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EventCalendar

  • The 5th IVI International Congress: Reproductive Medicine and Beyond by ComtecMed
    04-Apr-13 to 06-Apr-13 Seville , SPAIN (GYN - Contraception & Reproductive Health)
     
  • 2013 AIUM Annual Convention by American Institute of Ultrasound in Medicine
    06-Apr-13 to 10-Apr-13 New York (New York Marriott Marquis Hotel) , NY USA (CME - Medical Education)
     
  • Manejo clínico y terapéutico de la esterilidad. Segundo curso online by Fundacio Dexeus Salud de la Mujer
    09-Apr-13 to 31-May-13 online , SPAIN(gynecology)
     
  • Pediatric Nursing: Care of the Hospitalized Child by Continuing Education Inc.
    10-Apr-13 to 13-Apr-13 Anaheim (Hyatt Regency Orange County) , CA USA (CME - Obstetrics, Gynecology & Women's Health)
     
  • Medicina fetal Curso-Taller. Curso de Nivel I y II de la SESEGO by Fundacio Dexeus Salud de la Mujer
    15-Apr-13 to 17-Apr-13 Barcelona (Auditorio Salud de la Mujer Dexeus) , SPAIN (OB - Maternal Fetal Medicine)
     
  • Female Urology & Urogynecology Symposium (FUUS) by Quadrant HealthCom, Inc
    18-Apr-13 to 20-Apr-13 Las Vegas (ARIA) , NV USA (CME - Obstetrics, Gynecology & Women's Health)
     
  • Female Urology and Urogynecology Symposium (FUUS) 2013 by Quadrant HealthCom, Inc
    18-Apr-13 to 20-Apr-13 Las Vegas (ARIA) , NV USA (CME - Obstetrics, Gynecology & Women's Health)

FeaturedContent


New Medical Guidelines for Cervical Cancer Screening: Is there a role for new molecular diagnostics?
Daniel M. Jones, MD, PhD , January 31, 2013

Some may argue that the new ACOG, ACS and other cervical cancer screening guidelines will detect the majority of at-risk women. We should not be content with settling for identifying a majority of at risk women; rather, we should constantly reassess the availability of useful tests to see if we can improve reliability.

Using RVUs to Improve Your Practice’s Performance
Sara Larch, MSHA, FACMPE, Principal, Business of Medicine , May 21, 2012

In the early years, medical practices only utilized Relative Value Units (RVUs) to understand the Medicare fee schedule. Now the role of RVU analysis has expanded. RVUs have become the standard measurement in analysis of reimbursement and payer contracts, physician compensation and productivity, and practice staffing and operating costs.

2012 Geographic Practice Cost Indices
May 21, 2012

A geographic practice cost index (GPCI) accounts for geographic differences in the cost of practice around the country.

Can You Give Your Patients Too Much Information?
Sonja Kristiansen, MD , April 24, 2012

Like many of my patients, my life revolves around information. Personally, I use the same technology as most of you to keep track of obligations and loved ones. Professionally, the Houston Fertility Center team uses technology and constant communication to manage our patients' treatment plans.

The Fertility Preservation Pipeline Is Clogged for Women with Cancer
Sonja Kristiansen, MD , April 3, 2012

Here's a situation that illustrates how fantastic medical advances don't always translate to patients benefiting in the clinic. For that to happen, the science needs to be carried along a pipeline of practitioner communication, all the way to the patient.

What Infertility Can Teach Us about Customizing Healthcare Protocols
Liz Imler , March 29, 2012

I know what you're thinking: How can an issue like infertility teach us about customizing healthcare? And how can the assisted reproduction field help raise standards in women's healthcare? But it can, and it does… or it should.

Treating “Religious Infertility”
Lawrence Grunfeld, MD , January 27, 2012

Orthodox Jewish women may follow an ancient tradition that requires sexual abstention during her menses and for the seven days that follow. Once the woman has completed this, she immerses in a ritual bath to purify her soul and then is encouraged to have intercourse with her husband but when your patient experiences infertility, how do you treat the infertility while maintaining respect for her religious traditions?

CA-125: What is it good for?
David Holtz, MD , January 10, 2012

As a gynecological oncologist, I often see patients who want to be tested for cancer because a close family member has just been diagnosed. Understandably, they want to be sure they don’t have it.

Lipoleiomyoma of Uterus
Joe Antony, MD. Consultant Radiologist , December 14, 2011

The fibroid is a tumor that is very frequently encountered in the uterus on both clinical examinations as well as on routine pelvic sonography.

The Double Decidual Sac Sign
Joe Antony, MD. Consultant Radiologist , November 7, 2011

One of the problems with sonography of the early pregnancy is the inability to clearly determine if the gestation sac is intrauterine or extrauterine (ectopic) in nature. This task is even more complicated by the controversies arising from whether the “sac” seen is a true sac or a pseudosac of ectopic pregnancy.

