Episodios

  • BackTable Brief: Imaging and Surgical Strategies in Endometriosis with Dr. Wendaline VanBuren and Dr. Tatnai Burnett

    BackTable Brief: Imaging and Surgical Strategies in Endometriosis with Dr. Wendaline VanBuren and Dr. Tatnai Burnett
    Sep 16 2025
    When radiology meets surgery, endometriosis care becomes more precise, personalized, and proactive. In this BackTable OBGYN Brief, host Dr. Mark Hoffman is joined by Dr. Wendaline VanBuren, an associate professor of radiology at Mayo Clinic, and Dr. Tatnai Burnett, a minimally invasive GYN surgeon at Mayo Clinic, to discuss the complexities of diagnosing and managing endometriosis. The discussion covers the roles of advanced imaging techniques like MRI and ultrasound, the importance of pre-surgical planning, and the need for multidisciplinary collaboration. They share their approach to managing symptomatic and asymptomatic patients, the use of hormonal treatments, and the significance of monitoring potential malignant transformations in endometrioma cases. The episode underscores the critical role of imaging in planning effective surgical interventions for patients while highlighting the progression of endometriosis management protocols. TIMESTAMPS 00:00 - Introduction 01:07 - Discussing Endometriosis Management 02:18 - Imaging Techniques and Their Importance 04:24 - Interdisciplinary Collaboration 05:40 - Advanced Imaging Protocols 08:12 - Monitoring and Follow-Up Strategies 08:50 - Concerns About Malignancy 11:04 - Future Directions CHECK OUT THE FULL EPISODE OBGYN Ep. 69 https://www.backtable.com/shows/obgyn/podcasts/69/imaging-protocols-to-guide-endometriosis-treatment
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    17 m
  • Ep. 90 The Basics of “How To” for HRT Management: Effective and Safe Prescribing with Dr. Rachel Rubin

    Ep. 90 The Basics of “How To” for HRT Management: Effective and Safe Prescribing with Dr. Rachel Rubin
    Sep 2 2025
    When it comes to menopause care, the facts are better than the fears. In this Urology/OBGYN crossover episode of the BackTable Podcast, host Dr. Suzette Sutherland welcomes renowned urologist Dr. Rachel Rubin to explore various aspects of sexual health and hormone replacement therapy (HRT), particularly for menopausal women. --- SYNPOSIS Dr. Rachel Rubin shares her career journey, expertise in sexual health, and the critical role of hormone replacement therapy (HRT) in managing menopause. She addresses common challenges and misconceptions, particularly around estrogen use, by demystifying the Women’s Health Initiative studies and emphasizing the proven safety and benefits of systemic and vaginal HRT. Dr. Rubin offers practical guidance on prescribing estrogen, progesterone, testosterone, and DHEA, while highlighting her advocacy to remove outdated FDA black box warnings on vaginal estrogen. Through personal anecdotes and professional insights, she empowers practitioners with evidence-based strategies and underscores the importance of education and research in advancing women’s health. --- TIMESTAMPS 00:00 - Introduction03:41 - Challenges in Menopause Medicine07:21 - Misconceptions and Risks of HRT15:35 - Understanding Bioidentical Hormones18:48 - WHI Studies and Their Impact23:21 - Practical Guide to Prescribing HRT33:47 - Understanding Estrogen Levels and Risks36:04 - Debating Gels vs. Patches37:51 - Concerns with Compounded Products and Pellets38:50 - Patient Education and Meeting Them Where They Are42:12 - Progesterone Benefits and Sensitivities46:38 - Testosterone Therapy for Women51:36 - The Importance of Lab Tests55:39 - DHEA and Vaginal Health57:14 - Advocacy for Accurate Hormone Therapy Information01:00:05 - Conclusion and Final Thoughts --- RESOURCES The Peter Attia Drive episode with Dr. Rachel Rubin:https://peterattiamd.com/rachelrubin/ FDA Expert Panel on Menopause and Hormone Replacement Therapy for Women:https://www.youtube.com/live/_2ZRlOivC5M?si=-Xynb_BmWz2sWf4mDr. Rachel Rubin’s Hormone Therapy for Early Adopters Course:https://rachelrubinmd.thinkific.com/courses/MHTCME
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    1 h y 3 m
  • Ep. 89 New Guidelines for Genitourinary Syndrome of Menopause with Dr. Melissa Kaufman and Dr. Giulia Ippolito

