Multicultural group of three professional women looking at tablet

Many patients who visit The Center for Innovative GYN Care (CIGC) for a consultation are seeking a second opinion. In some cases, their symptoms have been dismissed or they haven’t been truly listened to. In others, they’re frustrated with the lack of treatment methods offered to them. In my 30-year career as a surgeon specializing in complex GYN conditions, I notice this happening most often with my African American patients.

Unfortunately, this trend isn’t surprising. The health care industry has a pervasive history of racial disparity. We’re seeing the effects of this divide even more clearly during the COVID-19 health crisis. Black men and women are more likely to develop more severe symptoms and have adverse outcomes of the virus compared to people of other races¹.

In gynecological care, we see a consistent divide in the variety of treatment options offered, necessitating the need for a second opinion.

A Lack of Options in Fibroid Treatment

When it comes to fibroids, as many as 80% of Black women will develop them by age 50. Compared to white women, they are more likely to have fibroids earlier in life and experience more severe symptoms. When they approach their regular physicians with concerns about severe bleeding or pelvic pain, Black women are more likely to be given only two options: “watch and wait” or a full hysterectomy.

It’s just not true that those are the only options available to them. “Watch and wait” is not a treatment, and the impacts of waiting on treatment can be detrimental.

One of the biggest myths about fibroids is that they can shrink over time — this is patently false. Fibroids are noncancerous tumors in the uterus that will grow over time and potentially cause problems with other organs in the pelvis.

Estrogen causes fibroids to grow and will continue to be produced by the ovaries until menopause occurs. Failing to remove fibroids even when they’re small can result in heightened levels of pain and more severe symptoms. For women interested in becoming pregnant, fibroids can make it more difficult to conceive and they increase the risk for a miscarriage or pregnancy loss.

On the other side of the spectrum, a full open hysterectomy is neither the only nor the best option. Treatment methods are just as nuanced as each patient’s health situation, and they need to be customized. At CIGC, we specialize in minimally invasive procedures that put the patient’s health and recovery first. Using the DualPortGYN technique, we are able to fully resolve conditions like fibroids, endometriosis and adenomyosis using two small incisions. Even for advanced stages of disease, our non-robotic techniques are effective and involve only a few weeks of recovery time. Why settle for open or robotic surgery with multiple large incisions and months of recovery when you don’t have to?

The Exclusivity in Endometriosis Care

For endometriosis, the industry has led patients to believe it’s necessary to pay out of pocket for surgery. The truth is that many surgeons don’t accept insurance due to low insurance payments for the condition. This belief has turned endometriosis surgery into an exclusive treatment based on financial status. It leaves out a large population of patients — many of whom are minorities — who may be unable to afford “cash-only” treatment centers. Unfortunately, many “cash-only” endometriosis surgeons charge $10,000 or more for their services.

The bottom line is patients can and should be able to use their insurance to get the care they need. And in a time of financial instability like the one we’re living through now, affordable treatment is more important than ever.

CIGC is a GYN oncology-trained practice, and endometriosis excision plays directly into what a GYN oncologist does. They are trained to specifically treat disease involving the bladder, bowel and ureter, which are all organs commonly impacted by endometriosis. While many GYN surgeons, including some laparoscopic endometriosis specialists, would need to bring in a general surgeon to help treat these complicated cases of endometriosis, CIGC oncology-trained surgeons are already experts who have successfully performed minimally invasive endometriosis excision surgeries — without the assistance of robotics — in thousands of cases. And with their exclusive training, they can often perform endometriosis surgery more effectively and with lower complication rates than teams of surgeons who do not have the pelvic surgery training needed to provide the best possible surgical care.

The Importance of Seeking a Second Opinion

If you or someone you love is struggling with severe symptoms like pelvic pain, heavy bleeding or infertility, find a doctor who will take your symptoms seriously. Your health is too important to settle for a doctor or physician who dismisses your concerns or makes you feel unheard.

All of us at CIGC are ready and waiting to offer you a second opinion. We want you to feel better sooner and get back to your life healthier than ever.



Dr. Paul MacKoul

Dr. Paul J. MacKoul is a laparoscopic GYN surgeon who specializes in minimally invasive surgical techniques. He is a co-founder of The Center for Innovative GYN Care.

View Bio