An interview with Paul D. Indman, M.D., Los Gatos, CA.

Of the 600,000 hysterectomies performed yearly in the U.S., approximately 300,000 are accompanied by prophylactic bilateral oophorectomy, traditionally suggested as the best strategy to decrease the rate of ovarian cancer.

OBGYN.net Conference CoverageFrom American Association of Reproductive Medicine55th Annual Meeting of ASRM held conjointly with CFAS- Toronto, Ontario, Canada - September, 1999

OBGYN.net Conference CoverageFrom American Association of Gynecological LaparoscopistsOrlando, Florida, November 2000. "AAGL The Founding Years" Jordan Phillips, MD, OBGYN.net Editorial Advisor and General Chairman andFounder of AAGL with Dr. Louis Keith, MD OBGYN.net Editorial Advisor

OBGYN.net Conference CoverageFrom American Association of Gynecological LaparoscopistsOrlando, Florida, November 2000

Dr. Paul Indman: “Jordan, this is a momentous occasion. It’s hard to believe there’s talk of your retirement and, of course, I don’t believe that you’re really retiring.”Dr. Jordan Phillips: “Well, it’s a change of activity. I will retire as of December 31, 2000 from the Board of Trustees. I anticipate continuing some of my other activities; I’m the Managing Editor of the Journal of the AAGL, and I plan to continue that and other things.”Dr. Paul Indman: “I’m sure you’ll be just as involved as ever.”Dr. Jordan Phillips: “Not on a day-by-day basis.”Dr. Paul Indman: “You’ve been characterized as a visionary by everyone who has spoke and certainly I think you are. Today we saw a presentation on space medicine doing laparoscopy in zero gravity. What do you see as the future of endoscopic surgery?”Dr. Jordan Phillips: “Number one, I think endoscopic surgery has proven that it’s a very important part of the armamentarium for surgery. I see that through the last several years the use of endoscopy has gone from just being a diagnostic tool and a sterilizing tool to being a full operating tool. So now we can do full surgeries using the endoscope but it requires one other major ingredient and that’s the skill of the surgeon so you must have a very competent surgeon doing complicated endoscopic procedures.”Dr. Paul Indman: “What is the AAGL doing to improve the skill of surgeons?”Dr. Jordan Phillips: “We continue to do many things. Not only do we have the annual meeting but we also have regional meetings, we have workshops, and we put on live cadaveric surgical anatomy programs. We’re doing a whole series of things besides publishing the Journal with all the recent articles, putting out News Scope, which is a news article, and having bulletins put out. AAGL has been very busy.”Dr. Paul Indman: “I think the AAGL has been responsible for improving the skill of surgeons around the world and certainly it’s probably the number one influence that I’ve seen. What are some of your wildest dreams that we’ll be doing in twenty-five years?”Dr. Jordan Phillips: “It’s come even faster than that and that is the majority of surgeries performed will be actually done through an endoscope. They’ll be very few operations performed in a routine gynecological practice that’s being done by open surgery. Open surgery doing a full open incision is almost obsolete and there are some departments in the world today where 90% of all gynecologic operations are done through an endoscope.”Dr. Paul Indman: “What do you see as the biggest resistance to that in our country?”Dr. Jordan Phillips: “The biggest resistance that we have is the case that we have to continue to train people and to make them better surgeons and smoother; safe surgeons I guess is the best term to use.”Dr. Paul Indman: “One of the problems I hear constantly with surgeons is that insurance companies are reimbursing less and less, they may essentially reimburse for a half an hours worth of work and the surgeons say - I can do this in a half an hour if I make a giant incision but it will take me three or four hours through a laparoscope, I can’t afford to do that. How can we get around that?”Dr. Jordan Phillips: “They’ve been able to prove that by using a laparoscope it’s less cost because they use less equipment, the patient doesn’t stay in the hospital as long, and most endoscopic operations are done in a short stay. That is they go in in the morning and they have the operation then go home in the afternoon so they don’t even stay overnight so the expenses will change because of the decreased hospital costs.”Dr. Paul Indman: “The total cost though but still the surgeon has such a major disincentive for doing that and I’m wondering how we can change that?”Dr. Jordan Phillips: “We tried to educate the insurance companies that we’re actually saving the insurance company money on their hospital bills and frankly we are. We have tried and we’ve convinced some of the insurance companies to actually have part compensation. If you do a hysterectomy through a laparoscope or do a hysterectomy through an open incision or vaginal they should have equal compensation, whichever method or approach you use.”Dr. Paul Indman: “Let’s get back to you, Jordan, because this is obviously a very important meeting. This is your last meeting where I guess your Chairing the Board.”Dr. Jordan Phillips: “That’s correct.”Dr. Paul Indman: “What do you think you will be doing next, personally?”Dr. Jordan Phillips: “Oh, we’re quite busy. My wife and I have a project in China called Medical Books for China International where we collect unwanted medical books that we send to China. We’ve now completed 60 shipments of 20 tons in each shipment so we’ve sent over 1,000 tons of medical books, journals, audio tapes, and video tapes to China that have been distributed to over 1,000 medical libraries. This takes a lot of organization, and it’s all handled through our own office. We’ve become the focal point for many institutions, many book dealers, and many book distributors to actually have them send their surplus books to us. Now it adds up to actually over 3 million books in all specialties not only in eye, ear, nose, throat, cardiology, chest, GI, GU, orthopedics, all specialties including nursing, veterinary medicine, basic science, medical law, and all of the various paramedical activities in books. So we’ve actually filled the shelves of many libraries in China, which were empty when we started.”Dr. Paul Indman: “So you’ll be working on that a lot?”Dr. Jordan Phillips: “Not a lot, we have it well organized. We have a staff that does it but it does require attention that we go to China. The Chinese distribute the books, we don’t distribute the books, and we’re planning for next June to have a World Congress in China on medical libraryship on the technical aspects of doing a medical library. There’s a lot to it where it’s changed with the use of computers and all the various new modalities that are available, and we’re going to introduce this to China. All of the Chinese major medical schools, and there are 127 medical schools in China, will come to this meeting. My wife, Mary Zoe Phillips, is actually Secretary General of this entire meeting. We did one ten years ago but now it’s ten years later.”Dr. Paul Indman: “What other visions for the future do you have, Jordan?”Dr. Jordan Phillips: “What other visions for myself?”Dr. Paul Indman: “For yourself and AAGL.”Dr. Jordan Phillips: “The AAGL will continue; it will continue its impact, continue its growth, and continue to be innovative. When you have these very dynamic young people who are push, push, push, I think that this is what’s going to happen. I have complete faith in the future.”Dr. Paul Indman: “You certainly need to be congratulated on such a wonderful organization and it’s a true family.” Dr. Jordan Phillips: “Yes, it really is a family and that’s what we started. In fact, we started right from the beginning and I didn’t call them board dinners, I called them family dinners and that’s just what it is. We got involved with the people, their children, their wives, and families and many other things. I can tell you one of the greatest joys I’ve had has been writing letters of recommendation for some of our people to become advanced in their academic activity. To write letters to become professors or associate professors, it’s a joy for me to do that.”Dr. Paul Indman: “The AAGL has been a family to me, thank you so much, Jordan.”Dr. Jordan Phillips: “You’re welcome, Paul Indman, it’s been a pleasure to see you. Thank you.”

