
BackTable OBGYN
FaktaHelseThe BackTable OBGYN Podcast is a resource for practicing OBGYN's to learn tips, techniques, and practical advice from their peers in the field. Listen here or on the streaming platform of your choice.
Siste episoder av BackTable OBGYN podcast
- Ep. 93 How to Optimize RVUs & Billing in Gynecology with Dr. Jon Hathaway (01:02:09)
No money, no mission. Understanding coding is the key to funding care and making your practice sustainable. In this episode of BackTable OBGYN, host, Dr. Mark Hoffman, chats with Dr. Jon Hathaway, associate professor at IU School of Medicine and coding specialist. They discuss the intricacies of medical billing, the impact of coding knowledge on revenue, and the systemic gaps in residency training regarding financial literacy. ---SYNPOSISDr. Hathaway shares his journey from mastering coding to becoming a national expert, providing a crash course on CPT, RVU, and ICD codes, and emphasizing the importance of accurate billing for the sustainability of healthcare practices. The episode offers valuable insights into the challenges and opportunities in medical coding and the broader financial aspects of healthcare.---TIMESTAMPS00:00 - Introduction 02:03 - Dr. Hathaway's Journey into Coding04:11 - Understanding the Financial Side of Healthcare07:10 - The Disconnect in Healthcare Payments11:26 - The Complexity of Medical Billing18:11 - The Role of CPT, RVU, and ICD Codes24:03 - The Process of Approving New Procedures32:38 - Understanding the Value Update Process33:47 - Case Study: Cystoscopy in Hysterectomy Codes35:26 - Survey Participation and Its Impact36:12 - Roles and Responsibilities in ACOG38:12 - Challenges of RVU-Based Compensation42:08 - Specialty-Specific RVU Valuation48:42 - Comparing OB and GYN Reimbursements50:02 - Envisioning an Ideal Healthcare System55:10 - Maximizing Billing Efficiency59:46 - Final Thoughts
- Ep. 92 Intrauterine Adhesions & Hysteroscopy: Management & Advancements with Dr. Noam Smorgick (00:55:32)
The future of gynecologic surgery is less invasive, more precise, and closer than you think. In this episode of the BackTable OBGYN podcast, host Dr. Mark Hoffman welcomes Dr. Noam Smorgick, Director of Minimally Invasive Gynecologic Surgery at Shamir Hospital in Israel. They discuss Dr. Smorgick’s journey into the field of OBGYN and her innovative approaches to intrauterine adhesion management and hysteroscopic surgery for complex pathologies.---SYNPOSISTopics include the advantages of hysteroscopic management over traditional methods, the importance of maintaining fertility, the nuances of the Israeli healthcare system, and the development of new surgical instruments and procedures. The episode also highlights shared decision-making in patient care and looks ahead to the future direction of gynecologic surgery. Dr. Smorgick shares insights from recent studies and her experiences, making it a valuable listen for practitioners and anyone interested in gynecologic surgery advancements.---TIMESTAMPS00:00 - Introduction02:05 - Dr. Smorgick’s Journey to Medicine05:01 - Insights into Israeli Healthcare System10:20 - Intrauterine Adhesions and Hysteroscopic Management11:28 - Research on Retained Products of Conception15:07 - Comparing Management of Pregnancy Loss22:02 - Future Directions in Hysteroscopic Surgery23:46 - Infertility Treatments in Israel25:50 - Managing Uterine Septums and Adhesions28:03 - Shared Decision Making in Surgery32:03 - Techniques and Tools for Metroplasty33:08 - Adhesion Prevention Strategies35:35 - Postoperative Care and Follow-Up36:59 - Office Hysteroscopy Procedures38:05 - Reusable vs. Disposable Instruments45:51 - Future of Hysteroscopy---RESOURCESNetherlands Publication: Prevalence of intrauterine adhesions after the application of hyaluronic acid gel after dilatation and curettage in women with at least one previous curettage: short-term outcomes of a multicenter, prospective randomized controlled trial: https://pubmed.ncbi.nlm.nih.gov/28390688/ Dr. Smorgick’s Publications: A comparison of reproductive outcomes following hysteroscopic management versus dilatation and curettage of retained products of conception: https://pubmed.ncbi.nlm.nih.gov/24997472/ Hysteroscopy-assisted suction curettage for early pregnancy loss: does it reduce retained products of conception and postoperative intrauterine adhesions?: https://pubmed.ncbi.nlm.nih.gov/37782418/
- BackTable Brief: Endometriosis Treatment: The Role of MRI & Multidisciplinary Planning with Dr. Wendaline VanBuren and Dr. Tatnai Burnett (00:17:11)
When radiology meets surgery, endometriosis care becomes more precise, personalized, and proactive. In this BackTable OBGYN Brief, host Dr. Mark Hoffman is joined by Dr. Wendaline VanBuren, an associate professor of radiology at Mayo Clinic, and Dr. Tatnai Burnett, a minimally invasive GYN surgeon at Mayo Clinic, to discuss the complexities of diagnosing and managing endometriosis. The discussion covers the roles of advanced imaging techniques like MRI and ultrasound, the importance of pre-surgical planning, and the need for multidisciplinary collaboration. They share their approach to managing symptomatic and asymptomatic patients, the use of hormonal treatments, and the significance of monitoring potential malignant transformations in endometrioma cases. The episode underscores the critical role of imaging in planning effective surgical interventions for patients while highlighting the progression of endometriosis management protocols. TIMESTAMPS 00:00 - Introduction 01:07 - Discussing Endometriosis Management 02:18 - Imaging Techniques and Their Importance 04:24 - Interdisciplinary Collaboration 05:40 - Advanced Imaging Protocols 08:12 - Monitoring and Follow-Up Strategies 08:50 - Concerns About Malignancy 11:04 - Future Directions CHECK OUT THE FULL EPISODE OBGYN Ep. 69 https://www.backtable.com/shows/obgyn/podcasts/69/imaging-protocols-to-guide-endometriosis-treatment
