Clinician's Roundtable

Host: Renée Simone Yolanda Allen, MD, MHSc., FACOG Pregnancy loss can occur in any trimester of pregnancy and for several possible reasons. For clinicians who treat pregnant patients, delivering the bad news of pregnancy loss is an avoidable part of practice. How do health care professionals best counsel these patients and their loved ones through these difficult times? Host Dr. Renee Allen joins Dr. Jocelyn Slaughter-Moore, practicing OB/GYN at Heras Healthcare for Women and attending physician at Clearview Regional Medical Center in Monroe, GA, to discuss counseling and coping strategies for patients who have experienced pregnancy loss.

Host: Renée Simone Yolanda Allen, MD, MHSc., FACOG In the US, more than one half of pregnant women are overweight or obese, and 8% of reproductive-aged women are extremely obese, putting them at a greater risk of pregnancy complications. In this episode, we review the magnitude of the problem, the anatomic and physiologic factors specific to the obese patient, and the maternal and fetal complications that can occur. Host Dr. Renee Allen welcomes Dr. Patrice Basanta Henry, an Ob-Gyn & MFM at Atlanta Maternal Fetal Medicine, an affiliate of Mednax National Medical Group. Dr. Basanta-Henry’s clinical interests include intrauterine growth restriction and endocrine disorders in pregnancy.

Host: Ana Maria Rosario Guest: Anita L. Nelson, MD Current clinical definitions and terminology for vaginal bleeding often fail to clarify frequency, duration, and volume. Moreover, standards of treatment sometimes differ between obstetric and gynecological points of view. Taken together, the risks for misclassifying and mistreating women with acute excessive vaginal bleeding are preventably high. Joining host Ana Maria Rosario at Omnia Education's Women's Health Annual Visit in Pasadena, CA to discuss key considerations for acute excessive vaginal bleeding is Dr. Anita Nelson, Professor Emeritus at the David Geffen School of Medicine at UCLA.

Host: Renée Simone Yolanda Allen, MD, MHSc., FACOG Host Dr. Renee Allen welcomes Dr. Victoria Green, renowned breast cancer researcher and OB/GYN clinician. Dr. Green is an Associate Professor in the Department of Gynecology & Obstetrics at Emory University School of Medicine. She will review USPSTF recommendations of biennial mammograms compared to ACOG's recommendations, as well as differences in how we define 'breast awareness' versus breast self-examination. Join the discussion!

Host: Prathima Setty, MD Disorders of sex development (DSDs) occur more frequently than most people realize, and yet there are numerous misconceptions persisting in the clinical arena as to how these disorders are best approached. For example, whereas older prevailing sentiments on presentations of ambiguous genitalia called for immediate sex assignments at birth followed by surgical alignments of those decisions, more modern philosophies advocate for direct patient involvement in these decisions a little later in life. Joining Dr. Prathima Setty to focus on this important topic is Dr. Earl Cheng, Professor of Urology, Division Head of Urology and Co-Head of Reconstructive Pediatric Urology at Northwestern University Feinberg School of Medicine. Dr. Cheng directs the Gender and Sex Development Program at Ann & Robert H. Lurie Children's Hospital of Chicago.

Host: Matt Birnholz, MD Guest: Edward R. Sauter, MD, PhD, MHA In the clinical arena, discussions on breast cancer prevention and treatment often center on what is considered most "cutting edge," from genetic mechanisms of disease to new combination pharmacotherapies to breast-conserving surgical innovations. But another field of study, targeting the potential roles of nutrition in breast cancer risk, remains commonly neglected by the medical community. What parts do nutritional choices and habits play in breast cancer development, and how can clinicians make better risk assessments given this information? Dr. Edward Sauter, Professor of Surgery and Director of the Cancer Treatment and Prevention Center at the University of Texas Health Sciences Center, joins Dr. Matt Birnholz to discuss emerging connections between nutrition and breast cancer.

Host: Matt Birnholz, MD From the floor of ACOG's annual scientific meeting, Dr. Matt Birnholz welcomes Dr. Leonard Glass, Founder and President of Physician Retraining & Reentry (PRR), a comprehensive educational platform which enables licensed physicians to reenter practice on a part-time basis in adult general practice outpatient clinics. It is also being considered as a means for recently established specialist physicians to expand their patient profile by including general practice, as well as the physicians with physical impairment who must transition to primary care because of manual dexterity is diminished for any number of reasons.

