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I asked our distinguished Board of Editors to identify the most important changes that they believe will occur over the next 5 years, influencing the practice of obstetrics and gynecology. Their expert predictions are summarized below.

Arnold Advincula, MD

As one of the world’s most experienced gynecologic robotic surgeons, the role of this technology will become even more refined over the next 2-5 years with the introduction of sophisticated image guidance, “smart molecules,” and artificial intelligence. All of this will transform both the patient and surgeon experience as well as impact how we train future surgeons.

Linda Bradley, MD

My hope is that a partnership with industry and hysteroscopy thought leaders will enable new developments/technology in performing hysteroscopic sterilization. Conquering the tubal ostia for sterilization in an office setting would profoundly improve contraceptive options for women. Conquering the tubal ostia is the last frontier in gynecology.

Amy Garcia, MD

I predict that new technologies will allow for a significant increase in the number of gynecologists who perform in-office hysteroscopy and that a paradigm shift will occur to replace blind biopsy with hysteroscopy-directed biopsy and evaluation of the uterine cavity.

Steven Goldstein, MD, NCMP, CCD

Among the most important changes in the next 5 years, in my opinion, will be in the arenas of precision medicine, genetic advancement, and artificial intelligence. In addition, unfortunately, there will be an even greater movement toward guidelines utilizing algorithms and clinical pathways. I leave you with the following quote:

“Neither evidence nor clinical judgement alone is sufficient. Evidence without judgement can be applied by a technician. Judgement without evidence can be applied by a friend. But the integration of evidence and judgement is what the healthcare provider does in order to dispense the best clinical care.” —Hertzel Gerstein, MD

Cheryl Iglesia, MD

Technology related to minimally invasive surgery will continue to change our practice, and I predict that surgery will be more centralized to high volume practices. Reimbursements for these procedures may remain a hot button issue, however. The materials used for pelvic reconstruction will be derived from autologous stem cells and advancements made in regenerative medicine.

Andrew Kaunitz, MD, NCMP

As use of contraceptive implants and intrauterine devices continues to grow, I anticipate the incidence of unintended pregnancies will continue to decline. As the novel gonadotropin-releasing hormone (GnRH) antagonists combined with estrogen-progestin add-back grow in use, I anticipate this will provide our patients with more nonsurgical options for managing abnormal uterine bleeding, including that associated with uterine fibroids.

Barbara Levy, MD

Quality will be redefined by patient-defined outcome measures that assess what matters to the people we serve. Real-world evidence will be incorporated to support those measures and provide data on patient outcomes in populations not studied in the randomized controlled trials on which we have created guidelines. This will help to refine guidelines and support more equitable and accessible care.

David Mutch, MD

Over the next 5 years, our expanding insights into the molecular biology of cancer will lead to targeted therapies that will yield better responses with less toxicity.

Errol R. Norwitz, MD, PhD, MBA

In the near future we will use predictive AI algorithms to: 1) identify patients at risk of adverse pregnancy events; 2) stratify patients into high-, average-, and low-risk; and 3) design a personalized obstetric care journey for each patient based on their individualized risk stratification with a view to improving safety and quality outcome metrics, addressing health care disparity, and lowering the cost of care.

Jaimey Pauli, MD

I predict (and fervently hope) that breakthroughs will occur in the prevention of two of the most devastating diseases to affect obstetric patients and their families—preterm birth and preeclampsia.

JoAnn Pinkerton, MD, NCMP

New nonhormone management therapies will be available to treat hot flashes and the genitourinary syndrome of menopause. These treatments will be especially welcomed by patients who cannot or choose not to take hormone therapy. We should not allow new technology to overshadow the patient. We must remember to treat the patient with the condition, not just the disease. Consider what is important to the individual woman, her quality of life, and her ability to function, and keep that in mind when deciding what therapy to suggest.

Joseph S. Sanfilippo, MD, MBA

Artificial intelligence will change the way we educate and provide patient care. Three-dimensional perspectives will cross a number of horizons, some of which include:

• advances in assisted reproductive technology (IVF), offering the next level of “in vitro maturation” of oocytes for patients heretofore unable to conceive. They can progress to having a baby with decreased ovarian reserve or in association with “life after cancer.”
• biogenic engineering and bioinformatics will allow correction of genetic defects in embryos prior to implantation
• the surgical arena will incorporate direct robotic initiated procedures and bring robotic surgery to the next level
• with regard to medical education, at all levels, virtual reality, computer-generated 3-dimensional imaging will provide innovative tools.

