Is there really such a thing as a specialist in endometriosis, much less the right one?
There is no such specialty, officially, as endometriosis. There is no one diploma on a doctor’s wall that certifies he or she is such a specialist. There is no one test that a doctor can take that, if passed, means he or she is an endometriosis specialist. All such “specialists” are self-appointed, that is, they themselves declare that they’re specialists in it.
A specialist in endometriosis talks the talk and walks the walk.
The problem is that just because someone identifies him/herself as an endometriosis specialist doesn’t mean it’s true. Some people call themselves that when they have a “special interest” in endometriosis or just want to do more surgeries that involve this devastating disease. But many patients undergo surgery as their “single best shot” at treating it, especially if infertility is part of their endometriosis problem. Such a sensitivity—with all that’s at stake—requires not just someone who talks about expertise, but who practices it—a lot. There are doctors, such as Dr. Ulas Bozdogan at NYCEndometriosis, who have done thousands of surgeries for endometriosis. That is the type of volume that should instill confidence because it is the only thing that says “specialist,” since you can’t find it hanging on a wall.
A specialist in endometriosis has more than just book knowledge.
What are the qualities you would want in an endometriosis specialist besides the book knowledge of this disease?
- Current knowledge—not just the book knowledge, but the latest knowledge in the entire medical literature. You want someone who lives, breathes, and—most importantly—reads endometriosis every day. With the sum total of all medical knowledge doubling just every few months, you want a doctor who has his or her finger on the pulse of ever-changing literature with an eye out for fresh perspectives on what can help you, individually.
- Fearlessness—there are difficult surgeries, and then…there are difficult A doctor who discourages you from having surgery because you’re overweight, have a medical condition or have had surgeries already is not the right endometriosis specialist for you. Trying to postpone surgery in this time-sensitive disease by wasting time on medical or hormonal approaches can be the wrong strategy if you’re fretting each month of infertility that goes by. It is true that most patients who finally find the right endometriosis specialist have already been to several other doctors and even may have had several other surgeries, so at what point should you give up? The right endometriosis specialist should be the last one you will ever need and, likewise, feel that this is true for him or her, too. Giving up is simply not an option. There’s just too much at stake.
- Compassion— there are still doctors who may tell you there is nothing more to offer you. There are those who say you are not a candidate for definitive therapy for a difficult problem, or that the problem itself is just too difficult. And unbelievably, there are still doctors who tell women the pain they feel is all in their heads! Whether you seek help because your quality of life is so bad due to chronic pain or because you are frightened you may never be able to have a baby, you need someone who recognizes what endometriosis is doing to you—as an emergency. It’s a 9-1-1 call. And even if it’s not life-threatening, it is in fact threatening to your life and you’re living it to fulfillment.
- Great hands—surgery is an exercise in dexterity. It is serious business, for sure, but that makes it all the more important for a surgeon to be skilled in doing the best and most complete therapeutic work in the shortest, most-efficient time.
- Better hands with robotic surgery—a surgeon may have great hands, but advances in surgery have left some of the best pairs of hands behind. The da Vinci robotic surgery allows a great surgeon to be even better, by offering stereoscopic vision from any vantage point within your pelvis, with magnification views for the most dexterous or tedious of dissections. Since endometriosis is invasive, a surgeon like Dr. Bozdogan, taking full advantage of the state-of-the-art technology that robotic surgery offers, knows where the endometriosis ends and normal tissue begins. This is important if you want your endometriosis removed but want to come out of the surgery with as much reproductive tissue as when you went in. Also, advanced endometriosis can literally obliterate normal anatomy, and the robot offers the best chance of restoring normal, functional anatomy. Seeking to be pain-free is a goal, but the function is the ultimate success.
- Deep-excision surgery—to eliminate endometriosis one must remove it entirely, not just “most” of it. Since it is invasive, a surgeon must know how to completely excise without damaging the adjacent tissue. Burning or lasering it superficially is not the proper way, and your doctor should know this.
How do you find this right endometriosis specialist? & What are the questions you should ask your doctor?
Are you board-certified in obstetrics and gynecology? The American College of Obstetricians and Gynecologists offers the most authoritative designation in the specialty of women’s health. Such a designation means your doctor has achieved the highest standard of expertise in women’s health. Even though there is no special (official) subspecialty of endometriosis, board certification is the starting point.
Do you still deliver babies? No one can do it all, and doctors who are still delivering babies as part of their practices are dividing their attention and time. While Dr. Bozdogan feels there are those who can deliver babies and practice as an endometriosis specialist, he points out that he himself isn’t doing obstetrics and can dedicate 100% of his time to your endometriosis condition.
How many endometriosis surgeries have you done? There is a saying that 10,000 hours of doing something makes one an “expert.” This may be arguable, but it is easy to see Dr. Bozdogan’s many-times-over this criterion emphasizes his expertise.
Have you done all types of endometriosis cases, from mild to severe? You shouldn’t want to go to a doctor who will refer you to a “more expert” doctor when things become too complicated. Maybe you should have gone to the “more expert” expert in the first place. Expertise like that of Dr. Bozdogan comes from doing endometriosis cases in of its variations—moderate-to-severe, “frozen pelvis endometriosis,” even obstructive adhesion disease and bladder/bowel involvement.
How do you do your surgeries? The most technologically advanced method uses the da Vinci robot, like the kind favored by Dr. Bozdogan. Not only is the control and skill superior to all other methods, but the tiny incisions make for speedier recovery and with less pain, both considerations of which are important in a woman wanting to seek pregnancy as soon as possible.
How many da Vinci robotic surgeries have you done? While hundreds are impressive, thousands like the number Dr. Bozdogan has done is hard to match. He even teaches da Vinci surgery to doctors looking to add it to their surgical practices.
The Most Informed Patients!
Endometriosis patients are some of the most informed patients there are. They do extensive research and hopefully ask all of the right questions. They know that no one guide—not even this one—will tell you everything you need to know about finding the right endometriosis specialist. But it is hoped that these considerations will give you a great start in finding such a specialist and make a rational contribution to your research. This, of course, is to be combined with the “gut” feeling between you and your doctor. The patient-doctor relationship should be special, and if you don’t feel that way, you’ve got the wrong doctor.