Selected Podcast
What and When to Refer to Pediatric and Adolescent Gynecology
Female reproductive health is critical in growing girls and young women. Julie Strickland, MD, Section Chief of Pediatric and Adolescent Gynecology, joins us for this episode of Pediatrics in Practice to talk about the need for pediatric and adolescent gynecologists, the conditions they treat and when to refer.
Featured Speaker:
Learn more about Julie Strickland, MD
Julie Strickland, MD
Julie Strickland, MD, is Section Chief of Pediatric and Adolescent Gynecology at Children's Mercy Kansas City and Professor of OB/GYN at the University of Missouri-Kansas City School of Medicine. Dr. Strickland received her medical degree from the University of Missouri-Columbia School of Medicine, where she also completed her residency in Obstetrics and Gynecology.Learn more about Julie Strickland, MD
Transcription:
What and When to Refer to Pediatric and Adolescent Gynecology
Dr. Michael Smith (Host): Female reproductive health is critical in growing girls and young women. But knowing what and when to refer to a specialist can be difficult. This is Pediatrics In Practice, the podcast from Children’s Mercy. I’m Dr. Mike. My guest is Dr. Julie Strickland, Section Chief of Pediatric and Adolescent Gynecology at Children’s Mercy. Dr. Strickland what is a pediatric adolescent gynecologist?
Julie Strickland, MD (Guest): Thank you for having me Dr. Mike. I would tell you that that is often a question asked of me because of increasing awareness of the importance of reproductive health in girls of all ages, not just adult women. Pediatric and adolescent gynecology is a relatively new field within obstetrics and gynecology and has recently just been recognized as a board certified focused practice within obstetrics and gynecology.
Basically, pediatric and adolescent gynecologists look at the reproductive health and reproductive structures and possible diseases of girls at all ages from neonatal life up through college age in general. So, we are prepared to provide consultation for gynecological disorders and disorders of reproductive function all the way through the pediatric lifespan.
Host: And what is the training that you underwent to become a pediatric adolescent gynecologist and is this a fellowship of OB/GYN or can also pediatricians come into this fellowship?
Dr. Strickland: So, the fellowship is only of OB/GYN. The training is usually the general obstetrics and gynecology training and board certification. And then new to this field is practice and experience beyond that of at least three years and then sitting for a focused examination as well as an examination of practice case lists at the board level to delineate special expertise in this area.
Host: And how many, if you know this, how many physicians from OB/GYN are board certified in this pediatric adolescent gynecology? Do you know the number?
Dr. Strickland: So, it is a new focused practice and the board has only been operational for about a year. In this first round of the board focus; over 200 people sat for this examination and passed. I don’t know the exact number, but I know it is over 200. So, by that, then they have this special focused practice. There are many OB/GYNs who are interested in both adolescent healthcare and public health and enjoy taking care of adolescents. But this focused practice is just beginning to sort of recognize that as a specialty among OB/GYNs.
Host: And I’m curious Dr. Strickland, what was the reason you went into this subspecialty?
Dr. Strickland: I think that I have always enjoyed taking care of young women. I have had a lot of experience and expertise in teen pregnancy and teen pregnancy prevention. And I have had in my career pretty large stints on public health. And as I began taking care of young women; I really saw a gap in that oftentimes many of the disorders were really things that really needed attention earlier. So, I gained more and more expertise working highly collaboratively at Children’s Mercy with other specialties in pediatric surgery, pediatric endocrinology and really forming a hybrid team of people to address reproductive abnormalities in children and adolescents.
Host: And what are some of those common conditions that the specialists like yourself would actually diagnose and treat?
Dr. Strickland: So, we see children throughout all of the lifespan. For example, in neonates, we would often evaluate ovarian problems, ovarian cysts, masses, congenital malformations that are identified at birth in the reproductive system. We often work with their pediatric surgeon with our rectal malformation clinic as well as our pediatric urologists.