- Ep. 91 Endometrial Sampling: Blind Biopsy vs. Visual Techniques with Dr. Linda Bradley (00:57:49)
Blind biopsies leave questions unanswered. In this episode of BackTable OBGYN, host Dr. Mark Hoffman welcomes back Dr. Linda Bradley, an expert in obstetrics, gynecology, and hysteroscopy from the Cleveland Clinic, to discuss the benefits and advancements of direct visualized endometrial sampling over traditional blind biopsy techniques. ---This podcast is supported by:Medtronichttps://www.medtronic.com/en-us/healthcare-professionals/specialties/gynecology/product-portfolio.html---SYNPOSISDr. Bradley emphasizes the importance of hysteroscopy for accurate diagnosis and treatment of various gynecological issues, including abnormal uterine bleeding. They explore the limitations of blind biopsies and the advantages of hysteroscopy in detecting focal lesions, avoiding unnecessary hysterectomies, and ensuring patient safety. The discussion also touches on the economic and procedural challenges in adopting hysteroscopy more widely in clinical practice.---TIMESTAMPS00:00 - Introduction 03:30 - The Evolution of Hysteroscopy at Cleveland Clinic04:49 - Challenges and Innovations in Hysteroscopy06:30 - Clinical Insights: Direct Visualized Endometrial Sampling12:03 - Case Studies and Practical Applications15:46 - The Importance of Visual Examination in Gynecology20:03 - Advocating for Hysteroscopy in Medical Practice31:07 - Patient History and Trauma Considerations31:34 - Cancer Detection and Missed Diagnoses32:14 - Challenges with Unscheduled Bleeding32:56 - Case Study: Blood Transfusions and Hysterectomy33:38 - Importance of Hysteroscopy34:43 - Hysteroscopy Techniques and Best Practices37:41 - Ultrasound and SIS (Saline Infusion Sonohysterography) for Imaging38:45 - Post-Operative Care and Follow-Up47:41 - Environmental and Economic Considerations in Healthcare52:51 - Final Thoughts and Patient Advocacy
- BackTable Brief: Imaging and Surgical Strategies in Endometriosis with Dr. Wendaline VanBuren and Dr. Tatnai Burnett (00:16:44)
When radiology meets surgery, endometriosis care becomes more precise, personalized, and proactive. In this BackTable OBGYN Brief, host Dr. Mark Hoffman is joined by Dr. Wendaline VanBuren, an associate professor of radiology at Mayo Clinic, and Dr. Tatnai Burnett, a minimally invasive GYN surgeon at Mayo Clinic, to discuss the complexities of diagnosing and managing endometriosis. The discussion covers the roles of advanced imaging techniques like MRI and ultrasound, the importance of pre-surgical planning, and the need for multidisciplinary collaboration. They share their approach to managing symptomatic and asymptomatic patients, the use of hormonal treatments, and the significance of monitoring potential malignant transformations in endometrioma cases. The episode underscores the critical role of imaging in planning effective surgical interventions for patients while highlighting the progression of endometriosis management protocols. TIMESTAMPS 00:00 - Introduction 01:07 - Discussing Endometriosis Management 02:18 - Imaging Techniques and Their Importance 04:24 - Interdisciplinary Collaboration 05:40 - Advanced Imaging Protocols 08:12 - Monitoring and Follow-Up Strategies 08:50 - Concerns About Malignancy 11:04 - Future Directions CHECK OUT THE FULL EPISODE OBGYN Ep. 69 https://www.backtable.com/shows/obgyn/podcasts/69/imaging-protocols-to-guide-endometriosis-treatment
- Ep. 90 The Basics of “How To” for HRT Management: Effective and Safe Prescribing with Dr. Rachel Rubin (01:02:33)
When it comes to menopause care, the facts are better than the fears. In this Urology/OBGYN crossover episode of the BackTable Podcast, host Dr. Suzette Sutherland welcomes renowned urologist Dr. Rachel Rubin to explore various aspects of sexual health and hormone replacement therapy (HRT), particularly for menopausal women. --- SYNPOSIS Dr. Rachel Rubin shares her career journey, expertise in sexual health, and the critical role of hormone replacement therapy (HRT) in managing menopause. She addresses common challenges and misconceptions, particularly around estrogen use, by demystifying the Women’s Health Initiative studies and emphasizing the proven safety and benefits of systemic and vaginal HRT. Dr. Rubin offers practical guidance on prescribing estrogen, progesterone, testosterone, and DHEA, while highlighting her advocacy to remove outdated FDA black box warnings on vaginal estrogen. Through personal anecdotes and professional insights, she empowers practitioners with evidence-based strategies and underscores the importance of education