
Hosted by BackTable · EN

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

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/

Everything you need to know about tubo-ovarian abscesses (TOAs): breaking the stigma, safer treatment, fertility preservation, and better outcomes. This episode of BackTable OBGYN features Dr. Katherine Smith, an assistant professor and MIGS Fellowship Program director at UT Southwestern. With hosts Dr. Amy Park and Dr. Mark Hoffman, Dr. Smith provides an extensive overview of contemporary TOA management, emphasizing the significance of early intervention and the evolving understanding of TOAs beyond traditional STI etiologies. --- SYNPOSIS The conversation delves into the management of TOAs, both non-ruptured and ruptured, and the underexplored connection to the female reproductive tract microbiome. They also touch on the integration of AI in clinical practice, particularly in streamlining administrative tasks. The episode underscores the need for updated guidelines and more research into the microbiological aspects of TOAs to improve patient outcomes. --- TIMESTAMPS 00:00 - Introduction 02:20 - Understanding TOAs: Early Interventions and Challenges04:43 - Clinical Management of TOAs08:06 - Surgical Approaches and Considerations22:25 - Microbiome and Infection Insights32:10 - Discussing Patient Reactions and Education32:47 - Teaching Practices and Medical Education34:18 - Clinical Observations and Data36:55 - Surgical Management of Ruptured TOAs40:50 - Challenges in Treating Infected Endometriomas50:13 - Exploring the Role of AI in Medical Practice54:23 - Concluding Remarks --- RESOURCES ACOG Recommends Concurrent Sexual Partner Treatment for Recurrent Bacterial Vaginosis for the First Timehttps://www.acog.org/news/news-releases/2025/10/acog-recommends-concurrent-sexual-partner-treatment-recurrent-bacterial-vaginosis-first-time Strange Bedfellows, Ina Park MD, MS https://www.inapark.net/the-book

Endometriosis and fibroids don't have to block your patient’s path to pregnancy. In this episode of BackTable OBGYN, host Dr. Mark Hoffman welcomes Dr. Jim Robinson, Director of Reproductive Surgery at Shady Grove Fertility in Maryland, to share his guidance on reproductive surgery applications and reproductive health. --- SYNPOSIS The conversation explores the management of endometriosis and fibroids, the use of office hysteroscopy, and the intricacies of hysteroscopic and laparoscopic procedures. Dr. Robinson covers the importance of individualized patient care, the latest advancements in reproductive technology, and insights from his unique career blending academic medicine with a focus on enhancing fertility outcomes. Listeners will gain a comprehensive understanding of the critical role surgical interventions play in reproductive endocrinology and the nuanced approach required to optimize patient outcomes. --- TIMESTAMPS 00:00 - Introduction 05:17 - Understanding Reproductive Surgery08:51 - Hysteroscopy in Reproductive Surgery16:28 - Endometriosis and Infertility23:50 - Diagnosing and Treating Adenomyosis28:10 - Surgical Interventions for Reproductive Health33:52 - Balancing Endometrioma Removal and Fertility35:49 - Surgical Approaches and Patient Goals36:46 - Complexities of Fertility Consultations42:48 - Impact of Fibroids on Reproductive Health45:33 - Adhesion Prevention in Myomectomy48:33 - Innovations in Fibroid Ablation52:10 - Understanding Isthmoceles and Their Impact58:11 - Concluding Thoughts --- RESOURCES ReceptivaDx: What does it mean to test positive for high levels of bcl6https://receptivadx.com/what-does-it-mean-to-test-positive-for-high-levels-of-bcl6/ Impact of hysteroscopic surgery for isthmocele associated with cesarean scar syndrome: https://pubmed.ncbi.nlm.nih.gov/28892298/

Ever wondered what it’s like to train and practice obstetrics and gynecology across New Zealand and Australia? In this episode of BackTable OBGYN, Dr. Amy Park sits down with Dr. Michael Wynn-Williams, a renowned gynecologist and endometriosis specialist. Dr. Wynn-Williams discusses his extensive training across New Zealand, Australia, the UK, and Scotland, emphasizing his role in minimally invasive gynecology.---SYNPOSISThe conversation covers the nuances of gynecology and obstetrics training in Australia and New Zealand, the balance between public and private healthcare systems, and the cultural differences in medical practice. Dr. Wynn-Williams also sheds light on issues like medical-legal environments, insurance, the impact of geography on healthcare delivery, and the integration of advanced ultrasound practices in endometriosis care. The episode provides valuable insights for those considering a career in gynecology in these regions.---TIMESTAMPS00:00 - Introduction07:35 - Training in Australia and New Zealand15:05 - Public and Private Healthcare Systems20:25 - Challenges and Equity in Healthcare24:39 - Balancing Public and Private Practice28:48 - Inpatient Services and Day Case Hysterectomy29:46 - City vs. Rural Practices and Equity Issues31:55 - Staffing Challenges in New Zealand33:57 - Living and Working in New Zealand and Australia35:25 - Navigating Medical Practice Transfers40:10 - Medical-Legal Environment in Australia and New Zealand43:31 - Gender-Based Reimbursement and Training Challenges51:41 - Endometriosis Ultrasound Scanning and Collaboration52:27 - Final Thoughts---RESOURCESThe Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), the professional body responsible for training, accreditation, and standards in obstetrics and gynecology in both countrieshttps://ranzcog.edu.au/