Ep. 105 Strategic Involvement with ACOG & Its Impact with Dr. Sivani Aluru

Some of the biggest advances in women’s health start with a simple question: why hasn’t this been fixed yet? In this episode of BackTable OBGYN, Dr. Tess Kim, a minimally invasive gynecologic surgeon at Massachusetts General Hospital and the founder of Fruits of Labor, a women's health medical device innovation company, joins host Dr. Amy Park. --- SYNPOSIS Dr. Kim’s educational journey began with medical school at Emory, followed by residency at Beth Israel Deaconess Hospital, and fellowship training at MGH. She discusses the founding of Fruits of Labor, which began with the Perry Peach—a warm compress device designed to reduce severe perineal tearing during childbirth and now acquired by Medicines360. Dr. Kim also talks about her creative process, the importance of addressing historically neglected areas in women's health, and the potential impact of her new project, Mellomallows, which aims to reduce discomfort during gynecological procedures such as IUD placement. The conversation concludes with a discussion of the challenges and opportunities in women's health innovation, the significance of supportive networks, and the role of passion and commitment in driving meaningful change. --- TIMESTAMPS 00:00 - Introduction02:03 - The Birth of PeriPeach: Addressing Severe Tearing06:51 - New Medical Devices: Mellomallows08:41 - The Creation and Mechanism of PeriPeach 11:11 - Company Development: Mentorship and Resources17:37 - Pitching Practice and Experience 19:26 - Project Funding and Working with Medicines36021:51 - Advice for Aspiring Innovators23:52 - Concerns About AI in Healthcare26:48 - Innovations in Women's Health29:06 - Challenges in Academic Medicine32:01 - The Importance of Female Innovators34:00 - Forming a Startup in Women's Health36:10 - Parting Advice for Future Innovators37:37 - The Future of Women's Health Innovations40:10 - Conclusion --- RESOURCES Fruits of Labor website:https://www.fruitsoflabormed.com/home PeriPeach website:https://www.peripeach.com/

3 Feb 43min

Fibroid care: how it was, how it’s changing, and where it’s headed next. In this episode of BackTable OBGYN, hosts Dr. Mark Hoffman and Dr. Amy Park welcome minimally invasive GYN surgeon Dr. Arleen Song to discuss the evolving landscape of fibroid care. --- SYNPOSIS Dr. Song, a veteran in the field with nearly 20 years of experience, shares her journey from Michigan to Duke, current treatments in fibroid management, and the importance of personalized care. The team explores new surgical techniques, the role of medical therapies such as Ella GnRH antagonists, and the importance of patient education. They also address challenges such as access to care, the significance of research funding, and the evolving understanding of fibroid genetics and long-term management. This episode provides a comprehensive overview of the state of fibroid care and the strides being made in this vital aspect of women's health. --- TIMESTAMPS 00:00 - Introduction02:21 - Evolution of Fibroid Treatment05:50 - Advancements in Minimally Invasive Surgery08:47 - Longitudinal Care and Personalized Treatment13:00 - Modern Approaches to Fibroid Treatment21:15 - New Technologies and Procedures27:01 - Preoperative Assessment and Imaging31:15 - Preoperative Counseling and Risk Assessment33:14 - Medications for Fibroid and Endometriosis37:59 - Challenges in Access to Care38:43 - Racial Disparities in Fibroid Research42:35 - The Importance of Specialized Care49:22 - Future Directions in Fibroid Treatment