and research in advancing women’s health. --- TIMESTAMPS 00:00 - Introduction03:41 - Challenges in Menopause Medicine07:21 - Misconceptions and Risks of HRT15:35 - Understanding Bioidentical Hormones18:48 - WHI Studies and Their Impact23:21 - Practical Guide to Prescribing HRT33:47 - Understanding Estrogen Levels and Risks36:04 - Debating Gels vs. Patches37:51 - Concerns with Compounded Products and Pellets38:50 - Patient Education and Meeting Them Where They Are42:12 - Progesterone Benefits and Sensitivities46:38 - Testosterone Therapy for Women51:36 - The Importance of Lab Tests55:39 - DHEA and Vaginal Health57:14 - Advocacy for Accurate Hormone Therapy Information01:00:05 - Conclusion and Final Thoughts --- RESOURCES The Peter Attia Drive episode with Dr. Rachel Rubin:https://peterattiamd.com/rachelrubin/ FDA Expert Panel on Menopause and Hormone Replacement Therapy for Women:https://www.youtube.com/live/_2ZRlOivC5M?si=-Xynb_BmWz2sWf4mDr. Rachel Rubin’s Hormone Therapy for Early Adopters Course:https://rachelrubinmd.thinkific.com/courses/MHTCME
- Ep. 89 New Guidelines for Genitourinary Syndrome of Menopause with Dr. Melissa Kaufman and Dr. Giulia Ippolito (00:54:11)
The guidelines are in and the myths are out. In this episode of the BackTable Podcast, Dr. Suzette Sutherland hosts Dr. Melissa Kaufman and Dr. Giulia Ippolito to discuss the new 2025 AUA/SUFU guidelines on genitourinary syndrome of menopause (GSM). ---SYNPOSISThe doctors delve into what GSM is, its symptoms, and the new evidence-based clinical guidelines for screening, diagnosing, and treating this condition. The episode emphasizes shared decision-making, safe use of local low-dose vaginal estrogen, and addresses concerns related to hormone therapy and cancer risks. Additionally, the doctors cover non-hormonal interventions, the role of vaginal moisturizers and lubricants, and the use of vaginal lasers. The importance of follow-up and ongoing patient education is also highlighted. The conversation aims to equip clinicians with the knowledge to better manage GSM and improve patient outcomes.---TIMESTAMPS00:00 - Introduction 01:35 - Overview of the 2025 AUA/SUFU Guidelines02:27 - Guideline Development Process05:48 - Categories of Guidelines07:03 - Understanding GSM: Symptoms and Diagnosis10:28 - Patient Education and Shared Decision Making15:22 - Hormonal Interventions and Safety Concerns17:17 - Local Vaginal Estrogen: Recommendations and Usage23:12 - Compounded Estrogens and Alternative Therapies25:48 - Understanding Estrogen Dosage Forms26:11 - Introduction to DHEA and Its Benefits27:15 - Exploring Ospemifene as an Alternative28:05 - Guidelines for Treating GSM Symptoms30:11 - The Role of Vaginal Estrogen in UTI Prevention33:01 - Non-Hormonal Interventions for GSM35:39 - Laser Treatments for GSM39:59 - Addressing Cancer Risks with Vaginal Estrogen44:48 - Endometrial Surveillance and Follow-Up49:14 - Advocating for Vaginal Estrogen Use51:13 - Conclusion and Final Thoughts
- BackTable Brief: Understanding Facility Fees in Healthcare Economics with Dr. Barbara Levy (00:17:27)
Where you perform a procedure could cost your patient thousands or save them just as much. In this Backtable OBGYN Brief, Dr. Mark Hoffman and Dr. Amy Park sit down with Dr. Barbara Levy to discuss the economic challenges and implications of performing medical procedures in various settings such as hospitals, ambulatory surgery centers (ASCs), and office environments. They explore how hospitals have leveraged billing structures for financial gain, often driving up patient costs, and highlight how procedures like hysteroscopies and endometrial ablations can be performed more efficiently and cost-effectively in office settings. The conversation also touches on how insurance companies and healthcare policy shape both patient expenses and physician practice. Dr. Levy emphasizes the importance of understanding the broader healthcare system to effectively advocate for positive changes in patient care and outcomes. TIMESTAMPS 00:00 - Introduction 00:48 - Hospital Lobbying and Facility Fees 02:43 - Impact on Patients and Physicians 04:06 - Insurance Companies and Healthcare Economics 08:34 - Office vs. ASC vs. Hospital Procedures 12:59 - Cryoablation and Patient Experience 14:53 - Conclusion and Final Thoughts CHECK OUT THE FULL EPISODE OBGYN Ep. 55 https://www.backtable.com/shows/obgyn/podcasts/55/insights-on-obgyn-coding-reimbursements
- BackTable Brief: Understanding Medical Facility Fees in Practice with Dr. Barbara Levy (00:19:46)
OBGYN Briefs - Understanding Medical Facility Fees in Practice The way you code and calculate costs might be affecting your practice more than you realize. In this episode of BackTable OBGYN, hosts Dr. Mark Hoffman and Dr. Amy Park welcome back Dr. Barbara Levy, a clinical professor at George Washington University and UCSD. They discuss the complexities of practice expenses and coding in medical specialties, emphasizing the differences between direct and indirect expenses which vary by geography and specialty. The conversation covers the challenges in surveying costs, the importance of accurate representation in surveys, and the strategic implications of coding. They also touch on the complications arising from procedure revaluation and the impact of site-of-service on reimbursements. TIMESTAMPS 00:00 - Introduction 00:48 - Understanding Practice Expenses 02:28 - Survey Challenges and Fraud Concerns 03:19 - Valuation of Medical Procedures 07:39 - Impact of Code Changes on Payments 11:01 - The Complexity of Medical Coding 15:18 - Site of Service and Facility Fees CHECK OUT THE FULL EPISODE OBGYN Ep. 55 https://www.backtable.com/shows/obgyn/podcasts/55/insights-on-obgyn-coding-reimbursements
