By way of introduction, I am originally from Brooklyn, New York where I attended public schools through High School. Growing up, I loved sports (especially baseball), math and science. I graduated from Yale University, where I was pre-med while majoring in Economics and Mathematics. I received my medical degree from New York University School of Medicine, where I subsequently did my Obstetrics and Gynecology and Urogynecology training, under the tutelage of Dr. Robert Porges, a consummate professional and great vaginal surgeon. I remained at NYU as an attending for many years and served in various leadership roles, including Residency Program Director in the Department of ObGyn (for 18 years), Chief of Gynecology and Urogynecology at Bellevue Hospital and Director of the Division of Urogynecology at the NYU School of Medicine. At NYU, we were fortunate to have an excellent group of female Urologists, and were able to cut across traditional departmental boundaries and collaborate by creating a unified practice between our two divisions. We all worked together with residents from both Departments and trained fellows from ObGyn and Urology residencies, a very fulfilling endeavor.
I left NYU in 2019 to take on my current position as Chair of the Department of Obstetrics and Gynecology at the Jersey Shore University Medical Center in the Hackensack Meridian Health (HMH) system, a role which has expanded to Regional Chair of the HMH South Region hospitals. During this time, I have enhanced my administrative and leadership skills, collaborated with full-time academic and part-time community physicians, along with nursing and hospital leadership to grow our department, emphasizing high-quality, safe care in a supportive environment focused on the well-being and diversification of our team members. During the 5 years that I have been here and despite the Covid pandemic beginning 6 months into my tenure (indicating that I cannot list “good timing” as a strength!), we have seen Gynecology volume grow by 30% and Obstetric volume by 50%. During this time, we established new programs in Family Planning and Pediatric and Adolescent Gynecology, while augmenting our subspecialty divisions in Urogynecology, Maternal-Fetal Medicine and Gyn Oncology. The academic output of a department which historically had been community-based, has more than tripled in terms of publications and presentations at national meetings. We also applied for and were granted a permanent increase in our residency complement. On a personal note, this year, I received the "Physician of the Year" award from the medical center, which was especially gratifying in that it is voted upon by nursing.
I am a member of many professional societies and organizations, including ACOG, APGO-CREOG, the New York Obstetrical Society, SGS and, of course, AUGS. I served as an oral boards examiner for ABOG for 15 years. For ACOG, I was one of two collaborators on the Pelvic Organ Prolapse Practice Bulletin (#85, 2007) and then was invited to join the Gynecology Practice Bulletin committee, which I served on for 3 years. During that time, I was one of two collaborators for the Urinary Incontinence Practice Bulletin (#155, 2015). Prior to my time with ACOG, I was a member of the Systematic Review Group for SGS.
After my term at ACOG, I was appointed to the AUGS Clinical Guidelines Committee and became Vice Chair of that committee one year later. Subsequently, the Guidelines Committee, along with 2 other committees, was folded into the Publications Committee, which I then vice-chaired for 3 years, before becoming chair of that committee, a role in which I currently serve. Thus, I have been on AUGS' committees handling guidelines and publications for the past 10 years. During this time, I've had the opportunity to work with many great AUGS members from around the country and, collectively, we've been able to produce a large number of documents providing guidance on a multitude of topics within our discipline. As chair of the committee, I've also had the chance to collaborate with some of our international colleagues on multi-society projects, which have been extremely satisfying to complete while working across multiple time zones.
I would be remiss not to mention my main community service which has been through involvement in youth sports organizations. I have 3 daughters who all (fortunately for me!) were interested in playing sports, primarily basketball and soccer. As such, I became involved in coaching travel basketball, which I did for 8 years (and 9 teams, having coached 2 teams simultaneously one year). Sports parallels what we do in the professional world in terms of having defined rules and competition, dealing with a variety of different personalities and situations, and having to utilize skills including flexibility, strategizing, teaching, communication and relationship-building. I truly believe that some of the achievements that have been attained during my time as Department Chair were the result of skills honed from coaching. I also went on to join our town’s youth basketball and soccer boards and became President of both (at different times), which not only required the organizational skills that go along with leadership positions, but also the ability to seek funding and establish philanthropic relationships in the community (in addition to the time management necessary in consideration of my day job!).
AUGS Directors at Large serve as Liaisons to one of the 6 councils within the organizational structure. I am seeking to join the Board as a Director at Large and would bring the skills and experiences I have developed over time in my various roles, a positive “can do” attitude, the desire and ability to build relationships, an objective metrics-based approach to problem solving and the motivation to continue to move our field and organization forward.