OBGYN.net Conference CoverageFrom the 34th Annual Meeting - Chicago, Illinois - November 2005

Leaving ovaries intact during hysterectomies for non-cancerous conditions may boost long-term survival rates for women under age 65, according to the results of a new study published in the August issue of Obstetrics and Gynecology.

According to government estimates, the incidence of ovarian cancer is almost 13 per 100,000 women per year, and most cases are diagnosed in an advanced stage. As such, proper treatment is critical to ensure survival. However, Dr Melissa M. Thrall, fellow in the department of obstetrics and gynecology at the University of Washington, found that less than 40% of women reliant on Medicare receive standard care.

Primary care physicians are the entry point for care for many patients. They are often responsible for determining when additional expertise is needed and to which specialist a patient should go for additional care. Although studies have shown that gynecologic oncologists can improve surgical and survival outcomes for patients with ovarian cancer, the referral rate from primary care physicians to gynecologic oncologists remains relatively low.

Women who are extremelly obese may not need to gain as much weight during the second and third trimesters of pregnancy as current guidelnes recommend, according to research presented at the Society for Maternal-Fetal Medicine's annual meeting, The Pregnancy Meeting, held from Feb. 7 to 12 in San Francisco.

Women who administer their own analgesia (patient-controlled epidural analgesia [PCEA]) during labor as compared to being administered a continuous epidural infusion (CEI) use less analgesia but experience similar levels of satisfaction, according to research presented at the Society for Maternal-Fetal Medicine's annual meeting, The Pregnancy Meeting, held from Feb. 7 to 12 in San Francisco

Consumption of folate prior to or during pregnancy does not appear to protect women from spontaneous preterm delivery, according to data presented at the Society for Maternal-Fetal Medicine's annual meeting, The Pregnancy Meeting, held from Feb, 7 to 12 in San Francisco

Alan Penzias, MD, offered other physicians advice on recruiting staff at the 2010 American Society for Reproductive Medicine meeting.

William Kutteh, MD, seems confounded by physicians who don’t believe in screening for and treating autoimmunity following recurrent pregnancy loss. “This is not a religious conversion event,” he said, concluding his remarks on the topic at the 2010 American Society for Reproductive Medicine meeting. “There’s a lot of data.”

More reproductive-age women with a diagnosis of cancer are receiving fertility preservation counseling from their doctors-but how many of those patients then decide to undergo fertility preservation? And how does their decision impact them later in life?

Research presented at the Annual American Society for Reproductive Medicine (ASRM) Meeting in Denver shows that physicians currently lack the tools and information needed when working with patients with low sexual desire.

New research from the Eunice Kennedy Shriver National Institute for Child Health and Human Development confirms the need for H1N1 vaccines in women before undergoing infertility treatment.

How do hormone levels affect women’s reactions to emotional stimuli? Researchers from the University of Vermont are attempting to answer this question by studying women’s brains using functional MRI (fMRI) during different stages of their menstrual cycles The results of their study were presented at the American Society for Reproductive Medicine (ASRM) Annual Meeting.

NICHD, Endometriosis, and Female Infertility Research