- BackTable Brief: Understanding the RUC's Role in Healthcare Costs with Dr. Barbara Levy (00:20:50)
OBGYN Briefs - Understanding the RUC's Role in Healthcare Costs Every procedure has a price, but how is it set? In this BackTable OBGYN Brief, Dr. Mark Hoffman and Dr. Amy Park welcome back Dr. Barbara Levy, a clinical professor at George Washington University and UCSD, to discuss her work with the key organizations influencing medical billing and reimbursement. They explore Dr. Levy's extensive involvement with ACOG, AMA's CPT Editorial Panel, and the RBRVS Update Committee (RUC), offering an overview of the complex systems governing coding and reimbursement in medicine. From how new procedures receive codes to the financial impact on physicians, this brief offers valuable insights for OBGYN practitioners navigating the world of medical billing and coding. TIMESTAMPS 00:00 - Introduction 00:48 - Personal Anecdotes and Career Beginnings 02:01 - Understanding Medical Reimbursement 03:17 - Roles and Responsibilities in Medical Committees 05:34 - The Coding Process Explained 09:16 - The Role of the RUC and CPT Editorial Panel 15:16 - RVUs and Practice Expenses 17:48 - Final Thoughts CHECK OUT THE FULL EPISODE OBGYN Ep. 55 https://www.backtable.com/shows/obgyn/podcasts/55/insights-on-obgyn-coding-reimbursements
- Ep. 88 Hormone Replacement Therapy in Menopause: Risks, Benefits, and Myths Debunked with Dr. Kelly Casperson (00:52:02)
Menopause isn’t just a diagnosis—it’s a transition, and the way we treat it needs to change. Dr. Kelly Casperson joins Dr. Suzette Sutherland in this urogynecology crossover episode of BackTable to challenge outdated beliefs about menopause and hormone replacement therapy (HRT). They revisit the impact of the 1990s Women’s Health Initiative (WHI) study and explain how its findings—especially around synthetic hormones—were widely misinterpreted and continue to adversely influence patient and provider decisions today. --- SYNPOSIS Dr. Casperson breaks down the differences between the hormones used in WHI and the safer, more targeted options available today. The conversation explores the broad benefits of modern HRT, including reduced risks of cardiovascular disease, osteoporosis-related fractures, and even dementia. Beyond the science, the episode also addresses the urgent need for better medical education and updated guidelines around menopause care.Dr. Casperson and Dr. Sutherland make the case for empowering patients through informed consent and better clinician training. They also discuss Dr. Casperson’s upcoming book, The Menopause Moment, which aims to equip women with the tools and knowledge to navigate this life stage with confidence. --- TIMESTAMPS 00:00 - Introduction02:50 - Focus on Menopause and Hormone Replacement Therapy04:20 - The Women's Health Initiative (WHI) Study05:39 - Understanding Risks and Misconceptions12:43 - Reevaluation of the Women’s Health Initiative Study18:31 - Impact of Media and Physician Education19:58 - Current State of Hormone Therapy22:17 - Broader Implications and Future Directions27:17 - Evaluating FDA Warnings and Gender Bias in Hormone Treatments29:49 - The Impact of Hormone Therapy on Women's Health32:11 - Risks of Not Using Hormones35:44 - Hormones and Brain Health: Debunking Myths40:41 - The Timing Hypothesis and Long-Term Hormone Use46:32 - Advocacy and Education for Menopause Awareness48:04 - Conclusion and Upcoming Resources --- RESOURCES PBS: The M Factor: Shredding the Silence on Menopause:https://www.pbs.org/show/the-m-factor-shredding-the-silence-on-menopause/ The Menopause Moment by Dr. Kelly Casperson: https://kellycaspersonmd.com/the-menopause-moment-book/ Systematic review and meta-analysis of the effects of menopause hormone therapy on risk of Alzheimer's disease and dementia:https://pmc.ncbi.nlm.nih.gov/articles/PMC10625913/
- Ep. 87 Evaluating Hormone Therapy in Menopause Management with Dr. Yahir Santiago-Lastra (00:50:11)
Vaginal estrogen is not the enemy. Outdated data is. In this crossover episode of the BackTable Urology and OBGYN podcasts, Dr. Suzette Sutherland and Dr. Yahir Santiago-Lastra delve into the persistent challenges and ongoing advocacy efforts surrounding the FDA's black box warning on vaginal estrogen. --- SYNPOSIS They explore the historical context and far-reaching influence of the 1990s Women’s Health Initiative (WHI) study, asserting that its misinterpretation continues to shape misconceptions and hinder effective menopause care. The discussion highlights recent data refuting the risks associated with vaginal estrogen therapies and underscores the urgent need for updated, evidence-based guidelines to support women throughout menopause. Dr. Santiago-Lastra also draws attention to gender-based inequities in hormone treatment, the robust evidence contradicting the current black box warning, and the multi-faceted advocacy required to bring about change. This episode is part of a broader series focused on various aspects of menopause. --- TIMESTAMPS 00:00 - Introduction02:01 - Menopause Series Overview03:55 - History of the Black Box Warning on Estrogen07:26 - Understanding the Black Box Warning12:11 - The Citizen's Petition and FDA Process18:11 - Gender Inequity in Medical Treatment22:45 - Factors Resulting in Gender Inequity29:02 - Genital Urinary Syndrome of Menopause (GSM)29:32 - Benefits of Vaginal Estrogen33:33 - Legislative Advocacy and Medicare34:43 - Professional and Patient Advocacy36:35 - Challenges and Progress in Label Change43:35 - Historical Context and Gender Equity45:07 - Recap and Future Directions