Guest: Olufunmilayo (Funmi) Olopade, MD, FACP Host: Maurice Pickard, MD Host Dr. Maurice Pickard welcomes Olufunmilayo (Funmi) Olopade, MD, FACP, Walter L. Palmer Distinguished Service Professor of Medicine & Human Genetics, Associate Dean for Global Health, and Director of Center for Clinical Cancer Genetics at the University of Chicago Medicine, Chicago, IL. Dr. Olopade reviews the latest information and best practices in establishing an interdisciplinary program in improving chronic disease treatment worldwide. She reviews challenges and progress toward providing better education, research and training, and service infrastructures addressing global health issues within the United States and around the world.

Host: Maurice Pickard, MD Guest: Olufunmilayo (Funmi) Olopade, MD, FACP Host Dr. Maurice Pickard welcomes Dr. Funmi Olopade, Walter L. Palmer Distinguished Service Professor in Medicine and Human Genetics, Director of the Hematology/Oncology Fellowship Program, and Director of the Center for Clinical Cancer Genetics at the University of Chicago. Dr. Olopade discusses disparities in health outcomes for black women with breast cancer. Dr. Olopade is an expert in cancer risk assessment and individualized treatment for the most aggressive forms of breast cancer, having developed novel management strategies based on an understanding of the altered genes in individual patients. She stresses comprehensive risk reduction and prevention strategies in high-risk populations, as well as earlier detection through advanced imaging technologies.

Host: Matt Birnholz, MD From mapping AEDs on a phone app to communicating with colleagues on Facebook, technology has become an integral part of daily life. Some would even call their phones an extension of the human nervous system, as evinced by a near-constant awareness of their battery life. Yet despite this high prevalence and demand for social media in regular affairs, medicine has been slow to adopt it. Join Dr. Matt Birnholz and Dr. Nathaniel DeNicola discuss the role of technology and social media in medicine, with particular attention to ACOG's adoption over the past 10 years.

Host: Matt Birnholz, MD Most women will readily testify that pelvic examinations are unpleasant experiences; they can be physically painful and induce anxiety. But recent studies have also indicated that examinations of asymptomatic, average-risk woman may lead to unexpectedly high rates false positives and unnecessary followup tests. So the perennial question resurfaces: are routine pelvic examinations more trouble than they're worth? Join Dr. Matt Birnholz and guest Dr. Hannah Bloomfield, Chief of Research at the Minneapolis VA Medical Center, speaking at ACOG’s annual scientific meeting. They focus on the latest research behind this question of whether routine pelvic examinations are really necessary for monitoring patient health, and the potential pros and cons of abandoning this practice in annual OB/GYN checkups.

Host: Matt Birnholz, MD Many people believe that exercise during pregnancy is detrimental to the health of the fetus. This belief seems to have come from an outdated study that the fetus’s heart rate drops if the mother exercises. More recent studies, however, have supported a counterposition that exercise during pregnancy is safe and can actually be beneficial for both the mother and fetus. Join Dr. Matt Birnholz and Dr. Linda Szymanski, Medical Director of Labor and Delivery at Johns Hopkins Hospital at the Johns Hopkins School of Medicine. They discuss the latest research on exercise during pregnancy, from benefits to harms, and how clinicians can counsel patients on the "right" amount of exercise during this life period.

Host: Matt Birnholz, MD Guest: Maureen Whelihan, MD There is a stigma around sex in the United States. That stigma makes it difficult both for patients to disclose details about their sex lives in clinical settings and for physicians to ask patients about sex. Consequentially patients may have treatable but unaddressed sexual problems because their physicians don't know those problems exists. Join Dr. Matt Birnholz and Dr. Maureen Whelihan, President of The Center for Sexual Health and Education in West Palm Beach, Florida, as they discuss case stories spanning the various ages and stages of sexual health, and their implications in helping physicians and patients talk about sex.

