physician | Dr. Lori Gore-Green | Gynecology and Obstetrics

by Dr. Lori Gore-Green on October 29, 2018

The RESPECT Model

Visiting a new doctor for the first time can be an anxiety-ridden experience for anyone. Not only are you likely meeting a new person, but you’re also confiding in that person with a very personal matter: your health.

A recent survey from this summer found that nearly 40% of women indicated they felt at least “somewhat concerned” prior to their first OB-GYN visit. Because of this number, physicians are working harder than ever to establish an open and trusting relationship with their patients. The RESPECT model is helping to do just that, in OB/GYN offices and beyond:

R—Rapport. Building rapport with the patient allows her to connect with you on a social level, not just as another appointment to check off. It strengthens your relationship as a rapport helps you see from her perspective and refrain from making assumptions.

E—Empathy. This may be harder said than done at times, but remembering that the patient needs help, and is here to be helped by you will keep you in a compassionate state of mind.

S—Support. As a physician, it’s your job to help patients and any obstacles they bring with them. You’re part of their team, and team members support one another.

P—Partnership. You’re working as a team to fix any given issue, and for that to work, the patient must have an equal say and solid understanding. This also means negotiating roles on occasion, and being flexible when it comes to a matter of control.

E—Explanations. Of course, as a physician, you must explain new concepts to patients in ways that make sense to them. What might make sense to the doctor after years of medical school, residency, and a long career likely will need to be broken down for someone not as knowledgeable in the field.

C—Cultural Competence. These days, many patients and physicians come from different backgrounds. They have different life experiences. To work well together, they must be able to respect their differences, and adjusting a style of care to allow for them.

T—Trust. This also happens when the physician and patient come from different backgrounds. There needs to be a trust in place for the doctor to effectively treat the patient, but that trust is not always just given. Often, it must be earned, and taking the time to actively work to establish that trust is the only way to achieve it.

by Dr. Lori Gore-Green on October 2, 2018

5 Other Reasons to Visit Your OB-GYN

A trusted OB-GYN is a critical part of any woman’s professional health team, whether or not you intend to have children. An OB-GYN makes sure your vagina is healthy and your reproductive system is in good working order. But, did you know that you can go to your OB-GYN for more than just those two things?

Screening for Breast Cancer

Think of your OB-GYN as the first line of defense in detecting breast and colon cancers. If your annual appointment includes a breast exam, your obstetrician should be the first to notice any strange growths or changes in your breasts. OB-GYNs can also do rectal exams.

Treating Depression

Though OB-GYNs are not psychiatrists, they’re still trained to screen for and evaluate mood disorders. Depending on the case, your doctor could start you on medication or refer you to psychiatrist. Because of your emotional connection with your OB-GYN, especially if they treated you through a pregnancy, they are a safe person to confide in and share your concerns with. If you’re pregnant, your doctor will also be knowledgeable on how the medication will impact both you and the baby, as well.

Skin Checks

Of course, while a dermatologist is trained to look for signs of skin cancer, your OB-GYN can still perform skin checks. And given how most people have between ten to forty moles, it’s not a bad idea to get a skin check during your annual visit. In the event they notice any suspicious growths, they can alert you early on and get you into the office of a dermatologist to take a closer look.

Family Planning

Unsurprisingly, as they have many pregnant patients, OB-GYNs are great resources in terms of family planning. Whether that means you discuss certain genetic conditions you could pass on or figuring out how to have “the talk” with your daughters, your OB-GYN can help address your fears and provide you with the most current information.

Bone and Joint Issues

Millions of women across the country develop osteoarthritis, which can be a devastating joint problem, and it can happen a good way away from the beginning of menopause. By measuring and recording your height yearly, your OB-GYN can catch signs like losing height. They can also perform bone scans to keep an eye on your mineral levels. If they can catch the development early on, you’ll be much better off.

Filed Under: Dr. Lori Gore-Green, Health, OBGYN Tagged With: Dr. Lori Gore-Green, gynecologist, Gynecology, health, OB/GYN, Obstetrics, physician, women, Womens Health

by Dr. Lori Gore-Green on August 6, 2018

Top 5 Fertility Tips

Lots of women become pregnant without needing to do much more than have sex that one time. For others, it can be a more difficult and even emotional process, especially if the woman has been trying for some time without success.

Although each woman’s life and situation is different, and each pregnancy, in turn, is different, here are a few tips that doctors recommend for women looking to become pregnant. Please consult your primary care physician before trying anything different your routine, however, to remain safe.

Consider counseling.

If you’re picturing a couch and a psychologist asking “And how does that make you feel?” you’re thinking of the wrong kind. Instead, women looking to become pregnant should receive pre-conception counseling about two to three months before trying, and this can be done with your OB-GYN. Pre-conception counseling is a conversation where your doctor will ask about your goals in getting pregnant, as well as take that time to screen you for potentially harmful conditions. By receiving counseling early, you’re able to find warning signs before they develop further.

