The Power of Proximity: Effects of a Multidisciplinary Fibroid Clinic on Inter-Specialty Perceptions and Practice Patterns

Study Objective To assess the effects of a multidisciplinary fibroid clinic on practice patterns and clinician perceptions. Design Annual rates of hysterectomies, myomectomies, and uterine fibroid embolizations (UFEs) were collected from 2012-2019. Rates of each procedure were compared over time before and after launching a multidisciplinary fibroid clinic at the academic medical center. Referral rates were also compared. The minimally invasive gynecologic surgeons (MIGSs) and interventional radiologists (IRs) involved in the clinic were interviewed 2 years prior to and after the clinic launch about their approaches to fibroids and perceptions of others who treat this condition. A phenomenological approach was used to identify and compare themes within the interviews by two researchers with excellent inter-rater agreement (k = 0.80). Setting Urban healthcare system with an academic medical center (894 beds) as well as community affiliate hospitals. Patients or Participants 6361 procedures performed for symptomatic uterine fibroids from 2012-2019 for 5747 patients (average age 49±9 years). Interventions Creation of a multidisciplinary fibroid treatment clinic staffed by MIGSs and IRs. Measurements and Main Results Annual rates of fibroid procedures increased over time (p Conclusion Creating the right practice environment may be more important for fostering inter-specialty collaboration and work satisfaction than shared mental models or procedural volumes in certain practice settings.