- Ep. 86 Understanding Fetal & Maternal Interventions: Procedures & Outcomes with Dr. Hiba Mustafa (01:00:22)
Step inside the evolving world of fetal therapy where precision, teamwork, and full-spectrum care matter most. In this episode of the BackTable OBGYN Podcast, Dr. Anthony Shanks, Vice Chair of Education in the OB department at Indiana University School of Medicine, interviews Dr. Hiba Mustafa, a distinguished maternal-fetal medicine specialist and fetal interventionalist at Riley Children's Hospital. They discuss Dr. Mustafa's expertise in fetal diagnosis and therapy, her training journey through various fellowships, and her role in directing multiple fetal medicine programs. --- SYNPOSIS Dr. Mustafa elaborates on the intricacies of fetal interventions, including procedures for complications in monochorionic twins, spina bifida repair, and new emerging therapies. They also touch on research methodologies like the Delphi consensus technique and summarize key findings from recent studies on conditions such as hemolytic disease, gastroschisis, lower urinary tract obstructions, and preterm birth in twin pregnancies. Dr. Mustafa shares insights on how to stay sharp in the field, the importance of teamwork in surgical procedures, and advice for those aspiring to enter the field of fetal therapy. --- TIMESTAMPS 00:00 - Introduction02:45 - The Role of a Fetal Interventionalist04:00 - Dr. Mustafa’s Training Journey07:42 - Fetal Surgery Fellowships16:43 - Conditions Treated by Fetal Interventionalists21:17 - Monitoring and Referrals for Monochorionic Twins30:04 - Understanding Percutaneous Procedures31:10 - Navigating the Equator in Fetal Surgery32:31 - Laser Surgery Techniques and Outcomes33:18 - The Importance of Placenta Delivery33:47 - In Utero Spina Bifida Repair36:19 - Minimally Invasive Techniques for Spina Bifida38:28 - Maintaining Skills in Fetal Interventions42:11 - Delphi Consensus Technique in Medical Research46:19 - Key Takeaways from Recent Research51:55 - Future of Fetal Therapy and Personal Insights
- Ep. 85 Understanding Single Port Laparoscopy: Techniques and Outcomes with Dr. Kevin Stepp (01:07:51)
Real innovation? It’s not just the tools and techniques you use, it’s how you think. In this episode of the BackTable OBGYN podcast, hosts Dr. Mark Hoffman and Dr. Amy Park welcome Dr. Kevin Stepp, a MIGS surgeon and urogynecologist in Charlotte, North Carolina, and an OBGYN professor at Wake Forest University School of Medicine. Dr. Stepp shares his journey into the field, including his serendipitous start in single-port laparoscopy and the many surgical innovations that he has pioneered. --- SYNPOSIS The conversation highlights the importance of anatomical knowledge, thinking beyond conventional surgical approaches, and the significance of teamwork and efficiency in the operating room. A central focus is placed on the development and application of single-port techniques, highlighting the associated learning curves and the evolving role of robotic surgery. The discussion also explores how surgical team dynamics, effective communication, and ongoing innovation collectively contribute to better patient outcomes and advancement in the medical field. --- TIMESTAMPS 00:00 - Introduction03:50 - Pioneering Single Port Laparoscopy10:10 - Challenges and Advantages of Single Port Surgery13:52 - Cosmetic Considerations and Incision Techniques27:27 - Innovative Approaches and Future Directions30:40 - Understanding 3D Anatomy in GYN Surgery32:10 - Sustaining Innovation in Urogynecology33:53 - Efficiency in Surgical Procedures39:20 - Advancement of Surgical Educational Materials 42:47 - Single Port and Robotic Procedures50:50 - Building a Team through Positive Surgical Culture01:02:13 - Continuous Improvement and Humility in Surgery
- Ep. 84 Personalizing Pelvic Pain Treatment: Tools and Challenges with Dr. Frank Tu (01:02:41)