Get checked out.

Both you and your partner should see a doctor, to make sure your vaccinations are all up to date, in particular. Getting sick while pregnant could lead to a higher risk of complications. By making sure both you and your partner are in the best possible health, you are creating the optimal condition to make a baby.

Quit the caffeine.

You could also stand to benefit from abstaining from alcohol and any kind of drugs. In general, though, if you shouldn’t have something while you’re pregnant, it might be a good idea to kick the habit beforehand. And, remember—energy drinks have caffeine, too! Not just coffee!

It’s also advisable to not be in the same vicinity as anyone who partakes in smoking. No matter how you ingest the smoke, second-hand or not, it could hurt your chances of becoming pregnant without complications.

Stay active.

This is just good life advice in general, but it’s especially true when gearing up to grow another human. The goal is to have thirty minutes of cardio five or six days each week. This is to keep your heart healthy and your weight at a manageable level. If you’re worried about the intensity affecting your fertility, talk with your doctor about the best exercises to do instead of your usual routine. Overall, though, if your period cycle is regular, you won’t need to change too much.

It’s okay to feel stressed.

The idea that you need to be completely serene and at peace to conceive a child has no basis in science. So if you’re feeling guilty because you’re always busy, but you still want to have a baby, don’t feel like you’re cheating yourself out of your chance. Anxiety is normal, and it won’t ruin your chances of having a healthy child.

Filed Under: Dr. Lori Gore-Green, Health, Pregnant Tagged With: Babies, Dr. Lori Gore-Green, gynecologist, Gynecology, health, OB/GYN, physician, pregnancy, pregnant

by Dr. Lori Gore-Green on May 14, 2018

C-Section Rates Too High in China

The C-section rate in China stands at about 50% of all deliveries and must be reduced.

According to a commentary recently published in BJOG: An International Journal of Obstetrics and Gynecology and summarized in an article completed for Science Daily, the rate of cesarean sections in China is far too high and efforts need to be made to reduce the reliance on the procedure. The research completed for the commentary indicates that, of the sixteen million babies born in 2010, approximately half of them were delivered through cesarean section. However, the article did acknowledge that the exact rate of births by cesarean section, but the literature available on the topic in China indicates that the rate of C-sections could range anywhere between thirty six percent and fifty eight percent.

Several reasons for the priority placed on cesarean sections are discussed. With the existing high number of deliveries occurring in the nation, cesarean sections may simply be the preferred method, due to the advantages of managing an enormous volume of births with limited resources. There are also a series of financial incentives for hospitals and physicians who engage in cesarean sections as opposed to traditional vaginal deliveries. Insurance is more willing to cover the costs of childbirth, if the baby is delivered by cesarean section. Physician and hospital revenues are also increased with the procedure as well; in addition, physician salaries are often supplemented, based in patient volume and collections. In this sense, cesarean sections allow for a higher salary for physicians, as they collect more than traditional vaginal deliveries.

Money also plays a role in the staffing influences over choosing cesarean sections as the preferred method of delivery. Staffing levels in China public hospitals are low and limited, due to government regulation. Per one thousand people in the population, there is only one and a half nurses or midwives. As cesarean sections require less nursing hours when compared to vaginal deliveries, it makes sense to pursue this avenue in the interest of staffing. Finally, training is varied and inconsistent in obstetrics and gynecology in China; less than two percent of physicians complete a masters or PhD level in their training.

There is also a factor of patient preference. Since the One Child Policy has been passed, mothers demand perfect outcome on the one and only attempt, particularly in wards that don’t offer pain control, epidurals or much nursing support. Fundamentally, there is a fear of labor that inclines mothers towards cesarean sections. However, in November, a less strict version of the One Child Policy is expected to go into action, which would allow for the birth of a second child. With the increased number of births would come an increased reliance on cesarean sections; therefore, the commentary postulates that this will force medical professionals to return once more to traditional vaginal deliveries, as to cut back on the risks in childbirth.

Filed Under: Dr. Lori Gore-Green Tagged With: birth, BJOG: An International Journal of Obstetrics and Gynecology, c-section, cesarean section, childbirth, China, cost effective, deliveries, Dr. Lori Gore-Green, Gynecology, high rate, insurance, OB/GYN, Obstetrics, physician, traditional, vaginal deliveries

by Dr. Lori Gore-Green on July 30, 2014

Top Medical Center Undergoes Traumatic Event

Dr. Nakita Levy, Gynecologist at Johns Hopkins, Committed Suicide after Investigation for Recording Patients.

Dr. Nikita Levy, Gynecologist at Johns Hopkins, Committed Suicide after Investigation for Recording Patients.

