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The Evolving Gynecologic Practice

In This Video

  • The gynecological practice at Massachusetts General Hospital has stayed up to date with the many advances and current trends in gynecology
  • The practice offers in-office procedures where previously patients may have required hospital admission
  • For patients who do require hospitalization, the enhanced recovery after surgery (ERAS) procedure is followed to decrease the length of stay and help alleviate common postoperative complications

Carey York-Best, MD, a gynecologic surgeon in the Department of Obstetrics and Gynecology at Massachusetts General Hospital and division director, Benign Gynecology and Obstetrics, discusses the department's evolving gynecologic practice, adapting with clinical advances to offer patients the best care possible.


We have a very special group of docs, many of whom have been at Mass General for many years and are very experienced. What really excites me about it is how we've been able to adapt the practice as many advances have been made in gynecologic care. We have adapted our practice along with current trends in gynecology and we are now able to offer fairly extensive office procedures in arenas where previously patients might have had to go to the operating room and had anesthesia or even be admitted to the hospital. We perform hysteroscopic endometrial polypectomies, misplaced IUD removals within our outpatient practice. We also have the ability to have IV sedation for more painful procedures.

In recent years, the American Medical Association has moved away from the recommendation of yearly PAP smears and bimanual exams for healthy women without gynecologic problems. Similarly, the American College of Obstetricians and Gynecologists (ACOG) has also endorsed that PAP smear frequency should be every three to five years, and that routine biannual exams should be something that's discussed between provider and patient in a shared decision-making process.

So as a result, most patients these days are having their routine gynecologic care and PAP smears through their primary care visits. For all patients who come to Mass General for their gynecologic surgical procedures, we use the ERAS procedure, which is enhanced recovery after surgery. In conjunction with our anesthesia colleagues, we use shorter-acting, non-opioid pain medications to minimize the use of opiates. We also use many strategies to minimize the length of stay for the patient at the hospital. We see them sooner, get them out of bed, and ambulating as soon as possible after surgery, and we have found that this decreases the length of stay within the hospital as well as some common postoperative complications.

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In this video, Carey York-Best, MD, a gynecologic surgeon in the Department of Obstetrics and Gynecology at the Massachusetts General Hospital and director of Benign Gynecology and Obstetrics, discusses the department's approach to team-based patient care.


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