What if surgery isn’t the only answer to pelvic pain? In this episode of the BackTable podcast, host Dr. Mark Hoffman and co-host Dr. Amy Park welcome Dr. Frank Tu, Vice Chair for Quality at Endeavor Health and Director of the Division of Gynecological Pain and Minimally Invasive Surgery. The episode explores the complexity of chronic pelvic pain, emphasizing its multifactorial origins and individualized treatment approaches.---SYNPOSISDr. Tu shares insights into the persistence and treatment of chronic pelvic pain, the role of trauma, and the evolving understanding of endometriosis and other gynecological conditions. The discussion covers patient treatment modalities, the potential of artificial intelligence in medical diagnostics, and the significant role of non-surgical interventions like physical therapy. Dr. Tu's reflections on interdisciplinary collaborations, preventative approaches, and the future directions of gynecologic pain management provide a comprehensive overview of this complex field.---TIMESTAMPS00:00 - Introduction05:21 - Mentorship and Influences07:01 - Research and Innovations in Pelvic Pain09:21 - Preventative Approaches to Chronic Pain14:15 - Exploring Pain Mechanisms and Treatments26:32 - The Role of Sensory Reintroduction30:20 - The Importance of Mental Health30:49 - Challenges in Treating Chronic Pelvic Pain31:24 - The Role of Surgery and Mental Health in Pain Management34:00 - Barriers to Effective Pelvic Floor Physical Therapy35:40 - The Complexity of Treating Dysmenorrhea44:11 - Exploring Personalized Medicine and AI in Pain Management51:22 - The Future of Pain Management and AI54:25 - The Role of Big Data and AI in Medical Research59:25 - Final Thoughts
- Ep. 83 Promoting Parity in Maternal Care and Academia with Dr. Ebony Carter (01:00:14)
Equity is not just a box to check; it is the framework for lasting change. In this week's BackTable podcast, guest host Dr. Veronica Lerner speaks with Dr. Ebony Carter, a high-risk obstetrician and Division Director for Maternal-Fetal Medicine at the University of North Carolina at Chapel Hill. Dr. Carter shares insights into her career journey, which was influenced by her mother's activism in health equity, her work on reproductive health disparities, and community engagement projects. ---SYNPOSISThe conversation underscores the importance of patient participation and agency in clinical decision-making. Dr. Carter and Dr. Lerner also discuss the development of an equity rubric for peer-reviewed journals, highlighting the need for inclusive and intentional research practices. They explore practical applications of the rubric, including the proper acknowledgment of contributors to foundational concepts. The episode further delves into Dr. Carter’s mentorship initiatives at the Green Journal and her guiding philosophy of pursuing impactful, community-driven work rooted in passion and purpose.---TIMESTAMPS00:00 - Introduction02:06 - Dr. Carter's Journey and Inspiration05:19 - Community Engagement and Health Equity06:19 - Patient Advocacy and Shared Decision Making08:54 - Collaborative Research and Community Partnerships16:58 - Addressing Bias in Medical Practice22:12 - Equity in Academic Publishing28:26 - Diversifying the Peer Review Pool30:33 - Creating and Implementing the Equity Rubric31:17 - The Impact and Application of the Equity Rubric33:31 - Personal Reflections on Equity and Research35:25 - Citing Foundational Work38:48 - Mentorship and Training Future Leaders47:05 - Career Transitions and Future Goals52:36 - Final Thoughts and Advice for Aspiring Professionals---RESOURCESFull Equity Rubric:https://journals.lww.com/greenjournal/Documents/OnG_Equity_Rubric_1.pdf Equity Rubric Introduction Video:https://youtu.be/Jh5_L-pYkuE?si=JREjSSCr98jqjVVB Equity Rubric Introduction Video Slide Deck:https://journals.lww.com/greenjournal/Documents/Green%20Journal%20Equity%20Rubric%20YouTube_final_2022_01_16%20(Slides).pdf
- Ep. 82 Building Effective Endometriosis Case Conferences with Dr. Peter Movilla and Dr. Anu Shenoy-Bhangle (00:57:27)
Curious how cross-specialty teamwork is reshaping endometriosis care? In this episode of BackTable OBGYN, host Dr. Mark Hoffman speaks with Dr. Peter Movilla, Associate Medical Director at Newton Wellesley Hospital, and Dr. Anuradha Shenoy-Bhangle, Assistant Professor of Radiology at Harvard Medical School, about their collaborative efforts in advancing endometriosis care. --- SYNPOSIS The discussion covers the development and benefits of monthly multidisciplinary conferences that include gynecologists, radiologists, colorectal, urologic, and thoracic surgeons. The conferences aim to improve preoperative planning, intraoperative accuracy, and postoperative care through detailed imaging techniques, primarily MRI. They also highlight the importance of educating fellows and colleagues, the role of ultrasound screening, and future directions like AI and PET imaging. The episode emphasizes the challenges and rewards of treating endometriosis and fostering better patient outcomes through teamwork and innovation. --- TIMESTAMPS 00:00 - Introduction 01:55 - The Journey to Specialization 07:02 - Building a Multidisciplinary Team 15:07 - The Value of Postoperative Reviews 22:49 - Patient Counseling and Personalized Care 29:36 - Challenges in Endometriosis Treatment 31:00 - Educating Beyond the Clinic 33:05 - Innovations in Imaging 46:22 - Future Directions in Endometriosis Research 53:15 - Conference Highlights and Final Thoughts --- RESOURCES Recommendations for MRI technique in the evaluation of pelvic endometriosis: consensus statement from the Society of Abdominal Radiology endometriosis disease‑focused panel: https://drive.google.com/file/d/1VRBpw5V3AH-rWGEG43K1CMCx2flCXl2M/view?usp=sharing
- Ep. 81 Surgical Considerations in Chronic Pelvic Pain with Dr. Mark Dassel (01:00:26)