In a recent article by The Boston Globe, Johns Hopkins is said to have to pay a $190 million in a gynecology settlement. A gynecologist at one of the world’s top medical centers, Johns Hopkins Health System, was fired after 25 years for secretly used tiny cameras to record and take pictures of his patients. Because of this, Johns Hopkins has been forced to pay $190 million to 8,000 women and girls that have been affected by this doctor’s actions. Dr. Nikita Levy was spotted by a female co worker with his pen like camera that he used around his neck and alerted authorities. Roughly 1,200 videos and 140 images where stored on his computers at home. After being investigated by authorities, Dr. Levy committed suicide.

Many women and girls were “brutalized” by this recent finding. Many had issues sleeping, they were unable to work, and ended up needing counseling. In the preliminary settlement which was approved by a judge on Monday, this was said to be one of the largest cases on record in the United States. Even though this case has been closed and never produced criminal charges, it still threatens the reputation of Johns Hopkins.

Lawyers working on the case state that thousands of women were traumatized even though their faces were not visible in the pictures and videos that were recovered. According to attorney, Howard Janet, 62 of the victims were young girls whose chaperones were sent out of the exam rooms by Dr. Levy, breaking hospital protocol. It is the hope of Johns Hopkins that the pictures are never leaked and that the victims involved in this recent case will achieve some sense of closer soon. Looking forward for the future, Johns Hopkins hopes that people will not think of the institute in a negative light after this recent case since the institute does so much good for the community.

Filed Under: Dr. Lori Gore-Green Tagged With: abuse, attorney, computer, court case, doctor, Dr. Lori Gore-Gree, Dr. Nikita Levy, files, girls, gynecologist, Gynecology, Health System, Howard Janet, Johns Hopkins, lawyers, patients, photographs, photos, physician, protocol, recorded, suicide, The Boston Globe, therapy, Top Medical Center, trauma, traumatized, women

by Dr. Lori Gore-Green on June 30, 2014

Controversy Over Necessity of Pelvic Exams

Pelvic exams may not be a necessary procedure during an annual gynecologist exam for women who are not pregnant.

The yearly trip to the gynecologist can be a dreaded event for many females. Pap smears are unpleasant and can often be only the tip of the iceberg, as many doctors also include pelvic and rectal exams as well. However, according to an article completed by the Daily News that summarizes a new series of guidelines released by the American College of Physicians, the pelvic exams may no longer be a necessary procedure to inflict upon women who are not pregnant.

In the procedures involved in the yearly check up with a gynecologist, women are often subjected to pelvic exams under the pretense that the ordeal can help in finding possible signs of ovarian cysts, sexual transmitted infections, uterine fibroids and early detection of cancer. However, according to findings published by the ACP in their journal Annals of Internal Medicine, the routine pelvic exam has not shown to benefit as it was previously thought to. The exam is now believed to rarely detect important disease and doesn’t reduce mortality in the average risk woman who is not pregnant. In fact, the examination is often associated with discomfort for many women, including a round of potential false positives and negative exams, along with additional unnecessary costs. However, this finding does not apply to pap smears, which are believed to still be beneficial.

The researchers with the American College of Physicians are not the first to suggest that pelvic exams could be excluded from the routine trip to the OBGYN. Carolyn Westhoff was the first to suggest eliminating the procedure, with an article published in 2011. The article indicated that if the woman was experiencing none of the typical concerning symptoms—such as discharge, abnormal bleeding, pain, urinary problems or sexual dysfunction—the procedure was very unnecessary. She, in turn, approves of the announcement made by the ACP.

However, Westhoff and the ACP are not without their opponents. The guideline is expected to stir up quite a bit of controversy. The American College of Obstetrics and Gynecology remains in favor of the annual pelvic exam, as it allows doctors to fully explain a patient’s anatomy to them—including a reassurance of normality and an ability to answer any questions.

Filed Under: Dr. Lori Gore-Green Tagged With: ACP, American College of Physicians, anatomy, Annals of Internal Medicine, annual, appointment, cancer, check up, discomfort, doctors, Dr. Lori Gore-Green, gynecologist, Gynecology, OB/GYN, Obstetrics and Gynecology, ovarian cysts, pap, pap smears, pelvic exams, physician, pregnant, procedures, sexual transmitted infections, The American College of Obstetrics and Gynecology, unnecessary, uterine fibroids, women, yearly

by Dr. Lori Gore-Green on April 28, 2014

Study Finds that Hormone Treatments Extend Survival of Lung Cancer

Hormones may be utilized for several purposes.

A study was recently conducted by Ann G. Schwartz, PhD, MPH, of Karmanos Cancer Institute of Detroit, Michigan. Schwartz was the lead author on the study, which sought to observe the potential connection between hormone use and lung cancer outcomes in women. The findings of the study were published in the March issue of the International Association for the Study of Lung Cancer’s journal—the Journal of Thoracic Oncology. An article recently completed by Science Daily summarized the study and the findings.

