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Becker’s Healthcare Podcast
Dr. Randi Goldman on Expanding Fertility Preservation and Oncofertility Care at Northwell Health
00:13:17
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- [00:02]
A
Every year, Becker's annual meeting brings healthcare leaders together to unpack the most pressing issues facing the industry. And every year, those conversations shift in profound and unexpected ways. This April, more than 3,500 healthcare executives will return to Chicago for Becker's 16th annual meeting. 795 elite speakers will offer new lessons, new case studies, and predictions about what comes next. Join us April 13th through the 16th. For the agenda and event details, visit Beckershospitalview.com and click on the Events tab in the upper right.
- [00:38]
B
This is Laura Dearda with the Beckers Healthcare Podcast. I'm thrilled today to be joined by Randy Goldman, Associate professor at the Donald and Barbara Zucker School of Medicine at Hofstra Northwell and Program Director of the Reproductive Endocrinology and Infertility Fellowship at Northwell Health, as well as the Chair of Patient Experience Committee at Northwell Health Physician Partners. Randy, it's a pleasure to have you on the podcast today.
- [01:02]
C
Thank you so much. It's great to be here.
- [01:04]
B
Absolutely. No, I'm excited for our conversation because I know, you know, health care is such a dynamic field and I in Northfall too is an innovative system. And so I'm excited to learn more about some of the things that you've been working on in the last year as well as your perspective on the future. But before we dive in, can you tell us a little bit more about yourself and what you are up to at Northwell?
- [01:25]
C
Of course, yes. Thank you. So as you mentioned, I'm a reproductive endocrinologist and infertility specialist at Northwell Health, which is also called rei, and I serve on the program as a program director for the REI Fellowship. I also have helped to lead several system level initiatives in things like fertility preservation, oncofertility as well as patient experience.
- [01:50]
B
Got it. That's helpful to understand. And you know, I'm curious, when you think about the last year or so, what was the most important initiative you led, what did you do and what were the results?
- [02:00]
C
I think the most important initiative I led was the expansion and sort of formalization of fertility preservation and oncofertility pathways across the system. And you know, Northwell is the largest health system in New York State. And so that really gives us the responsibility and the opportunity to sort of scale these evidence based care platforms across our population. Oncofertility is sort of a fancy way of saying the provision of fertility services that we provide for patients who either have an active cancer diagnosis or are cancer survivors. And this includes something called ovarian tissue cryopreservation or ovarian tissue freezing. Ovarian tissue freezing is a process where we can remove an ovary from a patient and then freeze the ovary itself so that in the future, if that patient wants to have a biological child and they are unable to, it is a method to preserve their fertility and kind of give them that opportunity in the future. And ovarian tissue freezing is mainly used for younger girls with cancer who don't have the ability to do egg freezing. Egg freezing is the gold standard for patients who are able to do it. Ovarian tissue freezing can also be used for patients who don't have the opportunity to wait about two weeks before cancer treatment. And so it's used in that context when developing these programs, the oncofertility pathways, fertility preservation pathways, we focused really on early identification of patients for whom these treatments might be beneficial, develop very clear referral pathways that are sort of easy to use. And this really required multidisciplinary coordination with lots of other teams, like the oncology teams, pediatric teams, social work, navigation. And it's something that I'm quite proud of. The results were really measurable. So we had increase in referrals, shorter time to fertility counseling, easier access to the treatment. So an increase in the number of patients who actually underwent fertility preservation treatment and really have expanded access for patients who previously would not have had a viable option before their cancer treatment.
- [04:28]
B
It's helpful to understand, and it sounds like an amazing service and opportunity for patients who are undergoing cancer treatment or have to make sure that they are preserving their fertility and have that kind of standard system in place to provide that access and knowledge, you know, is really great, great service to the community. Now, I'm curious, when you think about the future, what are some of the big priorities and headwinds that you're focused on for 2026?
- [04:57]
C
It's a great question. I think for me, the major priorities would be scaling these. These opportunities for our patients, improving and increasing access and making sure that they're sustainable. What that really means is being able to embed these fertility preservation pathways into existing routine care pathways, expanding the navigation models so that no patient falls through the cracks, and also using data to track outcomes. Whenever you go to conferences or you read about a study looking at fertility preservation and oncofertility, you know, the sort of dot, dot, dot at the end of everything was. And, you know, we need more outcome data. So being in such a large institution, we really are. I think we have a unique opportunity to provide a lot of that outcome data. Some of the, you know, difficulties are things like, like constraints in workforce, challenges of implementing innovation in a large. Where you're not creating parallel tracks, but really working together, not in silos, to make sure things come together for the betterment of patient care. It's not only patients with cancer. Fertility preservation is an option that a lot of patients would benefit from. Another example of something that we're working on is an endometriosis fertility program. Because endometriosis really can negatively impact infertility. Up to 50% of patients with endo can struggle to conceive in the future. So they also need kind of easy access to fertility preservation services and patients with disorders or diseases like sickle cell or thalassemia, where they have the option of getting gene therapy or a stem cell transplant which can effectively cure them of sickle cell or thalassemia, but also significantly increase the likelihood of their having permanent infertility. These are all kind of similar ideas that can benefit from pathways like this that utilize existing resources just in a more kind of efficient and thoughtful way.