    Ep. 89 New Guidelines for Genitourinary Syndrome of Menopause with Dr. Melissa Kaufman and Dr. Giulia Ippolito
    Aug 12 2025
    The guidelines are in and the myths are out. In this episode of the BackTable Podcast, Dr. Suzette Sutherland hosts Dr. Melissa Kaufman and Dr. Giulia Ippolito to discuss the new 2025 AUA/SUFU guidelines on genitourinary syndrome of menopause (GSM). ---SYNPOSISThe doctors delve into what GSM is, its symptoms, and the new evidence-based clinical guidelines for screening, diagnosing, and treating this condition. The episode emphasizes shared decision-making, safe use of local low-dose vaginal estrogen, and addresses concerns related to hormone therapy and cancer risks. Additionally, the doctors cover non-hormonal interventions, the role of vaginal moisturizers and lubricants, and the use of vaginal lasers. The importance of follow-up and ongoing patient education is also highlighted. The conversation aims to equip clinicians with the knowledge to better manage GSM and improve patient outcomes.---TIMESTAMPS00:00 - Introduction 01:35 - Overview of the 2025 AUA/SUFU Guidelines02:27 - Guideline Development Process05:48 - Categories of Guidelines07:03 - Understanding GSM: Symptoms and Diagnosis10:28 - Patient Education and Shared Decision Making15:22 - Hormonal Interventions and Safety Concerns17:17 - Local Vaginal Estrogen: Recommendations and Usage23:12 - Compounded Estrogens and Alternative Therapies25:48 - Understanding Estrogen Dosage Forms26:11 - Introduction to DHEA and Its Benefits27:15 - Exploring Ospemifene as an Alternative28:05 - Guidelines for Treating GSM Symptoms30:11 - The Role of Vaginal Estrogen in UTI Prevention33:01 - Non-Hormonal Interventions for GSM35:39 - Laser Treatments for GSM39:59 - Addressing Cancer Risks with Vaginal Estrogen44:48 - Endometrial Surveillance and Follow-Up49:14 - Advocating for Vaginal Estrogen Use51:13 - Conclusion and Final Thoughts
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    54 m
  • BackTable Brief: Understanding Facility Fees in Healthcare Economics with Dr. Barbara Levy

    BackTable Brief: Understanding Facility Fees in Healthcare Economics with Dr. Barbara Levy
    Aug 5 2025
    Where you perform a procedure could cost your patient thousands or save them just as much. In this Backtable OBGYN Brief, Dr. Mark Hoffman and Dr. Amy Park sit down with Dr. Barbara Levy to discuss the economic challenges and implications of performing medical procedures in various settings such as hospitals, ambulatory surgery centers (ASCs), and office environments. They explore how hospitals have leveraged billing structures for financial gain, often driving up patient costs, and highlight how procedures like hysteroscopies and endometrial ablations can be performed more efficiently and cost-effectively in office settings. The conversation also touches on how insurance companies and healthcare policy shape both patient expenses and physician practice. Dr. Levy emphasizes the importance of understanding the broader healthcare system to effectively advocate for positive changes in patient care and outcomes. TIMESTAMPS 00:00 - Introduction 00:48 - Hospital Lobbying and Facility Fees 02:43 - Impact on Patients and Physicians 04:06 - Insurance Companies and Healthcare Economics 08:34 - Office vs. ASC vs. Hospital Procedures 12:59 - Cryoablation and Patient Experience 14:53 - Conclusion and Final Thoughts CHECK OUT THE FULL EPISODE OBGYN Ep. 55 https://www.backtable.com/shows/obgyn/podcasts/55/insights-on-obgyn-coding-reimbursements
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    17 m
  • BackTable Brief: Understanding Medical Facility Fees in Practice with Dr. Barbara Levy