Host: Matt Birnholz, MD Studies in the field of anthropology have shown that having a healthy grandmother plays a critically positive role in family cohesion. But the wholistic, personalized health needs of women in their elder years are not always recognized. This care disparity is all the more prominent in general OB/GYN practice, but thanks to the work of a select few, the trends may be about to change. Dr. Matt Birnholz speaks with Dr. Sarah Berga, Professor and Chair of OB/GYN at Wake Forest School of Medicine at ACOG’s annual meeting in San Francisco. They discuss maintaining grandmothers' health across both physiological and psychological spectra, and how this attention in care fundamentally changes larger family units for the better.

Host: Maureen Whelihan, MD The increasingly recognized concept of a clinician's "work-life balance" is critical to thriving and avoiding burnout, but the philosophy behind this balance remains poorly understood. Some argue that adequate time alottment to one's priorities is the key factor in sustaining a positive medical career trajectory, but a select few believe that time allocation alone is not enough. Dr. Michael Foley, Chairman of the Department of Obstetrics and Gynecology at Banner University Medical Center-Phoenix, argues in favor of what he calls work-life harmony, where aspects of meaningfulness, relationships, and wellbeing better guide one's life and career decisions. Joining host Dr. Maureen Whelihan at ACOG's Annual Scientific Meeting in San Francisco, Dr. Foley applies a martial arts-centered perspective on medical careers based on his extensive experience as a seventh-degree black belt and the founder of The Center for Humane Living.

Over the past decade, Food Protein Enterocolitis, or FPIES, has emerged as the most actively studied non–IgE-mediated gastrointestinal food allergy because of its acute onset, severity of symptoms, and distinctive clinical features. Yet as a rare allergic disorder of infancy and young childhood, it is often misinterpreted and misdiagnosed in clinical practice, leading to difficult treatment paths for patients and their families. Joining Dr. Renee Matthews to present a case history from the vantage point of a patient's mother, including challenges faced in reaching the correct diagnosis and starting effective treatment regimens, is Jennifer Kandt.

Host: Matt Birnholz, MD Dr. Matt Birnholz welcomes Dr. Tom Gellhaus, President-Elect of The American College of Obstetricians and Gynecologists, to discuss his vision for ACOG's initiatives to come, inspired in part by both his unique clinical training background and his extensive legislative activity experience on behalf of OB/GYN specialists nationwide. Dr Gellhaus is Clinical Associate Professor of OB/GYN and Director of General OB/GYN at the University of Iowa Hospitals and Clinics in Iowa. City.

Host: Matt Birnholz, MD Dr. Matt Birnholz welcomes Dr. Mark DeFrancesco, 66th President of The American College of Obstetricians and Gynecologists, to the program. Dr. DeFrancesco looks back at the accomplishments of his immediate predecessors, and reflects on the three-fold initiative to which he will dedicate his efforts on behalf of ACOG to advance the OB/GYN specialty for years to come. Dr. DeFrancesco is managing partner at Westwood Women’s Health in Waterbury, Connecticut, a division of Women’s Health Connecticut. He is a founding member of this organization, and served as its chief medical officer for many years.

Host: Matt Birnholz, MD Dr. Matt Birnholz welcomes Dr. Jeanne Conry, 64th President of The American Congress of Obstetricians and Gynecologists, Assistant Physician-in-Chief at The Permanente Medical Group in Roseville, CA, and Associate Clinical Professor of OB/GYN at the University of California, Davis. Dr. Conry reflects on three presidential initiatives she advanced during her tenure: (1) formal, ongoing investigations into the environmental impacts on health, (2) a national campaign to reduce maternal morbidity and mortality, and (3) launch of the Well Woman Task Force.

Host: Matt Birnholz, MD In the past several years, endometrial ablation has become an increasingly utilized method for minimalizing heavy menstrual bleeding. What's more, this procedure has since been brought into the outpatient setting. But what do clinicians who are considering bringing this procedural practice into their offices need to know before moving forward? Joining Dr. Matt Birnholz to discuss the benefits and limitations of in-office endometrial ablation is Dr. Monte Swarup, Partner at New Horizons Women’s Care from the Arizona OB/GYN Affiliates, and Clinical Assistant Professor at Midwestern University in Phoenix, AZ.