What is the next generation of healthcare?

As ACOG President, I feel a great responsibility to help our members and our specialty lead and evolve in these changing and often challenging times. To do so, we must focus on building a strong foundation upon the rigorous standards of excellence that guide us every day. One of the things I most enjoy about membership in ACOG is the community. With a central goal at hand, superior care for women and families, we come together to learn from, support, and develop alongside our peers. As we face more constant, direct, and often negative forces beyond our exam rooms, our community has another imperative: advocacy.

By cultivating the knowledge and capability of our existing and newest members, we ensure the future of our profession and the patients we serve. In part, this requires legislative and political advocacy by all of our Fellows and Junior Fellows. We must lend the diversity and depth of our community’s knowledge and expertise to help reach safe and sustainable outcomes on issues regarding women’s healthcare.

There are a lot of ways to become an advocate for our field, beginning with staying up to date on the most pressing political and legislative issues at hand through ACOG’s Government Affairs Newsletter. I hope you’ll also join me in one of my primary presidential initiatives, ‘All in for Advocacy Campaign,’ an initiative to increase legislative and political advocacy in every state, by every ACOG member. This initiative is just getting underway, but below I’ve outlined the key components.

  • Grand Rounds Initiative: I want to speak to every ob-gyn residency program in America about the importance of advocacy! Are you a residency program director/instructor or a current resident? Email govtrel@acog.org to schedule your Grand Rounds presentation!
  • Calls to ACOG Members: I am reaching out weekly to a randomly selected group of ACOG Fellows and Junior Fellows. I want to hear from you to gain a better perspective on what drives ob-gyns across the United States!
  • Promoting Advocacy at ADMs: ACOG’s legislative and political advocacy will certainly be on the agenda at our Annual District Meetings – offering another great opportunity to get ACOG Members involved in our legislative work in DC and the State Houses. I plan to be at most ADMs to lead these important discussions.
  • Get Out the Vote: The easiest and most important way to participate in the political process is to VOTE. Watch for ACOG Voter’s Guide highlighting the most important issues impacting ob-gyns this election year!
  • ACOG Section Lobby Days: Your ACOG Section may have a state legislative action day at your state capitol this year. As ACOG President, I will join as many as possible, calling on state legislators to act on

The stakes are high, and I encourage each of our members to sign up and advocate on behalf of our profession and patients. We must fully engage in the political and legislative process and advocate for the highest and safest standards of care for women and families.

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About Tom Gellhaus, MD

Tom Gellhaus, MD is ACOG President through 2017. He is a Clinical Associate Professor in the Department of Obstetrics and Gynecology at the University of Iowa Hospitals and Clinics in Iowa City, Iowa. Dr. Gellhaus graduated from Yankton High School in Yankton, South Dakota, received his Bachelor of Arts Degree in Chemistry from Augustana College in Sioux Falls, South Dakota and his Doctor of Medicine Degree from the University of Oklahoma in Oklahoma City, Oklahoma. He completed his residency in Obstetrics and Gynecology at the University of Iowa Hospitals and Clinics. Following residency, he entered private practice in Davenport, Iowa and after 20 years in private practice, he returned to academic medicine at the University of Iowa. Over the past 20 years, Dr. Gellhaus has served in many ACOG positions at the local, regional, national and international levels. Dr. Gellhaus’ interests are in the areas of health care advocacy and policy. He has also been very involved and active in global healthcare. He has completed the McCain Fellowship, a month long in-depth experience in advocacy, at ACOG in Washington, D.C. in 1999. In 2001, he was a Primary Care Policy Fellow with the U.S. Department of Health and Human Services. He has remained active in Advocacy and Policy as a member of ACOG’s Government Affairs Committee and the Ob/Gyn PAC. Dr. Gellhaus has also been very active in leading groups on short-term medical and surgical mission projects for the last 20 years. He has done numerous presentations about these short-term medical and surgical mission projects throughout the United States.

5 thoughts on “What is the next generation of healthcare?