Four hundred and eighty five women were included in the study. At the start of the study, baseline data was collected, which included the stage of the disease at diagnosis, treatment type (surgery or radiation), smoking status, age, race and educational attainment. Once this data was gathered, the only factor taken under consideration was the use of hormone therapy and its ability to predict the survival outcomes in women with lung cancer. Some women were treated with just estrogen; others were given a combination of estrogen and progesterone. On average, women diagnosed with lung cancer without any hormone therapy as treatment survive 37.5 months. Those who are given hormone therapy survive, on average, eighty months. Specific averages for patients given just estrogen survived approximately eighty-three months, while those who were provided with a combined treatment of estrogen and progesterone survived eighty-seven months.

From these findings, Schwartz was able to declare that reproductive and hormonal factors do influence women who have been diagnosed with non-small all lung cancer. However, she disclaims that research in this field is limited and that further studies would be required to observe the effect these treatments could have on long-term sufferers from lung cancer.

Filed Under: Dr. Lori Gore-Green Tagged With: Ann G. Schwartz, Dr. Lori Gore-Green, estrogen, Gynecology, hormones, International Association for the Study of Lung Cancer, Journal of Thoracic Oncology, Karmanos Cancer Institute of Detroit, Michigan, OB/GYN, Obstetrics, physician, therapy, treatment, women

by Dr. Lori Gore-Green on March 20, 2014

Physicians on Social Media

Social media can be a touchy subject for some individuals depending on their lifestyles, careers, areas of expertise, and so on. While social media can help many professionals, if an individual is not careful enough with what the put on the Internet, it is also something that can hurt. In a recent video on obgynnews.com, Dr. Matthew DeCamp, tells us what physicians specifically should leave off the Internet.

Matthew DeCamp is an assistant professor at the Johns Hopkins Berman Institute of Bioethics and in the Johns Hopkins division of general internal medicine. He expresses in this video that there are certain things that physicians post on their social media forums that can be detrimental to their careers and the lives of their patients. In particular, some dangerous areas to post about are alcohol consumption, profane language, or statements about patients – even without mentioning names.

Many times an individual in the medical field, or any professional field for that matter, will post something on social media that is derogatory or exploits someone’s personal business, and even when they think they are in the clear because they’ve kept names out of it, they are wrong. That patient may be identified by any other individual reading the post. As a physician, there are tons of documents that need to be signed and confidentiality is huge. There is never a reason for a doctor or nurse or assistant to be speaking about a patient or client on the Internet. This is absolutely an invasion of privacy.

Social Media is not a bad thing by any means, however the users must be extremely cautious of what is on their profiles, as well as what is in the fine print. Some social media profiles allow the public to see almost everything you put out there, so awareness is key. Educate yourself on every single profile you are on or wish to be on. Privacy settings are another very important part that individuals must read through entirely. Social media can be the perfect way to market and advertise a business or skill set as well. Learn how to make it a positive and stay away from anything questionable!

Filed Under: Dr. Lori Gore-Green Tagged With: awareness, confientiality, Dr. Lori Gore-Green, Gynecology, internet, OB/GYN, Obstetrics, physician, privacy settings, social media, Texas

by Dr. Lori Gore-Green on February 26, 2014

About Infertility

A number of women suffer from infertility. Infertility is the term for when women try to get pregnant and within a year of trying fails or has miscarriages. This can happen for several reasons.

Women’s ovaries provide them with tons of eggs throughout their lifetime. Normally, during ovulation, eggs are released from the ovaries and they travel down the fallopian tube until they are fertilized. If these eggs are not used, they are shed during a woman’s menstrual cycle. For women who are infertile, they either re not producing the eggs at all, or they are producing eggs that cannot be fertilized. Premature Ovarian failure or Polycystic Ovary Syndrome may be the reason for these two problems.

The good news is that there are treatments for infertility that include medicine, reproductive technologies or surgery. Sometimes it is difficult to find out if one is infertile. The process takes time because everyone’s body is different. It also takes time to find the treatment that is best for each individual.

Infertility in women can come from her environment, a physical problem, lifestyle factors or hormones. Men can also be infertile. 1/3 of the time it is because of the man, 1/3 of them time it is because of the woman, and the other 1/3 of the time, no specific issue is found. More good news is that 2/3 of couples who cannot have children and are found infertile and treated for it, they are then able to have children.

The medical world is extremely advanced and will just keep advancing. When it comes to technology, it has really helped doctors save lives and create lives. Infertility no longer means you absolutely cannot have children, there is usually an answer.

Filed Under: Dr. Lori Gore-Green Tagged With: Dr. Lori Gore-Green, Gynecology, infertile, infertile men and women, infertility, infertility causes, infertility treatments, medical industry, OB/GYN, Obstetrics, physician