Having been a Residency Director for nearly two decades, I understand and appreciate how to work with people from diverse backgrounds, listen to their needs and involve them in the decision-making process. As a Division Director at a large academic-medical center, I learned much about faculty practice management, including the finances of medicine and intricacies of coding in Urogynecology in particular. I became especially aware of the challenges of blending academic and clinical demands and the importance of emphasizing well-being to avoid burnout. Now as Department Chair, all of these learned skills have coalesced, with the addition of learning about and understanding the needs of community-based physicians, while instituting policies to achieve high quality, safe care across all the divisions in the Department. My time on AUGS Guidelines and Publications committees, especially the past 3 years as Chair of Publications, has enabled me to understand the Society’s structure, vision and strategic plan better, align committee members with these goals, formulate strategies to meet the objectives, represent AUGS when working with other societies and ultimately, provide oversight in the development of high-quality content for our members. In all of these roles, an ability to communicate effectively and transparently and facilitate relationships between parties is of paramount importance (between residents and attendings as Program Director; faculty and fellows and mid-level providers as Division Director; private and community physicians and nursing as Department Chair) and I believe lends itself well to the role of liaison for the AUGS board.
I have been attending AUGS meetings since the mid-1990s and, at one of the very first meetings I attended, the inaugural June Allyson Grant was announced--by June Allyson! In the years since, I’ve seen and appreciated the growth of the Society, the refining of its goals, and the advancements in our subspecialty that it has fostered. I am happy and honored to have served the Society and hope to continue to do so as a Director at Large.
What do you believe are the major challenges facing AUGS?
My list is below, but what I think the challenges are that are facing AUGS is not as important as what the membership thinks. To successfully identify and respond to the issues, effective communication with the membership at large is critical and I would want to speak with, poll and/or survey members to gain a better appreciation of what they want to address.
1) Provider Reimbursement - In particular, differences in reimbursement by physician gender exist in Urogynecology as in other medical specialties, with female surgeons receiving lower payments from Medicare. In addition, disparities exist between specialties; e.g., Urologists vs. Urogynecologists.
2) Accessibility to Care - Research by several members of our society has demonstrated that the prevalence of Pelvic Floor Disorders is increasing and one study estimated that approximately 3700 PFD specialists will be needed in the United States by 2030. Currently, we are well short of that number.
3) Finances of the Society - Largely as a result of the pandemic, AUGS’ profitability has been impacted and a portion of our reserves depleted in order to finance operations. This has improved in the past 2 years but is an important focus for the Society going forward.
4) Emerging technology - AI tools hold the potential to improve surgical care, including preoperatively (patient selection and preparation), intraoperatively (improving performance and OR efficiency), and postoperatively (potential for reducing complications).
5) Relative lack of Research Funding - Urogynecology still lags many other medical specialties in availability of funding for research.
6) Increasing and diversifying membership/competition with other societies
7) Physician Burnout
What suggestions do you have to respond to these challenges?
First, my standard approach to problem solving is to diligently gain a complete understanding of the issues, which involves information gathering, data analysis and obtaining opinions from a diverse group of stakeholders, before formulating a strategy. Therefore, an inherent aspect of problem solving is being intimately involved in the process, and, if I’m fortunate enough to join the Board, that is how I would go about responding to these issues.
That said, my brief thoughts at this point are as follows:
1) Provider Reimbursement
- Support the function of Payment Reform and Coding committees
- Advocacy
- Utilize published data demonstrating lower reimbursement for female providers in Urogynecology (and all specialties) as well as disparities between Urology and Urogynecology subspecialties
2) Accessibility to care
- Raise awareness and education
- Increase training programs and incentives for rural practice
3) Finances of the Society
- Continue to augment content in user-friendly and interesting formats at the Annual meeting (as has been occurring in the past several years) to drive attendance
- Philanthropy
- Based on Dr. Bradley's Presidential Address in Portland last year, less than 5% of our membership had donated to the AUGS foundation (this may be the reason why, to my surprise, I received the Donor of the Year award in 2023–there is not a lot of competition when 95% of people are on the sidelines!). We need to continue to promote the important things that AUGS does for its members and ensure that they are aware of them.
4) Emerging technology
- Promote and support research on applications of AI in Urogynecology, recognizing its potential impact on more rapid acquisition of information, evaluating the ability of natural language processing platforms to provide accurate information to patients, and assess the ability of AI to improve procedural performance.
- Dovetailing with this will be the need to continue to recruit a younger, more diverse membership, as below, who will be more facile with emerging technology and more apt to utilize it
5) Relative lack of research funding
- Continued government advocacy, highlighting patient stories to drive the need for more research in this area
- Continued well-vetted partnerships with industry
6) Increasing/diversifying membership
- We have seen >30% increase in membership over the past 8 years and we need to continue that progress
- Marketing
- Use of social media
- Assuring that fellowship programs have distinct DEI statements (we recently reviewed this and found that < 15% currently have such a statement on their website)
7) Physician burnout
- Education on strategies for individuals
- Advocacy for organizations, hospitals, medical centers to implement and improve interventions to better support physicians
- Address systems issues, including EMR and reimbursement (as above)