    BackTable Brief: Understanding Medical Facility Fees in Practice with Dr. Barbara Levy
    Jul 29 2025
    OBGYN Briefs - Understanding Medical Facility Fees in Practice The way you code and calculate costs might be affecting your practice more than you realize. In this episode of BackTable OBGYN, hosts Dr. Mark Hoffman and Dr. Amy Park welcome back Dr. Barbara Levy, a clinical professor at George Washington University and UCSD. They discuss the complexities of practice expenses and coding in medical specialties, emphasizing the differences between direct and indirect expenses which vary by geography and specialty. The conversation covers the challenges in surveying costs, the importance of accurate representation in surveys, and the strategic implications of coding. They also touch on the complications arising from procedure revaluation and the impact of site-of-service on reimbursements. TIMESTAMPS 00:00 - Introduction 00:48 - Understanding Practice Expenses 02:28 - Survey Challenges and Fraud Concerns 03:19 - Valuation of Medical Procedures 07:39 - Impact of Code Changes on Payments 11:01 - The Complexity of Medical Coding 15:18 - Site of Service and Facility Fees CHECK OUT THE FULL EPISODE OBGYN Ep. 55 https://www.backtable.com/shows/obgyn/podcasts/55/insights-on-obgyn-coding-reimbursements
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    20 m
  • BackTable Brief: Understanding the RUC's Role in Healthcare Costs with Dr. Barbara Levy

    BackTable Brief: Understanding the RUC's Role in Healthcare Costs with Dr. Barbara Levy
    Jul 22 2025
    OBGYN Briefs - Understanding the RUC's Role in Healthcare Costs Every procedure has a price, but how is it set? In this BackTable OBGYN Brief, Dr. Mark Hoffman and Dr. Amy Park welcome back Dr. Barbara Levy, a clinical professor at George Washington University and UCSD, to discuss her work with the key organizations influencing medical billing and reimbursement. They explore Dr. Levy's extensive involvement with ACOG, AMA's CPT Editorial Panel, and the RBRVS Update Committee (RUC), offering an overview of the complex systems governing coding and reimbursement in medicine. From how new procedures receive codes to the financial impact on physicians, this brief offers valuable insights for OBGYN practitioners navigating the world of medical billing and coding. TIMESTAMPS 00:00 - Introduction 00:48 - Personal Anecdotes and Career Beginnings 02:01 - Understanding Medical Reimbursement 03:17 - Roles and Responsibilities in Medical Committees 05:34 - The Coding Process Explained 09:16 - The Role of the RUC and CPT Editorial Panel 15:16 - RVUs and Practice Expenses 17:48 - Final Thoughts CHECK OUT THE FULL EPISODE OBGYN Ep. 55 https://www.backtable.com/shows/obgyn/podcasts/55/insights-on-obgyn-coding-reimbursements
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    21 m
  • Ep. 88 Hormone Replacement Therapy in Menopause: Risks, Benefits, and Myths Debunked with Dr. Kelly Casperson