In a child, we take care of injuries, ovarian diseases, genital infections and irritations are a big common one as well as dermatologic problems that affect the child. In the adolescents, it’s more traditional gynecology. We treat menstrual functions. We are very interested in early diagnosis and treatment of endometriosis for our patients who present with pelvic pain and menstrual related dysfunction. And we continue to treat girls throughout their teenage years addressing issues of healthy reproductive function, sexually transmitted disease prevention, and pregnancy prevention.
Host: And so going back then to the general practitioner, the general pediatrician; obviously reproductive health can be – female reproductive health can be very complicated, and so do you have any advice for the general practitioner of when should they reach out to somebody like yourself?
Dr. Strickland: So, our whole specialty is set up to be consultants and it works best when we often work in combination with primary care physicians. We often partner with them. Many of our patients come from far away and so that’s optimal if we can partner with them. Different primary care doctors have different comfort levels as far as reproductive healthcare. So, we try to be supportive in all those different levels. I think that we can always say that we feel that we would love to see particularly patients who begin to develop menstrual dysfunction, that have problematic periods either with bleeding or pain and we appreciate so much the primary care doctors using that menstruation as an important vital sign.
So, it is often a time when we discover other problems of health. So, we are always glad to see those patients and be a resource during all time periods. Likewise in the neonatal period we are often a resource to primary care physicians who do great exams and see something that doesn’t look quite right and they are often very astute at diagnosing congenital malformations that are important to identify early even if we don’t treat them until they are older.
Host: So, fantastic information Dr. Strickland. So, in summary, what would you like the general practitioner, the general pediatrician, the community practitioner; what would you like for them to know about female reproductive health and the role of a specialist like yourself?
Dr. Strickland: So, I’d like for them to know first of all, their own role which is to continue to do genital exams throughout the childhood period and to identify early abnormalities and for us, we see our role as being very supportive and collaborative with primary care doctors too if they identify abnormalities of growth and development throughout the childhood and adolescence. That we would like to be able to see those children. We think that early access makes a really big difference and so, just knowing that we are out there is the biggest thing that I’d like to convey and that we would like to partner in healthy pediatric and adolescent care.
Host: Yeah, excellent summary. That’s Dr. Julie Strickland, Section Chief of Pediatric and Adolescent Gynecology at Children’s Mercy. Thanks for checking out this episode of Pediatrics in Practice. Please visit www.childrensmercy.org to get connected with Dr. Strickland or any other provider. If you found this podcast helpful, please share it on your social channels and be sure to check the entire podcast library for topics of interest to you. And be sure to check back soon for the next podcast. I’m Dr. Mike. Thanks for listening.
What and When to Refer to Pediatric and Adolescent Gynecology
Dr. Michael Smith (Host): Female reproductive health is critical in growing girls and young women. But knowing what and when to refer to a specialist can be difficult. This is Pediatrics In Practice, the podcast from Children’s Mercy. I’m Dr. Mike. My guest is Dr. Julie Strickland, Section Chief of Pediatric and Adolescent Gynecology at Children’s Mercy. Dr. Strickland what is a pediatric adolescent gynecologist?
Julie Strickland, MD (Guest): Thank you for having me Dr. Mike. I would tell you that that is often a question asked of me because of increasing awareness of the importance of reproductive health in girls of all ages, not just adult women. Pediatric and adolescent gynecology is a relatively new field within obstetrics and gynecology and has recently just been recognized as a board certified focused practice within obstetrics and gynecology.
Basically, pediatric and adolescent gynecologists look at the reproductive health and reproductive structures and possible diseases of girls at all ages from neonatal life up through college age in general. So, we are prepared to provide consultation for gynecological disorders and disorders of reproductive function all the way through the pediatric lifespan.
Host: And what is the training that you underwent to become a pediatric adolescent gynecologist and is this a fellowship of OB/GYN or can also pediatricians come into this fellowship?
Dr. Strickland: So, the fellowship is only of OB/GYN. The training is usually the general obstetrics and gynecology training and board certification. And then new to this field is practice and experience beyond that of at least three years and then sitting for a focused examination as well as an examination of practice case lists at the board level to delineate special expertise in this area.
Host: And how many, if you know this, how many physicians from OB/GYN are board certified in this pediatric adolescent gynecology? Do you know the number?