Anxious for Two: Assessing and Treating Antenatal Anxiety Disorders
Orit Avni-Barron, MD. , October 25, 2011

She just paged you again. It is “urgent”, just like the last 5 times. You sigh deeply: no matter how many times you tell her that her labs are normal, explain that some shortness of breath is expected in the last trimester, or reassure her that her heartburn is not a first sign of a heart attack (yes, you checked) – it simply won’t stick.

Hemorrhagic Ovarian Cyst: A Sonographic Perspective
Joe Antony, M.D. , October 9, 2011

When a graafian follicle ruptures to release an oocyte, it is transformed into a corpus luteum. The corpus luteum is lined by a layer of granulose cells which rapidly become vascularized; some of these thin-walled vessels can rupture. This causes bleeding into the corpus luteum, resulting in the formation of a hemorrhagic cyst of the ovary.

What are they? What causes them to grow?
Paul D. Indman, MD , October 2, 2011

What are Uterine Fibroids? The walls of the uterus are made of smooth muscle called myometrium, and the inside lining, with glandular tissue, is called endometrium. “Uterine fibroid” is a slang term for leiomyoma, or often simply myoma. Fibroids are benign tumors made of smooth muscle cells.

Types of Uterine Fibroids
Paul D. Indman, MD , September 19, 2011

Uterine Fibroids are classified by their location, which effects the symptoms they may cause and how they can be treated. Fibroids that are inside the cavity of the uterus (Submucous myomas) will often cause bleeding between periods and often cause severe cramping. Fortunately, these fibroids can usually be easily removed by a method called “hysteroscopic resection,” which can be done through the cervix without the need for an incision.

Hypocoiled Umbilical Cord
Dr. Joe Antony, MD. , September 8, 2011

Significance of the umbilical cord: the umbilical cord can be aptly termed the life line for the fetus during its intrauterine life but can often be the cause for its misery in case of cord pathology.

AboutOurBloggers

 

GUEST BLOGGER

David Holtz, MD

David Holtz is a practicing Gynecologic Oncologist with Main Line Gynecologic Oncology Associates and the Director of the Division of Gynecologic Oncology for the Main Line Health System. He is the first gynecologic surgeon in Pennsylvania to perform procedures for uterine and cervical cancer with the daVinci Robot, and he is a Clinical Assistant Professor with Thomas Jefferson University Hospital and the Lankenau Institute for Medical Research. Dr. Holtz’s clinical interests include minimally invasive surgery for women’s cancers and nanoparticles in the treatment of ovarian cancer.

 

GUEST BLOGGER

Donald Shuwarger, MD

Dr Don Shuwarger is a board-certified general ob/gyn practicing in northwest North Dakota. His career spans 26 years, most of which has been spent serving smaller cities. He earned his MD from Baylor College of Medicine in 1981 where he completed his ob/gyn residency in 1985. He earned his MBA from UMass-Amherst in 2005. In 2008 Shuwarger took a sabbatical to join the US Antarctic Program as a physician at McMurdo Station and the new Amundsen-Scott South Pole Station. From 2009 - 2010 he was the Chief Medical Officer at the US Army Kwajalein Atoll in the Marshall Islands. He has one 22 year old daughter who is an EMT and is studying to be a registered nurse.

GUEST BLOGGER

Amy Tuteur, MD

Dr Tuteur is an obstetrician gynecologist. She received her undergraduate degree from Harvard College, her medical degree from Boston University School of Medicine, and did her internship and residency at Boston's Beth Israel Hospital. Dr Tuteur is a former clinical instructor at Harvard Medical School. She left the practice of medicine to raise her four children. She blogs at The Skeptical OB.

ISSUES IN INFERTILITY

Reproductive Medicine Associates of New York

RMA of New York offers patients up-to-date, appropriate infertility treatment in a caring, compassionate manner.

ISSUES IN INFERTILITY

Eric Flisser, MD

Dr Flisser, MD is the Medical Director of Reproductive Medicine Associates of New York. He is Board Certified in Reproductive Endocrinology & Infertility and in Obstetrics & Gynecology. He is an Associate Member of the American Society for Reproductive Medicine and the Society for Reproductive Endocrinology and Infertility. He is also a member of the Nassau County Obstetrics and Gynecology Society, New York-Metropolitan Embryologist Society, and the American College of Obstetricians and Gynecologists. His professional interests include reproductive surgery, in vitro fertilization, and oocyte donation.

