DOI: 10.5061/dryad.qnk98sfjc
title: Fibroid treatment rates over time at a single academic medical system

description: Background: Multidisciplinary collaboration has generally been shown to
 have positive effects on healthcare but can be difficult to facilitate.
 This study assessed the effects of a multidisciplinary fibroid clinic on
 practice patterns and clinician perceptions to better understand drivers
 of interspecialty collaboration. Materials and Methods: Annual rates of
 hysterectomies, myomectomies, and uterine fibroid embolizations (UFEs)
 performed in an urban healthcare system 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 gynecologists 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). Results
 and Discussion: Annual rates of fibroid procedures increased over time
 (p&lt;0.01) but the relative number of UFEs decreased (p=0.01). UFE
 referrals by the clinic gynecologists significantly increased as did the
 number of combined fibroid procedures (p&lt;0.01). However, the rates
 of one fibroid procedure relative to others were not different between the
 clinic and rest of the healthcare system (p=0.55). Specialty-specific
 perceptions of fibroid treatments and inter-specialty dynamics did not
 change. Despite this, clinicians unanimously perceived the clinic and
 post-clinic practice patterns as positive and distinct from their previous
 work and relationships between gynecology and IR elsewhere. Limitations of
 this study included its single clinic design and potential confounder of
 differences in advertising pre- versus post-clinic. 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.
description: Annual rates of hysterectomies, myomectomies, and uterine fibroid
 embolizations (UFEs) performed in an urban healthcare system 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
 gynecologists 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).
description: The qualitative data associated with this work is not able to be
 shared publically according to the approving IRB given the potentially
 sensitive nature of the interview transcripts and small number of
 participants, making their anonymized transcripts potentially
 identifiable. Anonymized transcripts can be obtained by contacting the
 Northwestern University IRB directly and/or the authors for approved
 access.