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Insurance companies also win because Milton o•ers a lower-cost setting, and our doctors love it, too, because they get to practice in the communit y one or two days a week. It 's a lovely environment, and we recruit with that model in mind." The progra m bega n by holding focus g roups with loca l prima r y ca re physi- cia ns, which enabled t he hospita l to a ssess a nd pinpoint the communit y 's ne e d s . A l s o i mp or t a nt w a s en s u r - i n g t h a t t h e OB - G Y N s e r v i c e h a d t he cr itica l pi l la rs to suppor t it a s it g rew into a comprehensive women's hea lth prog ra m. "There are other components to wom- en's hea lth besides OB-GY N," expla ins Dr. Yeats. " These include physica l a nd occupationa l therapy that go a long with pelvic f loor dysfunction. Then there are imag ing a nd laborator y ser vices, a nd u ltra sounds, a nd ot her subspecia lt y ser vices. So this is something we could not have done in isolation." Dr. Shin is able to prov ide prenata l a nd postnata l ca re in t he loca l com- munity, as well as perform g ynecologic surger y in a high-qua lity, cost-effective community hospita l. At the sa me time, s he a l so del iver s ba bie s at BI DMC, which is just eight miles away. Nurse practitioner Glynn was instru- menta l in the early stages of developing the prog ra m. " She's been i n t he com mu n it y for a ver y long time, a nd wa s a huge help in getting the women's hea lth ser vice off the g round," expla ins Dr. R icciotti. "Dr. Shin was from Atla nta so Patricia prov ided that cohesive, friend ly face to the loca l ca re network that wa nted to have reproductive hea lth ser v ices in Milton." RAPID EXPANSION A s if to prove just how strong dema nd was for these ser vices, less tha n a yea r a f t er D r. S h i n joi ne d t he pr o g r a m , Dr. Fa rid was added to the tea m to help accommodate the g row th. "It cer tainly worked out ver y well for our community and is rea lly emblematic of the multi-cultura l medica l staff that we have and the multi-cultura l patients that we ser ve," says Dr. Yeats. A nd when Dr. Sh i n noted t hat she didn't wa nt her patients travelling into Boston to see subspecia lists, BIDMC urog ynecologist Ja net Li, MD, FACOG, a n d g y ne c olo g ic onc olo g i s t L e s l ie Ga rrett, MD, joined the staff in Milton. "A lice Sh in wa s rea l ly spea rhead- ing get ting specia lists out to Mi lton because she looks out for her patients," Dr. R icciotti says. "She doesn't wa nt to send them to Boston for urog ynecologi- ca l eva luation. We joke that she sta lked Janet Li to get her to come out to Milton. We a lways wanted to offer ser vices like that and A lice has made it happen. She's the leader." Wit h approx i mately 25 percent of women reporting pelvic f loor disorders, from urina r y a nd feca l incontinence to pelvic f loor prolapse, the need for uro- g y necolog ica l treatment continues to grow, particularly in loca l communities. " Women with pelvic f loor disorders have historica l ly been ma rg ina lized a nd not well ta ken ca re of," says Dr. Li. " The magnitude of the negative impact these symptoms have on women's lives is not widely recog nized. There is a lot of oppor t unit y to educate t he public a n d h e a l t h c a r e c o m m u n i t y a b o u t pelv ic f loor disorders a nd how ma ny opt ion s t here a re for i mprov i n g t he sy mptoms a nd enabling these women to live fuller lives." Comprehensive treatment options a re of fered at BID -Mi lton, including counseling on lifest yle a nd behaviora l mo d i f ic at ion s , Kegel s , p elv ic f lo or physica l therapy, medications, mini- ma lly invasive outpatient sling surger y, urethra l bulking injections, tibia l ner ve stimulation (Urgent PC system), sacra l ner ve stimulation (InterStim), intra- vesica l Botox injections, a nd pessa r y. There a re a lso ma ny treatments for prolapse including pessar y and various surg ica l repa irs, which a re genera l ly approached i n a m i n i ma l ly i nva sive fa shion, either va g ina l ly, robotica l ly or lapa roscopica lly. " Pat ient s a re more l i kely t o se ek ca re a nd i mprove t hei r l ives i f t hey can access that care loca lly," says Dr. Li. " We a re thrilled to be able to offer our ser vices to help women living in Milton a nd the surrounding communities." Nurse Practitioner Maura S. Rya n, MSN, R N, A N P-BC works a longside Dr. Li. The Mi lton Women's Hea lt h prac- t i c e c o n t i n u e s t o g r o w. T h i s f a l l , BIDMC neurolog ist Kaa rkuzha li Babu Krishna mur thy, MD, a n epilepsy spe- cia list, and Ioana Fat, MD, a gestationa l diabetes specia list, a lso bega n seeing patients at the off ice. 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. ■ BID-Milton's Chief Medical Officer Ashley Yeats, MD Gynecologic oncologist Leslie Garrett, MD M D N E W S . C O M /// M D N E W S S O U T H O F B O S T O N / R H O D E I S L A N D ■ 2 016 1 5