    Ep. 88 Hormone Replacement Therapy in Menopause: Risks, Benefits, and Myths Debunked with Dr. Kelly Casperson
    Jul 8 2025
    Menopause isn’t just a diagnosis—it’s a transition, and the way we treat it needs to change. Dr. Kelly Casperson joins Dr. Suzette Sutherland in this urogynecology crossover episode of BackTable to challenge outdated beliefs about menopause and hormone replacement therapy (HRT). They revisit the impact of the 1990s Women’s Health Initiative (WHI) study and explain how its findings—especially around synthetic hormones—were widely misinterpreted and continue to adversely influence patient and provider decisions today. --- SYNPOSIS Dr. Casperson breaks down the differences between the hormones used in WHI and the safer, more targeted options available today. The conversation explores the broad benefits of modern HRT, including reduced risks of cardiovascular disease, osteoporosis-related fractures, and even dementia. Beyond the science, the episode also addresses the urgent need for better medical education and updated guidelines around menopause care.Dr. Casperson and Dr. Sutherland make the case for empowering patients through informed consent and better clinician training. They also discuss Dr. Casperson’s upcoming book, The Menopause Moment, which aims to equip women with the tools and knowledge to navigate this life stage with confidence. --- TIMESTAMPS 00:00 - Introduction02:50 - Focus on Menopause and Hormone Replacement Therapy04:20 - The Women's Health Initiative (WHI) Study05:39 - Understanding Risks and Misconceptions12:43 - Reevaluation of the Women’s Health Initiative Study18:31 - Impact of Media and Physician Education19:58 - Current State of Hormone Therapy22:17 - Broader Implications and Future Directions27:17 - Evaluating FDA Warnings and Gender Bias in Hormone Treatments29:49 - The Impact of Hormone Therapy on Women's Health32:11 - Risks of Not Using Hormones35:44 - Hormones and Brain Health: Debunking Myths40:41 - The Timing Hypothesis and Long-Term Hormone Use46:32 - Advocacy and Education for Menopause Awareness48:04 - Conclusion and Upcoming Resources --- RESOURCES PBS: The M Factor: Shredding the Silence on Menopause:https://www.pbs.org/show/the-m-factor-shredding-the-silence-on-menopause/ The Menopause Moment by Dr. Kelly Casperson: https://kellycaspersonmd.com/the-menopause-moment-book/ Systematic review and meta-analysis of the effects of menopause hormone therapy on risk of Alzheimer's disease and dementia:https://pmc.ncbi.nlm.nih.gov/articles/PMC10625913/
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    52 m
  • Ep. 87 Evaluating Hormone Therapy in Menopause Management with Dr. Yahir Santiago-Lastra

    Ep. 87 Evaluating Hormone Therapy in Menopause Management with Dr. Yahir Santiago-Lastra
    Jul 1 2025
    Vaginal estrogen is not the enemy. Outdated data is. In this crossover episode of the BackTable Urology and OBGYN podcasts, Dr. Suzette Sutherland and Dr. Yahir Santiago-Lastra delve into the persistent challenges and ongoing advocacy efforts surrounding the FDA's black box warning on vaginal estrogen. --- SYNPOSIS They explore the historical context and far-reaching influence of the 1990s Women’s Health Initiative (WHI) study, asserting that its misinterpretation continues to shape misconceptions and hinder effective menopause care. The discussion highlights recent data refuting the risks associated with vaginal estrogen therapies and underscores the urgent need for updated, evidence-based guidelines to support women throughout menopause. Dr. Santiago-Lastra also draws attention to gender-based inequities in hormone treatment, the robust evidence contradicting the current black box warning, and the multi-faceted advocacy required to bring about change. This episode is part of a broader series focused on various aspects of menopause. --- TIMESTAMPS 00:00 - Introduction02:01 - Menopause Series Overview03:55 - History of the Black Box Warning on Estrogen07:26 - Understanding the Black Box Warning12:11 - The Citizen's Petition and FDA Process18:11 - Gender Inequity in Medical Treatment22:45 - Factors Resulting in Gender Inequity29:02 - Genital Urinary Syndrome of Menopause (GSM)29:32 - Benefits of Vaginal Estrogen33:33 - Legislative Advocacy and Medicare34:43 - Professional and Patient Advocacy36:35 - Challenges and Progress in Label Change43:35 - Historical Context and Gender Equity45:07 - Recap and Future Directions
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    50 m