When should you consider surgical management of chronic pelvic pain conditions? In this episode of the BackTable OBGYN podcast, Dr. Mark Dassel, a MIGS surgeon at Intermountain Health in Salt Lake City, joins hosts Dr. Mark Hoffman and Dr. Amy Park to discuss medical and surgical management strategies for chronic pelvic pain, particularly endometriosis. --- SYNPOSIS Dr. Dassel emphasizes the importance of stopping the hormonal triggers associated with pain and explores various medical treatments, including hormonal therapies and the role of contraceptives. He also highlights his approach to surgical interventions such as endometriosis excision, endometrioma removal, and hysterectomy, and the importance of holistic treatment plans involving pelvic floor physical therapy and central pain modulators. The episode also covers the complexities of diagnosing and treating pelvic pain, the role of early intervention, and the value of multidisciplinary care. --- TIMESTAMPS 00:00 - Introduction 07:55 - Differentiating Causes of Chronic Pelvic Pain 10:13 - Multidisciplinary Care and Costs 14:26 - Acute vs Chronic Pain 17:00 - Centralized Pain 18:46 - When to Offer Surgery 23:42 - Fertility and Endometriosis 33:25 - Hormonal Suppression Post-Surgery 37:24 - Pelvic Floor Botox and Physical Therapy 44:42 - Hysterectomy for Pelvic Pain 51:53 - Nerve Ablation and Pain Management 57:10 - Final Thoughts
- Ep. 80 Endometrial Ablation: Past, Present, and Future with Dr. Ted Anderson (01:00:56)
Endometrial ablation has become a cornerstone procedure in the treatment of abnormal uterine bleeding, but is it the right solution for every patient that meets the indication? In this episode of the BackTable OBGYN Podcast, Dr. Ted Anderson from Vanderbilt University joins host Dr. Mark Hoffman to discuss the evolution of endometrial ablation and its contemporary utilization, including patient selection, technical considerations, and alternative treatments for abnormal uterine bleeding. --- SYNPOSIS Dr. Anderson begins by detailing the history of abnormal uterine bleeding alongside the evolution of the endometrial ablation techniques that have been used to treat it. Shifting focus to current day practice, he then shares his approach to endometrial ablation, covering patient selection and the technical aspects of his approach. Throughout the conversation, Dr. Anderson emphasizes the importance of how we define success in endometrial ablation, explaining that eumenorrhea (normal bleeding that no longer interferes with life events) is the goal, as opposed to the more traditional view that amenorrhea is the target outcome. The episode closes with a discussion on the role of alternative treatments, such as the Mirena IUD and hysterectomy for abnormal uterine bleeding. --- TIMESTAMPS 00:00 - Introduction 09:29 - History of Abnormal Uterine Bleeding and Endometrial Ablation 23:31 - Evolution of Endometrial Ablation Devices/Techniques 31:11 - Selecting the Right Patient for Ablation Success 34:38 - Post-Tubal Sterilization Ablation Syndrome 38:27 - The Role of IUDs in Managing AUB 44:07 - Reevaluating Endometrial Ablation Success Metrics 49:55 - Innovative Ablation Techniques: Cryoablation and Steam 51:48 - Adenomyosis and Fertility-Sparing Treatments 57:28 - Final Thoughts
- Ep. 79 Laparoscopy in Pregnancy: Key Considerations for Surgeons with Dr. Craig Sobolewski (00:52:07)
What surgical techniques and safety measures are important to consider when operating in a pregnant patient? In this episode of the BackTable OBGYN podcast, Dr. Craig Sobolewski, a minimally invasive GYN surgeon at Duke, speaks with host Dr. Mark Hoffman about the intricacies of laparoscopic surgery in pregnant patients. --- SYNPOSIS The surgeons delve into the critical importance of understanding anatomy and ensuring proper exposure during surgeries, particularly the challenges and techniques for operating during pregnancy. Key discussions include the use of liver retractors, the management of symptomatic ovarian cysts, and the methods for performing and evaluating abdominal cerclages. They also explore the physiological changes in pregnant patients and the adjustments needed for anesthesia, laparoscopic entry, pressures during surgery, and pre/post-operative care. --- TIMESTAMPS 00:00 - Introduction 07:20 - Laparoscopy in Pregnant Patients 11:23 - Common Surgeries During Pregnancy 15:56 - Laparoscopic Surgery Techniques 24:04 - Physiologic Changes in Pregnancy 27:33 - Access Methods and Pressure Considerations 28:53 - Managing Torsion and Cysts in Pregnancy 30:21 - Energy Use and Safety in Pregnant Patients 31:38 - Preoperative and Postoperative Care 34:15 - Cerclage Procedures and Counseling 47:46 - Professional Reflections and Conclusions
- Ep. 78 The Business of Gynecology in Canada with Dr. Jonathon Solnik (01:04:05)
