Development of an Innovative Hybrid Clinic for Rapid Multidisciplinary Decision Making and Algorithm Development for Patients with Symptomatic Uterine Fibroids

Optimal patient management often requires a multi-disciplinary approach. Interventional radiologists and oncologists often sit on tumor boards for complex medical decision making. Patients with non-oncological symptoms that have significant impact on quality of life seek rapid optimized medical treatment. Patients with dysfunctional uterine bleeding or bulk symptoms from fibroids often self-refer to interventional radiologists. They may report a “hysterectomy or medical management” discussion from physicians who may not be familiar with the latest techniques. Even with skilled management, patients may be led down the path of uterine artery embolization or myomectomy based on the training experience of the operator or, in collaborative environments, may have to travel long distances or repeat appointments to see both interventional radiologists and gynecologists for medical opinions.

In our single-center institution, the Fibroid Care Center represents an innovative approach to the hybrid clinic model. Each patient sees both an interventional radiologist and gynecologist. The history, labs, and imaging are reviewed. Patients are presented with options, including the consensus opinions among the multidisciplinary physicians. This process allows for enriched medical decision making and problem solves where multiple techniques may be needed (such as when innumerable and small stalk intracavitary fibroids are present). In addition, the hybrid model allows for research collaboration to define a stronger treatment algorithm for patients and identification of factors that lead to increased treatment efficacy and safety.