What happens when a fully integrated healthcare system aligns training, data, and access to improve surgical outcomes? In this BackTable OBGYN episode, Dr. Eve Zaritsky joins hosts Dr. Mark Hoffman and Dr. Amy Park to discuss how Kaiser’s integrated health system enables rapid care coordination, large-scale quality improvement, and population-level research using one of the largest US datasets.

---

Get the BackTable app

https://www.backtable.com/app

---

Timestamps

01:17 - Introduction
03:35 - How Kaiser Works
07:24 - Research Using Big Data
09:19 - Changing Hysterectomy Culture
13:36 - Ending Racial Disparities
15:22 - Handling Large Uteri
17:52 - Vaginal Hysterectomy Trends
20:38 - Myomectomy Reintervention Rates
24:23 - Shared Decision Making
26:30 - Mini Lap Versus Robotic
27:41 - Hybrid Extraction Strategy
29:08 - Credentialing Robotic Myomectomy
30:19 - MIG Referral Pathways
32:03 - Fibroids Across Asian Subgroups
34:55 - Mentoring Research Pipeline
36:44 - Funding Analysts Through GME
40:49 - Endometriosis Disparities Findings
43:59 - Mentorship Mindset

---

More about this episode

Dr. Zaritsky describes how a coordinated, system-wide effort transformed hysterectomy care, shifting from 80% open procedures to nearly 90% minimally invasive within five to eight years through focused training, reducing low-volume practice, and tracking system metrics, ultimately decreasing racial disparities once minimally invasive rates exceeded 90%. She also highlights Kaiser-based research on variation in vaginal hysterectomy by service area and surgeon volume, long-term reintervention rates for fibroids across procedures, increasing use of minimally invasive myomectomy, and a JAMA analysis showing differences in fibroid diagnosis among Asian subgroups with the highest rates in South Asians. The episode concludes with Dr. Zaritsky calling attention to how Kaiser’s research infrastructure creates robust opportunities for meaningful mentorship across all levels of training, supporting the development of physicians, residents, and medical students.

---

Resources

Minimally Invasive Hysterectomy and Power Morcellation Trends in a West Coast Integrated Health System

https://pubmed.ncbi.nlm.nih.gov/28486359/

Racial Disparities in Endometriosis and Pelvic Pain Treatment Within an Integrated Health Care Delivery System

https://pubmed.ncbi.nlm.nih.gov/40839882/

Uterine Fibroid Diagnosis by Race and Ethnicity in an Integrated Health Care System
https://pubmed.ncbi.nlm.nih.gov/40172885/