New Obstetrical and Gynecological Subspecialty Services Now Offered in a Local Community Setting
When Ashley Yeats, MD, came to Beth Israel Deaconess Hospital-Milton (BID-Milton) as Chief Medical Officer in 2011, one of his goals was to build a robust women’s health program where women could have local access to the same level of OB-GYN care found in tertiary hospitals.
“I have always felt very strongly about women’s health being a foundational building block of a community hospital and community practices,” says Dr. Yeats. “Our relationship with Beth Isreal Deaconess Medical Center [BIDMC] really opened up an exceptional opportunity to establish that, and for our community to maintain access to high-quality OB-GYN services.”
Thanks to its affiliation with BIDMC, the hospital is now able to offer outpatient gynecological and obstetrical care in Milton, including prenatal visits, while babies are delivered at BIDMC through the Milton Women’s Health practice of OB-GYNs Alice Shin, MD, and Huma Farid, MD. In addition, new gynecological and obstetrical subspecialists from BIDMC now see patients in the office as well.
The BIDMC-BID-Milton partnership brought with it the leadership and expertise of Hope Ricciotti, MD, Chair of the Department of OB-GYN at BIDMC.
“The BIDMC-BID-Milton is part of our systemwide clinical integration,” says Dr. Ricciotti. “It’s a big win for patients because there are many women in the area who need to see a subspecialist and it saves them the hassle of going downtown. Insurance companies also win because Milton offers a lower-cost setting, and our doctors love it, too, because they get to practice in the community one or two days a week. It’s a lovely environment, and we recruit with that model in mind.”
The program began by holding focus groups with local primary care physicians, which enabled the hospital to assess and pinpoint the community’s needs. Also important was ensuring that the OB-GYN service had the critical pillars to support it as it grew into a comprehensive women’s health program.
BID-Milton’s Chief Medical Officer Ashley Yeats, MD
“There are other components to women’s health besides OB-GYN,” explains Dr. Yeats. “These include physical and occupational therapy that go along with pelvic floor dysfunction. Then there are imaging and laboratory services, and ultrasounds, and other subspecialty services. So this is something we could not have done in isolation.”
Dr. Shin is able to provide prenatal and postnatal care in the local community, as well as perform gynecologic surgery in a high-quality, cost-effective community hospital. At the same time, she also delivers babies at BIDMC, which is just eight miles away.
Nurse practitioner Glynn was instrumental in the early stages of developing the program.
“She’s been in the community for a very long time, and was a huge help in getting the women’s health service off the ground,” explains Dr. Ricciotti. “Dr. Shin was from Atlanta so Patricia provided that cohesive, friendly face to the local care network that wanted to have reproductive health services in Milton.”
As if to prove just how strong demand was for these services, less than a year after Dr. Shin joined the program, Dr. Farid was added to the team to help accommodate the growth.
“It certainly worked out very well for our community and is really emblematic of the multi-cultural medical staff that we have and the multi-cultural patients that we serve,” says Dr. Yeats.
Gynecologic oncologist Leslie Garrett, MD
And when Dr. Shin noted that she didn’t want her patients travelling into Boston to see subspecialists, BIDMC urogynecologist Janet Li, MD, FACOG, and gynecologic oncologist Leslie Garrett, MD, joined the staff in Milton.
“Alice Shin was really spearheading getting specialists out to Milton because she looks out for her patients,” Dr. Ricciotti says. “She doesn’t want to send them to Boston for urogynecological evaluation. We joke that she stalked Janet Li to get her to come out to Milton. We always wanted to offer services like that and Alice has made it happen. She’s the leader.”
With approximately 25 percent of women reporting pelvic floor disorders, from urinary and fecal incontinence to pelvic floor prolapse, the need for urogynecological treatment continues to grow, particularly in local communities.
“Women with pelvic floor disorders have historically been marginalized and not well taken care of,” says Dr. Li. “The magnitude of the negative impact these symptoms have on women’s lives is not widely recognized. There is a lot of opportunity to educate the public and healthcare community about pelvic floor disorders and how many options there are for improving the symptoms and enabling these women to live fuller lives.”
Comprehensive treatment options are offered at BID-Milton, including counseling on lifestyle and behavioral modifications, Kegels, pelvic floor physical therapy, medications, minimally invasive outpatient sling surgery, urethral bulking injections, tibial nerve stimulation (Urgent PC system), sacral nerve stimulation (InterStim), intravesical Botox injections, and pessary.
There are also many treatments for prolapse including pessary and various surgical repairs, which are generally approached in a minimally invasive fashion, either vaginally, robotically or laparoscopically.
“Patients are more likely to seek care and improve their lives if they can access that care locally,” says Dr. Li. “We are thrilled to be able to offer our services to help women living in Milton and the surrounding communities.”
Nurse Practitioner Maura S. Ryan, MSN, RN, ANP-BC works alongside Dr. Li.
The Milton Women’s Health practice continues to grow. This fall, BIDMC neurologist Kaarkuzhali Babu Krishnamurthy, MD, an epilepsy specialist, and Ioana Fat, MD, a gestational diabetes specialist, also began seeing patients at the office.
For more information about Women’s Health Services at BID-Milton, or to refer a patient, please call 617-754-0500 or visit bidmilton.org.