Dr. Strickland: So, it is a new focused practice and the board has only been operational for about a year. In this first round of the board focus; over 200 people sat for this examination and passed. I don’t know the exact number, but I know it is over 200. So, by that, then they have this special focused practice. There are many OB/GYNs who are interested in both adolescent healthcare and public health and enjoy taking care of adolescents. But this focused practice is just beginning to sort of recognize that as a specialty among OB/GYNs.
Host: And I’m curious Dr. Strickland, what was the reason you went into this subspecialty?
Dr. Strickland: I think that I have always enjoyed taking care of young women. I have had a lot of experience and expertise in teen pregnancy and teen pregnancy prevention. And I have had in my career pretty large stints on public health. And as I began taking care of young women; I really saw a gap in that oftentimes many of the disorders were really things that really needed attention earlier. So, I gained more and more expertise working highly collaboratively at Children’s Mercy with other specialties in pediatric surgery, pediatric endocrinology and really forming a hybrid team of people to address reproductive abnormalities in children and adolescents.
Host: And what are some of those common conditions that the specialists like yourself would actually diagnose and treat?
Dr. Strickland: So, we see children throughout all of the lifespan. For example, in neonates, we would often evaluate ovarian problems, ovarian cysts, masses, congenital malformations that are identified at birth in the reproductive system. We often work with their pediatric surgeon with our rectal malformation clinic as well as our pediatric urologists.
In a child, we take care of injuries, ovarian diseases, genital infections and irritations are a big common one as well as dermatologic problems that affect the child. In the adolescents, it’s more traditional gynecology. We treat menstrual functions. We are very interested in early diagnosis and treatment of endometriosis for our patients who present with pelvic pain and menstrual related dysfunction. And we continue to treat girls throughout their teenage years addressing issues of healthy reproductive function, sexually transmitted disease prevention, and pregnancy prevention.
Host: And so going back then to the general practitioner, the general pediatrician; obviously reproductive health can be – female reproductive health can be very complicated, and so do you have any advice for the general practitioner of when should they reach out to somebody like yourself?
Dr. Strickland: So, our whole specialty is set up to be consultants and it works best when we often work in combination with primary care physicians. We often partner with them. Many of our patients come from far away and so that’s optimal if we can partner with them. Different primary care doctors have different comfort levels as far as reproductive healthcare. So, we try to be supportive in all those different levels. I think that we can always say that we feel that we would love to see particularly patients who begin to develop menstrual dysfunction, that have problematic periods either with bleeding or pain and we appreciate so much the primary care doctors using that menstruation as an important vital sign.
So, it is often a time when we discover other problems of health. So, we are always glad to see those patients and be a resource during all time periods. Likewise in the neonatal period we are often a resource to primary care physicians who do great exams and see something that doesn’t look quite right and they are often very astute at diagnosing congenital malformations that are important to identify early even if we don’t treat them until they are older.
Host: So, fantastic information Dr. Strickland. So, in summary, what would you like the general practitioner, the general pediatrician, the community practitioner; what would you like for them to know about female reproductive health and the role of a specialist like yourself?
Dr. Strickland: So, I’d like for them to know first of all, their own role which is to continue to do genital exams throughout the childhood period and to identify early abnormalities and for us, we see our role as being very supportive and collaborative with primary care doctors too if they identify abnormalities of growth and development throughout the childhood and adolescence. That we would like to be able to see those children. We think that early access makes a really big difference and so, just knowing that we are out there is the biggest thing that I’d like to convey and that we would like to partner in healthy pediatric and adolescent care.
Host: Yeah, excellent summary. That’s Dr. Julie Strickland, Section Chief of Pediatric and Adolescent Gynecology at Children’s Mercy. Thanks for checking out this episode of Pediatrics in Practice. Please visit www.childrensmercy.org to get connected with Dr. Strickland or any other provider. If you found this podcast helpful, please share it on your social channels and be sure to check the entire podcast library for topics of interest to you. And be sure to check back soon for the next podcast. I’m Dr. Mike. Thanks for listening.