27 Jan 55min

Vaginal rejuvenation is often misunderstood, misrepresented, and overdue for honest conversations in medicine. In this crossover episode between BackTable Urology and BackTable OBGYN, Dr. Nirit Rosenblum, a urology and OBGYN professor at NYU Langone Medical Center, is joined by Dr. Karyn Eilber, Chair of the Cedars-Sinai Medical Group Department of Surgery, and Dr. Ariana Smith, Chief of Urology at Pennsylvania Hospital. Together, they bring a multidisciplinary lens to one of the most misunderstood areas of women’s health. --- This podcast is supported by: Medtronichttps://www.medtronic.com/en-us/healthcare-professionals/specialties/bladder-bowel-solutions/therapies-procedures/implantable-tibial-neuromodulation.html?cid=VURL:MIX:podcast:phportfolio --- SYNPOSIS The discussion revolves around the broad definition of vaginal rejuvenation, distinguishing between medical and cosmetic interventions. They address common misconceptions, the roles of different health professionals, and emphasize the importance of pelvic floor physical therapy and the appropriate use of systemic and vaginal estrogen therapy. The conversation also highlights critical gaps in research surrounding laser and radiofrequency interventions, underscoring the need for stronger evidence, clearer patient education, and continued advocacy around menopause care and sexual function. --- TIMESTAMPS 00:00 - Introduction02:11 - Defining Vaginal Rejuvenation04:35 - Common Procedures and Misconceptions10:04 - Insurance and Coverage of Procedures12:04 - Laser and Radiofrequency Therapies18:10 - Vaginal Estrogen and Lift of Black Box Warning19:59 - The Role of Systemic Hormone Therapy26:56 - Vaginal Rejuvenation Misconceptions32:21 - Pelvic Floor Physical Therapy and Timing of Procedures34:24 - Regional Variations in Therapeutic Availability38:40 - Gender Inequity in Healthcare40:16 - Final Thoughts --- RESOURCES Joint Report on Terminology for Cosmetic Gynecologyhttps://journals.lww.com/fpmrs/abstract/2022/06000/joint_report_on_terminology_for_cosmetic.2.aspx

20 Jan 43min

Who should consider fertility preservation, when is the right time, and what are the risks? In this episode of BackTable OBGYN, Dr. Amy Park interviews Dr. Mindy Christianson, the section head of Reproductive Endocrinology and Infertility at the Cleveland Clinic, who shares how fertility preservation is evolving for patients planning families and those facing fertility-impacting treatments. --- SYNPOSIS Dr. Christianson discusses her journey into the field of fertility preservation, inspired by an early encounter with a breast cancer patient. The conversation covers various aspects of fertility preservation, including the preservation of eggs, embryos, ovarian and testicular tissue, and planned fertility preservation. Dr. Christianson elaborates on the protocols, patient demographics, and the evolving collaboration between oncology and reproductive endocrinology. The discussion also highlights technologies like ovarian tissue transplantation and in vitro maturation, as well as practical tips for healthcare providers on improving patient access to fertility preservation services. --- TIMESTAMPS 00:00 - Introduction03:34 - Understanding Fertility Preservation07:56 - Consultation Process for Fertility Preservation17:36 - Advancements in Egg Freezing Technology25:55 - Egg Freezing Recommendations26:34 - Collaboration Between Oncology and REI26:52 - Pediatric Oncology and Fertility Preservation28:58 - Ovarian Tissue Transplantation33:17 - Uterine Transposition Surgery40:05 - Gene Editing and Fertility Preservation43:01 - Financial and Emotional Aspects of Fertility Preservation48:02 - Practical Advice for OBGYNs51:12 - Resources and Final Thoughts --- RESOURCES Livestrong Fertilityhttps://livestrong.org/how-we-help/livestrong-fertility/ Resolve: The National Infertility Associationhttps://resolve.org/ Society for Assisted Reproductive Technologyhttps://www.sart.org/ American Society for Reproductive Medicinehttps://www.asrm.org/

13 Jan 54min

A physician’s expertise can extend beyond the exam room and into the courtroom. In this episode of BackTable OBGYN, Dr. Elizabeth Moore, a general OBGYN and founder of MooreExperts, joins host Dr. Mark Hoffman to share her expertise on the intricacies of medical-legal work. --- SYNPOSIS They cover Dr. Moore's journey into expert witness work, including how the pandemic shifted her career focus and ultimately led to the creation of a platform to assist OBGYNs in navigating legal cases. They discuss the challenges of managing extensive medical records, the importance of adhering to the standard of care, and the unique nature of obstetrics cases. They also emphasize the need for precise, evidence-based report writing to avoid unnecessary trials and address the emotional and financial toll legal processes can take on physicians. Finally, the episode explores the need for better systems to protect both patients and healthcare providers while offering insight into future challenges, including AI and private equity involvement in legal cases. --- TIMESTAMPS 00:00 - Introduction05:08 - First Experiences in Medical-Legal Work08:57 - The Role of Education in Legal Cases11:37 - Challenges and Rewards of Medical-Legal Work13:58 - Understanding Standard of Care and Malpractice15:59 - The Importance of Detailed Reports and Depositions20:02 - The Jury System and Its Challenges25:45 - Balancing Professional and Personal Life29:43 - Getting Started in Medical-Legal Work32:07 - Recognizing Patterns in Medical Litigation33:51 - Educating Attorneys for Fair Trials36:33 - Concerns and Improvement of Medical Expert Testimonies45:54 - The Role of Systems in Reducing Medical Errors51:52 - Future Challenges and Opportunities in Medical Legal Work56:07 - Final Thoughts --- RESOURCES ACOG Technical Bulletin 365: Seeking and Giving Consultationhttps://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2007/05/seeking-and-giving-consultation MooreExperts OBGYN Consulting Medical Legal Expert Witness Masterclasshttps://www.mooreexperts.com/ Bless This Mess: A Picture Story of Healthcare by Dr. Stephen Klaskohttps://www.amazon.ae/Bless-This-Mess-Picture-Healthcare/dp/1483479625