ULTRASOUND

Joe Antony, MBBS, MD

Dr Antony's expertise includes radio diagnosis, ultrasound and color Doppler imaging, x-ray imaging, CT imaging, and MR imaging. Presently, he is a consultant radiologist at PVS Hospital in Cohin, Kerala, India and is consultant radiologist and CEO of Ultrascan Centre, which is a color Doppler and ultrasound imaging clinic in Cochin, India.You can see his full ultrasound gallery at
ultrasound-images.com and sites.google.com/site/drjoea. He blogs at cochinblogs.blogspot.com and ultrasound-images.blogspot.com.

UTERINE FIBROIDS

Paul Indman, MD

Dr Indman, MD has helped pioneer techniques in gynecology and minimally invasive surgery. He has taught physicians locally, nationally, and internationally, and has published chapters in textbooks on advanced surgical techniques, and in numerous medical journals. Dr Indman is an editorial advisor on OBGYN.net. You can read more about him and his work on his eFibroids Web site.
 

 


MedicaForums

Medica Forums - 5/19/13
Had a case the other day with the above finding on a pap. She was age 36 and had a Mirena in place. How do people feel about the idea of trying to do an EMB with an IUD in place? If not, how do we proceed?
Medica Forums - 5/16/13
Hello,

Has anyone tried FetalGrowth app (App Store for iPhone/iPad) ? I'm interested in using a simple and handy tool to calculate fetal percentiles, and I came across this app, which seems it does the job (plots growth charts, as well). I haven't seen anything else, besides this app, so I was wondering if there are people who have already tried it.

Thanks !
Medica Forums - 5/12/13
Welcome to the new ObGyn.net Forum!

To all the members of OB-GYN-L… Thank you for coming! I’m thrilled that you’ve decided to check out the new Forum site, and look forward to reading about what’s on your mind.

If you’re new to the ObGyn.net community... welcome aboard! You’ve just joined an outstanding group of physicians and health care professionals who have been sharing information, answering questions, and building professional relationships via the site’s listserv for nearly 20 years.

Feel free to poke around on the site to get a feel for things, or take a look at the Help Topics page for instructions on how to use the different features of the site.

A few quick tips:
For those of you who like getting new Forum messages delivered directly to your inbox, the first thing you’ll want to do is click on the ‘Follow this forum’ button on the main page. You’ll have the option of getting notifications immediately, as a daily digest, a weekly digest, or only when you’re not online (which is to say, if you’re on the site when someone posts a message, you won’t be notified of it). You won’t be able to post on the site just by replying to the email, but the message will contain a link that takes you directly to the message you’d like to reply to.

You can also follow individual conversations without following the whole list by going into the topic and clicking the ‘Follow this topic’ button next to the title.

Also, in ‘My Profile’ you can:
  • Enter your professional information, including specialty, subspecialty, and education (by clicking ‘Edit my profile’)
  • See your activity on the Forum, such as what discussions you have initiated or replied to, content you’ve ‘liked,’ and activity of people you’ve made your friends
In ‘My Settings’ you can:
  • Add or change your photo
  • Edit your birthday, gender, interests, location
  • Create a signature for your posts
  • Change the types of content you get notifications for, or change the way you receive notifications
If you have questions, feel free to respond to this post or send me a direct message by clicking on the envelope icon.

Happy posting!
Medica Forums - 5/11/13
I helped another physician with removal of a retained placenta last night, we were unsuccessful in removing it vaginally, her cervix was too closed to allow manual removal and we could only get a few pieces out with ring forceps and a large curette, so we did a laparotomy/hysterotomy and were able to preserve the uterus. The placenta turned out not to be an accreta and it was easily removed via that route through a low vertical incision on the uterus. Any thoughts on the appropriate CPT code would be appreciated. The patient came in through the ER five days after home delivery by her husband. She was severely anemic, rcvd 7 units of blood and is still quite ill and in the ICU but improving.

Ronald E. Ainsworth, MD, FACOG
Medica Forums - 4/15/13
Recently, I had the occasion to review a case of a term primigravida with PROM in a private hospital (no housestaff or in house obstetricians). She was seen by an obstetrician soon after arrival, evaluated, and pitocin induction begun.

She did not deliver for around 29 hours after admission, and the delivering obstetrician (a different physician) was physically present during the last 2 hours of labor prior to delivery.

Simply put, while the two involved obstetricians were in communication by phone with the nursing staff throughout labor (separately as their "shifts" did not overlap), no one actually came to the bedside and wrote a note) from admission until around 2 hours before delivery.

Medical staff bylaws call for a daily progress note; this bylaw was easily met.

In reviewing the case, it did not "feel good" that no one came to the bedside.

My questions:

1. Does anyone have or know of any guidelines to mandate such bedside attendance? Of course, we all hope that the involved physicians would not need said guidelines.
2. Does anyone have a suggestion of hospital/nursing protocols? Simply, in this case I would like to have had a charge nurse or bedside nurse simply say, "Hey, no one has been by for a while. What's up?"

Garry
Medica Forums - 4/12/13
Hey, what textbooks would you advise for my son who is beginning residency this summer?

