Noel Robert Williams, M.D., F.A.C.O.G. Specializing in the practice of Gynecology and Menopausal Medicine When I was graduating from the Ohio State University College of Medicine 14 years ago, the Dean reminded all of us “new doctors” that the half life of medical information was only “4 years”. “This meant that half of what we had learned would be outdated or incorrect in 4 years.” He paused and then said “the scary thing is…… we don’t know which half!” This thought has stayed with me ever since I graduated so many years ago. The practice of medicine is constantly changing. The specialty of Gynecology is no exception. Originally gynecologists were trained to direct the care of the female reproductive tract alone. Now we try to develop a partnership with each patient. Our focus has expanded to include not only the reproductive tract, but also the holistic care of women. Evaluating a woman’s overall health status, instituting preventive care practices and advocating non-gynecologic medical issues for the female patient are now the norm for a gynecologist. I would have never imagined 14 years ago that patients would regularly come to appointments ready to discuss all the latest data on treatment options fresh from doing research on the internet. Nor would I thought that I would routinely direct and/or coordinate the care of my patients with urologists, internists, neurosurgeons, rheumatologists, family physicians and many other medical specialists on a daily basis. The role of the gynecologist in a woman’s health care has changed. The practice of gynecology has evolved much beyond the overall role of the physician over the last decade. There have been great strides in the medical and surgical management of different gynecologic conditions. Fourteen years ago no one had thought or heard of menopausal medicine. Now it is what I spend the majority of my time evaluating and treating. Big surgeries with long recoveries were the usual trend when treating the more complex anatomical problems of the female reproductive tract. Now the focus is on minimally invasive surgeries (laparoscopy/hysteroscopy/laser). I prefer these approaches over exploratory surgery whenever possible. Anesthesia techniques have altered. Starting simple over the counter medications before surgery, and keeping patients awake during surgery by using regional anesthesia (spinal or epidural) lowers surgical discomfort, increases safety and facilitates the return to normal activity. These are but a few examples of how the practice of gynecology has developed over my time as a physician. These changes in the role of the gynecologist, their relationship with the patient, and the evolution in treatment strategies reflect the medical community’s continuing effort to make health care safer and more effective for each individual patient. I look forward to my next 14 years in medicine to be as exciting and challenging as the last 14 years.