrosis—from normal liver to cirrhosis and hepatocellular carcinoma—can be felt and visualized using a segmented anatomical model. She shares how this tool enhances patient education during discussions about non-invasive liver testing, such as FibroScan, CAP scores, FIB-4, ELF testing, and more. Designed to support visual learners and improve comprehension of disease state, this video is a valuable resource for clinicians and patients navigating the complexities of metabolic-associated fatty liver disease (MASLD) and its progression to MASH. Learn how tactile and visual teaching aids can bridge the gap between diagnostics and patient understanding in hepatology care.
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Differentiating Between F3 and F4
July 2025
In this comprehensive discussion, HoChong Gilles, a nurse practitioner with 25 years of hepatology experience at the Richmond VA Medical Center, explores the critical importance of accurately distinguishing between F3 (advanced fibrosis) and F4 (cirrhosis) in patients with MASH (metabolic-associated steatohepatitis). While both stages carry increased risks of liver-specific and overall mortality, Gilles explains that F3 may still be reversible with lifestyle changes or pharmacotherapy, whereas F4 signals irreversible liver damage with heightened risk of complications like portal hypertension, hepatic encephalopathy, and liver cancer. Viewers will gain a deeper understanding of how non-invasive tests—like FIB-4, ELF, FibroScan, and MRE—perform in identifying fibrosis stage, including their limitations and overlaps. Gilles also outlines when to consider liver biopsy, especially in cases with discordant test results, atypical features, or clinical uncertainty. This video emphasizes how staging accuracy informs eligibility for therapies, surveillance strategies like HCC screening, and overall prognosis. Learn how to approach this nuanced distinction in clinical practice and why F3 vs. F4 isn't just semantics—it's a turning point in patient care.
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Addressing Health Disparities: Equity Considerations in MASH/MASLD Care
July 2025
In this episode, Patrick Horne, NP at the University of Florida (UF Health), explores the impact of health disparities and socioeconomic inequality on the diagnosis and management of MASH (metabolic-associated steatohepatitis) and MASLD (metabolic dysfunction-associated steatotic liver disease). With a focus on rural and underserved populations, Patrick discusses how limited access to quality healthcare, healthy food, exercise options, and non-invasive testing (NITs) like FibroScan or MRI elastography can delay diagnosis and worsen outcomes. He shares practical, empathetic strategies for individualizing care, such as using accessible tools like FIB-4 or APRI, promoting low-cost physical activity like walking or swimming, and providing culturally sensitive nutrition advice tailored to financial and geographic realities. Patrick emphasizes the provider’s role as a patient advocate and coach, helping patients navigate barriers and create sustainable lifestyle modifications. This episode offers key insights for clinicians working to close gaps in care and promote equity in liver disease management.
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Pharmacotherapy Review
July 2025
Join Christina Hanson, FNP-C, from South Denver Gastroenterology, as she provides an in-depth overview of the current pharmacologic treatment landscape for Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction-Associated Steatohepatitis (MASH). This expert-led session explores the three cornerstones of MASH management—lifestyle and weight loss interventions, cardiovascular risk reduction, and liver-directed therapy—while highlighting the evolving role of GLP-1 receptor agonists and the recent FDA approval of resmetirom, the first medication indicated for adults with MASH and moderate to advanced fibrosis. Christina also discusses clinical trial data from MAESTRO-NASH, reviews historical agents like vitamin E and pioglitazone, and offers practical guidance on patient selection, safety considerations, and monitoring strategies. Whether you’re a GI provider, hepatology specialist, or primary care clinician managing fatty liver disease, this video provides valuable insights into how emerging therapies are shaping the future of MASH treatment.
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