- [07:18]
B
It's fascinating to hear about and you know, to be having those types of outcomes and in a position to provide more of that research makes a big difference, I know, for people far beyond the Northwell market. And so it's cool to have that opportunity. And, you know, when you're looking at putting all this together in the great technology I know it takes in order to make all of this happen, how do you really see that impact and make sure that your teams are continuing to be innovative while also understanding what they need to do on a daily basis in order to make this all work?
- [07:56]
C
That's a really good question as well. So a lot of it, I think, comes down to education. I think our teams are really dedicated to not just the status quo, but in innovative health care that can help patients reach their goals later on. As a fertility doc, my focus is on fertility, but I think when you are able to engage the stakeholders and explain why things are going to be important for patients, they're excited to be a part of something innovative and new. Of course, maintaining what we do on a day to day basis is of course critical as well, but I think that there's a way to do both and do both in a very positive way. And the idea is that you're innovating and you're creating new pathways, you're creating new workflows to get patients into treatment. And then hopefully that ultimately becomes the status quo and it becomes part of the routine care, which obviously takes repetition and Takes learning. But. But I find that when you're building things that are new and you're involving other stakeholders, it also helps to provide purpose. Right. You know, we went into medicine so that we could help people. And what better way to help people than find innovative solutions to their health problems?
- [09:21]
B
I love that. And you know, really, truly kind of grounds the mission and vision of everything that you're doing now. What do you think the hardest thing you'll have to do in the coming year will be?
- [09:31]
C
So this is something that I tend to struggle with a little bit, and that's my initial impetus is always to say yes. And I've always been that way. I think the hardest part is going to be saying no to good ideas. In order to focus on ideas that could be executed well and at a large scale in a large health system like Northwell, you have to have some discipline around prioritization. And that can be as important as innovation itself. Because we have to recognize that resources and time are finite. Right. So there could be a lot of good ideas, but figuring out which ones are going to be the most tangible and are going to have the biggest impact is always a challenge, especially for people who are sort of programmed to try to always say yes to things. So it's really just navigating, you know, the best of those options, knowing that you can always table things. Right. Just because you can't do something immediately and in the next year doesn't mean that it can't be kind of rethought of two years or five years from now.
- [10:42]
B
Absolutely. I love that. And I think, you know, being able to push yourself and challenge yourself in the especially new year, but kind of constantly trying to make those improvements makes a big difference and can really be the space where growth happens, it seems.
- [10:56]
C
Definitely, definitely. I think it's a skill to have in and of itself is kind of identifying what things are worth saying yes to. Because there are lots and lots of great ideas, but sort of prioritizing them is I truly think is a skill that is one that I've certainly needed to learn myself.
- [11:20]
B
Absolutely. I think a lot of us can relate to that.
- [11:26]
C
Yeah.
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B
Now, before we wrap up here, I'm curious, where do you see some of the best opportunities for organizational growth?
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C
Ooh. I think strongest growth opportunities for me are sort of at the intersection of lots of things that already exist, like specialty care, navigation, and of course, data. I'm extremely data driven and very evidence based programs like the ones that we've built, fertility preservation programs, this endometriosis program that we're starting and more like complex reproductive decision making really benefit enormously from these coordinated and longitudinal models where you're thinking about the patient's health from more than a single lens. And health systems that are able to sort of integrate clinical excellence along with patient experience and very strong positive outcomes and being able to track those outcomes are going to be able to differentiate themselves quickly in an otherwise very competitive market. And I think that that has to do with finding the right people, the right teams, the right infrastructure and the right resources. And, you know, it's. It's something that certainly is able to be learned, but I think that those are probably the best opportunities for sort of growth that I can see.
- [12:50]
B
I love that. Randy, thank you so much for joining us on the podcast today. This has been such a fun and informative conversation, and I look forward to seeing you as well at our annual meeting in April. I know you'll be spe on a panel and we'll continue to dig deeper into some of these themes we talked about today as well as, you know, have the opportunity to connect and learn from one another.
- [13:09]
C
Thank you. I am really looking forward to it. It was wonderful to speak with you.