How does gynecology care in the United States compare to Canada? In this episode of the BackTable OBGYN podcast, Dr. Jonathon Solnik, head of gynecology and minimally invasive surgery at Mount Sinai in Toronto, speaks with hosts Dr. Mark Hoffman and Dr. Amy Park about the significant differences between the healthcare systems in the US and Canada. --- SYNPOSIS The doctors cover financial incentives and constraints faced by hospitals in the US vs. Canada, the role of insurance companies, and how resource limitations impact clinical practice. Dr. Solnik shares insights from his career journey, emphasizing the challenges and opportunities he has encountered in Canada, including longer wait times for elective surgeries and the intricacies of the Canadian global budget system. The conversation also covers the impact of robotics in surgery, standardization of care, and the differences in the handling of high-acuity medical cases. The episode provides an insightful discussion on how different healthcare models affect patient care, physician practices, and hospital administration. --- TIMESTAMPS 00:00 - Introduction 01:39 - Dr. Solnik’s Career Journey 03:30 - Healthcare System Differences: US vs Canada 09:57 - Balancing Quality and Volume in Healthcare 12:18 - Private Practice in Canada 25:03 - Wait Times and Capacity Issues 34:44 - Oncology and Semi-Salaried Positions 39:03 - Negotiating CPT Codes and RVUs 42:14 - Access to Care in Remote Areas 44:42 - Robotics in Surgery 55:09 - Incentives and Productivity in Healthcare Systems 01:01:33 - Concluding Thoughts
- BackTable Brief: Diagnosing Female Urinary Incontinence with Dr. Sarah Boyles (00:17:23)
How can we streamline the proper diagnosis and treatment of female urinary incontinence? The solution often lies in bridging comprehensive patient workup to pelvic floor physical therapy. Learn more in this BackTable OBGYN brief with Dr. Sarah Boyles and host Dr. Suzette Sutherland! Key topics include what to look for during a pelvic exam, the importance of external skin inspection, prolapse evaluation, urethra assessment, and pelvic floor muscle strength testing. The doctors also address effective treatment options, the necessity (or lack thereof) of specific diagnostic tests, the significant role of bladder diaries, and the benefits of pelvic floor physical therapy. Practical advice for behavioral management, therapy for stress and urgency incontinence, and the reasons for structured evaluation methodologies are also highlighted. TIMESTAMPS 00:00 - Introduction 00:30 - Conducting a Thorough Pelvic Exam 02:45 - Evaluating Pelvic Floor Muscle Strength 04:28 - Initial Diagnostic Workup 06:07 - The Role of Bladder Diaries 09:49 - Treatment Algorithms for Urinary Incontinence 15:03 - Conclusion CHECK OUT THE FULL EPISODE OBGYN Ep. 61: Evaluating Female Urinary Incontinence: Essential Steps for the Generalist https://www.backtable.com/shows/obgyn/podcasts/61/evaluating-female-urinary-incontinence-essential-steps-for-the-generalist
- BackTable Brief: Understanding Female Urinary Incontinence with Dr. Sarah Boyles (00:17:29)
Urinary incontinence can greatly impact our patients’ quality of life. It’s essential to recognize the different types and treat them appropriately. In this BackTable OBGYN Brief, Dr. Sarah Boyles and Dr. Suzette Sutherland provide an overview of female urinary incontinence for their general practice and specialized physician colleagues. The conversation dives into the different types of incontinence, including stress, urgency, mixed, and overflow incontinence, and the importance of accurate diagnosis and appropriate treatment plans. The discussion also emphasizes essential diagnostic steps, including urinalysis and measuring post-void residuals, and points out the importance of patient education and expectation management. TIMESTAMPS 00:00 - Introduction 00:30 - Prevalence of Female Urinary Incontinence 01:25 - Impact on Quality of Life 03:01 - Types of Urinary Incontinence 07:35 - Diagnostic Approaches CHECK OUT THE FULL EPISODE OBGYN Ep. 61: Evaluating Female Urinary Incontinence: Essential Steps for the Generalist https://www.backtable.com/shows/obgyn/podcasts/61/evaluating-female-urinary-incontinence-essential-steps-for-the-generalist
- Ep. 77 Surgeon to CMO: Navigating the Career Shift with Dr. Mark Hoffman (00:57:05)
What skills and disciplines can a surgeon take from their training to succeed in a new leadership / hospital administration role? In this episode of BackTable OBGYN, Dr. Mark Hoffman discusses his transition from a minimally invasive gynecologic surgeon to the Chief Medical Officer at his hospital with co-host Dr. Amy Park. --- SYNPOSIS The doctors cover the importance of high-functioning teams, the unexpected challenges of hospital administration, and the impact of clinical experience on decision-making. Additionally, they explore the broader responsibilities and skill sets required for effective leadership in a hospital setting, and offer advice for others considering a similar career shift. Dr. Hoffman emphasizes the value of servant leadership, the benefits of focusing on strengths, and the necessity of building strong, resilient teams. --- TIMESTAMPS 00:00 - Introduction 05:16 - Transitioning to Hospital Administration 07:17 - Balancing Workload 10:33 - Teamwork and Leaning into Strengths 13:30 - Decision Making in Administration 26:20 - Unique Challenges for OBGYNs in Hospital Administration 31:48 - Engagement in Leadership 35:03 - Focusing on People to Improve Patient Care 44:18 - Building Effective Leadership Teams 45:25 - Transitioning to Hospital Administration 52:07 - Finding Joy in Leadership and Mentorship
- BackTable Brief: Exploring Libido: From Hormones to Desire with Dr. Kelly Casperson (00:14:22)