  1. Dr. Gellhaus,
    I respect your proposed platform, but I am concerned for the future of our field.
    There have been so many seismic shifts in the last few years, I feel like we’re playing ‘rope a dope,’ and holding on, waiting for the bell, so that we can catch our breaths.
    As a rural doc, I feel abandoned by our state and national organizations.
    Are we going to address the generational and gender expectations?
    Rural hospitals can’t employ 6-7 docs for call, so we struggle to recruit, we overpay (which threatens the bottom line), we hire locums after locums and retreads, and pray nothing bad happens…

    We get residents a few times a year, and I’m shocked by how little they know and how little they’ve done.
    A third year resident with 200 svd’s and 150 c sections?
    No hysterectomies and 20-30 laparoscopies?

    As far as hysterectomies go, I preach vaginally surgery, but it’s dying, and now Covidien is discontinuing the vaginal ligasure.
    Where was ACOG’s outcry?
    If a tree falls in the forest, and no one is there, does it make a sound?

    So we have a desperate shortage of providers ( note, that’s is hoe we are all called now) to work rurally.
    We have residents that have scant skills, and those of us with the experience have no one teach and no support from anyone.

    Wow, so now we are to beat the drum for political advocacy?
    For what?
    No paps, no pelvics, no breast exams, don’t order tests or ultrasounds, and have to fill out reams of paper so that meds can be denied?

    I love what I do, and and look forward to the challenges each day, but I can’t fix all of the above, and we need help.

  2. /Sometimes we go so far down the rabbit hole, we forget the main objective. the main objective today should be wellness. Through wellness we will reduce illness by as much as 50%. That’s the greatest advancement in health care possible. Yet, wellness gets ignored. Most Drs don’t even know what wellness is, or how to enhance it. We give it some lip service, but few practice wellness and put their body where their advice lies. Wellness can be relatively simple: good nutrition (why are we not leading the charge against GMOs???, against high fructose corn syrup, and against the US Food Pyramid?). Adequate exercise: minimum of 30 min per day of movement. 16-18% of people belong to health clubs. Most are inactive. Many MDs are grossly overweight — they can be good examples. how many exercise? And, for men and women, as they age, need adequate hormone replacement (see Morgentelar and Elite Study for example). There are studies which should be used as example of superior care. MD-vip has a 5 yr study showing that hospital admiissions were reduced 44% in 5 yrs just because the physician had time to do what we’ve been trained to do. We should be advocating these superior programs that save lives and decrease costs. Our leadership needs to promote wellness. Our colleagues need to set the example. There is an enormous amount of education that needs to happen. Look to Jeff Bland, PhD and his Functional Medicine. Look to Age Management Medical Group. There are other good organizations that need to take leading roles. ACOG should be advocating for the individual OB-GYN who is given 10 minutes with a pt. This is not workable. This is not wellness. And, MDs need to be trained in wellness.

  3. Many residents and GME fellows are new to their locations, and may not be registered to vote. A letter from ACOG to all OBGYN Program Directors advocating a voter registration effort among their housestaff would help this along. This could be followed by instructions about how to get an absentee ballot, as many schedules, despite work-hour restrictions, can make in-person voting difficult.

  4. Another big problem, financially unsustainable private practice, which apparently was a factor in the new AGOG president leaving it 10 years ago, threatens to destroy the privacy, and intimate nature of women’s health. Roughly 80% of obgyns have been forced into hospital employment, openly breaking federal stark and anti-kickback laws, publically admitted by these hospital corporations. Extremely private conversations are compromised in a hospital-employed (clinic) environment. One obvious casually is vaginal laxity and repair, a former staple obgyn, is all but disappeared. And not a word about this from ACOG. Hmmm?

  5. One of the most pressing issues facing women today is pelvic pain. Advocacy is LOW on the priority list comparatively. You have no training available in medical school and thus women are left floundering in excruciating pain. This issue has been written about in medical journals for over 30 years but has been totally ignored by ACOG. Most doctors don’t have a clue what the Pudendal Nerve is or how to treat Pudendal Neuralgia. Women and men are flying all over this country trying to find help for this horrible condition. Since mesh has become commonplace, incidence of Pudendal Neuralgia has become even more common. Treatment has NOT. Many states do not have one doctor who can treat this condition, some states are lucky if they have one doctor who can treat the condition with conservative methods but no surgeons. ACOG should be embarrassed with the state of care in this area.

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