Post here or email privately if better.

Thanks,

Garry
Medica Forums - 4/8/13
<p>Hello  friends ,

           I want to know how much does a facelift cost on average? Do you know anyone what is facelift cost ? please help me .........
Medica Forums - 4/7/13
Hello,

I really need help from OB/GYNs and I'm having a hard time getting it. I find your opinions really valuable. I'm researching recommendations for cosleeping. This is for my dissertation, so your time is truly appreciated! Please complete the full survey. It will help me tremendously.

The study takes about 5 to 10 minutes to complete. Please don't hesitate to contact me at bhamel@pacificu.edu with any questions.

If you are interested in participating, please follow the link provided below:

https://www.surveymonkey.com/s/Cosleeping

Thank you in advance for your time. If possible, please forward this to other OB/GYNs you know.

Sorry if this an innappropriate use of the forum. But it seems like the right place to find the participants I need.
Medica Forums - 4/7/13
.

Our hospital bought an electronic medical record (EMR) system for the clinics. There is a large hosptial group practice including pediatrics, medicine, FP, OB/GYN, and other specialities and sub-specialities. Furthermore, the hospitalists and the ER doctors are also employed in the same hosptial group practice.

The hospital spent millions of dollars on an EMR. As best I can tell there are only two useful things that the EMR does. One is to automatically calcualte the BMI, which it does very well. THe other is to make records available on any patient to any doctor anywhere in the practice. It does not do this well -- it requires lots of mouse movements and clicks and different documents come up in different formats, making it labor intenisve. But, with enough time, effort, and frustration, one can obtain copies of every document in the sustem, either on a computer screen or on paper.

Swith to the ER now. A paitnet whom I had seen the previous week in consultatio comes into the ER for a non-pregnancy problem. They call me on the telephone in the evening. "No problem", I say. I did a torough evaluation and wrote a detailed note on the patient and her OB and non-OB problems only a few days ago. "Just go to the EMR and you can print out my note with all the details."

Seems, however, that for some reason the EMR is not available in the ER (or on the wards for that matter). When I asked the hosptial administrator about it the next morning, he said that he and the hosptial lawyers were working on the problem.

Apparently the government thinks that the ER doctors and hospitalists have nothing better to do with their time than to print out copies of patients' medical records from the EMR and sell them on the black market. Therefore, we cannot let those nasty doctors have access to the EMR records. Nevermind that the ER doctors are in the same group practice as all the other doctors. Never mind that the patient is willing to sign a release so that the doctor who is taking care of her can see the records of the practice. We have to protect the patient even if it means that vital information is rendered unavailable and that things are made more difficult, complicated, and expensive. It reminds me of the Army in Viet Nam where they would have to "destroy a village in order to save it!" Apparently the EMR makes us destroy a patient in order to save her.

Thank GOD for the EMR. Three million dollars and the only benefit is that we can get a BMI 10 seconds faster.

I think the NEJM got it correct last month when they said in an atricle that the only ones who truly benefit from electronic medical record systems are the people who make and sell them.



Dean Huffman
Medica Forums - 4/7/13
Decline in Semen Concentration and Morphology in a Sample of 26,609 Men Close to General Population Between 1989 and 2005 in France


http://www.medscape....22498EV&spon=16

EducationalTutorials


Educational Tutorial: Complications of Laparoscopy
February 7, 2012

There are a variety of complications that can occur during laparoscopic surgery. In this tutorial learn some of the complications and tips to avoid them.

Educational Tutorial: Low Molecular Weight Heparin in Recurrent Abortions
January 17, 2012

Review information on low molecular weight heparin in recurrent miscarriages in this educational tutorial.

FromPhysiciansPractice

Primary Care Can't Thrive Without Nurse Practitioners
Courtney H. Lyder, ND,  May 17, 2013
With a projected shortfall of primary-care physicians, it's time for alternate solutions to patient care. Nurse practitioners are one logical remedy.
VWhat Physicians Can Learn from the Allscripts EHR Lawsuit
Marisa Torrieri,  May 16, 2013
Lawsuit prompts question: What should physicians do to ensure they end up with a great EHR instead of buyer’s remorse?
Eight Ways ICD-9 Will Still Matter to Medical Practices
Brenda Edwards, CPC,  May 15, 2013
What should your medical practice do with your ICD-9-CM book after October 1, 2014? Keep it.
Seven Ways Technology Can Speed Up Patient Collections
Cheyenne Brinson,  May 15, 2013
Failing to adopt widely available billing and collections technology can cost medical practices big. Here's how to do it right.
Four Reasons Private Medical Practice is Becoming Extinct
Carol Stryker,  May 15, 2013
It’s becoming increasingly difficult for private medical practices to thrive. Here’s what’s driving the trend toward consolidation.
 

 

 

 

 

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