30 Dec 202558min

What if the key to improving obstetrical surgery outcomes isn’t a new technology, but rethinking who’s in the operating room? In this episode of BackTable OBGYN, host Dr. Mark Hoffman and co-host Dr. Amy Park welcome Dr. Sony Singh, a prominent figure in the field of minimally invasive gynecologic surgery (MIGS) and obstetrics, to share perspectives on the emerging role of MIG surgeons in obstetrical surgery. --- SYNPOSIS Dr. Singh shares his extensive career journey, from his education in Canada and Australia to his current role as department chair of OBGYN at the Ottawa Hospital. The conversation delves into the integration of MIGS into obstetric surgery, including procedures like laparoscopic cerclages, placenta accreta management, and cesarean scar pregnancies. The hosts and guest discuss the challenges and importance of building a robust team, regionalization of care, maintaining work-life balance, and the eventual transition of leadership roles to sustain the high standards of care. This episode highlights the crucial role of minimally invasive specialists in advancing OBGYN practices while promoting a sustainable work culture. --- TIMESTAMPS 00:00 - Introduction 02:08 - Dr. Singh’s Journey07:37 - The Role of MIG Surgeons in Obstetrical Surgery16:06 - Building a Collaborative Team18:38 - Challenges and Best Practices25:26 - Expanding the Scope of MIG Surgeons30:19 - The Evolution of Urogynecology and MIGS31:31 - Leadership and Building Programs37:54 - Scaling Up and Regionalization of Care42:53 - Balancing Work and Personal Life54:37 - Concluding Thoughts --- RESOURCES Canadian Society for Advancement of Gynecologic Excellencehttps://cansage.org/about/ From Strength to Strength, by Arthur Brookshttps://www.arthurbrooks.com/books

9 Dec 202558min

How economically viable is gynecologic surgery today, and what happens if the system keeps pushing the limits? In this episode of BackTable OBGYN, Dr. Marisa Dahlman from Virginia Mason in Seattle sits down with hosts Mark Hoffman and Dr. Amy Park to discuss the evolving landscape of this field and the pressures surrounding reimbursement. --- SYNPOSIS Dr. Dahlman begins by sharing her career path and fellowship experience before the conversation expands to explore the shift from MIGS (Minimally Invasive Gynecologic Surgery) to CBG (Complex Benign Gynecology), current reimbursement challenges, the difficulty of balancing obstetric and gynecological practice, and how these forces influence training and clinical life. They also discuss the stressors new graduates face while building viable practices, broader healthcare system challenges, resource allocation, and potential solutions to improve practice sustainability and patient care. --- TIMESTAMPS 00:00 - Introduction 03:06 - Fellowship Training and Career Pathways11:43 - Impact of Reimbursement on Fellowship Applications15:20 - Workforce Issues and Future of GYN Surgery28:02 - Advocacy and Leadership in Healthcare29:27 - Understanding Hospital Revenue and Efficiency31:54 - The Role of Physician Leadership in Healthcare35:35 - Navigating Healthcare System Mergers36:47 - The Future of Healthcare Amidst Financial Cuts41:40 - Addressing Healthcare Costs and Reimbursement45:11 - The Importance of Women's Health Services47:37 - Strategies for Improving Healthcare Systems53:48 - Concluding Thoughts --- RESOURCES Trends in gynecologic surgery reimbursement and physician payhttps://pubmed.ncbi.nlm.nih.gov/40305043/

2 Dec 202556min