James Simon, MD, CCD, IF, NCMP

Medicine’s near-term future portends the realization of truly personalized medicine based upon one’s genetic predisposition to disease, and intentional genetic manipulation to mitigate it. Such advances are here already, simply pending regulatory and ethical approval. My concern going forward is that such individualization, and an algorithm-driven decision-making process will result in taking the personal out of personalized medicine. We humans are more than the collected downstream impact of our genes. In our quest for advances, let’s not forget the balance between nature (our genes) and nurture (environment). The risk of forgetting this aphorism, like the electronic health record, gives me heartburn, or worse, burnout!

I asked our distinguished Board of Editors to identify the most important changes that they believe will occur over the next 5 years, influencing the practice of obstetrics and gynecology. Their expert predictions are summarized below.

Arnold Advincula, MD

As one of the world’s most experienced gynecologic robotic surgeons, the role of this technology will become even more refined over the next 2-5 years with the introduction of sophisticated image guidance, “smart molecules,” and artificial intelligence. All of this will transform both the patient and surgeon experience as well as impact how we train future surgeons.

Linda Bradley, MD

My hope is that a partnership with industry and hysteroscopy thought leaders will enable new developments/technology in performing hysteroscopic sterilization. Conquering the tubal ostia for sterilization in an office setting would profoundly improve contraceptive options for women. Conquering the tubal ostia is the last frontier in gynecology.

Amy Garcia, MD

I predict that new technologies will allow for a significant increase in the number of gynecologists who perform in-office hysteroscopy and that a paradigm shift will occur to replace blind biopsy with hysteroscopy-directed biopsy and evaluation of the uterine cavity.

Steven Goldstein, MD, NCMP, CCD

Among the most important changes in the next 5 years, in my opinion, will be in the arenas of precision medicine, genetic advancement, and artificial intelligence. In addition, unfortunately, there will be an even greater movement toward guidelines utilizing algorithms and clinical pathways. I leave you with the following quote:

“Neither evidence nor clinical judgement alone is sufficient. Evidence without judgement can be applied by a technician. Judgement without evidence can be applied by a friend. But the integration of evidence and judgement is what the healthcare provider does in order to dispense the best clinical care.” —Hertzel Gerstein, MD

Cheryl Iglesia, MD

Technology related to minimally invasive surgery will continue to change our practice, and I predict that surgery will be more centralized to high volume practices. Reimbursements for these procedures may remain a hot button issue, however. The materials used for pelvic reconstruction will be derived from autologous stem cells and advancements made in regenerative medicine.

Andrew Kaunitz, MD, NCMP

As use of contraceptive implants and intrauterine devices continues to grow, I anticipate the incidence of unintended pregnancies will continue to decline. As the novel gonadotropin-releasing hormone (GnRH) antagonists combined with estrogen-progestin add-back grow in use, I anticipate this will provide our patients with more nonsurgical options for managing abnormal uterine bleeding, including that associated with uterine fibroids.

Barbara Levy, MD

Quality will be redefined by patient-defined outcome measures that assess what matters to the people we serve. Real-world evidence will be incorporated to support those measures and provide data on patient outcomes in populations not studied in the randomized controlled trials on which we have created guidelines. This will help to refine guidelines and support more equitable and accessible care.

David Mutch, MD

Over the next 5 years, our expanding insights into the molecular biology of cancer will lead to targeted therapies that will yield better responses with less toxicity.

Errol R. Norwitz, MD, PhD, MBA

In the near future we will use predictive AI algorithms to: 1) identify patients at risk of adverse pregnancy events; 2) stratify patients into high-, average-, and low-risk; and 3) design a personalized obstetric care journey for each patient based on their individualized risk stratification with a view to improving safety and quality outcome metrics, addressing health care disparity, and lowering the cost of care.

Jaimey Pauli, MD

I predict (and fervently hope) that breakthroughs will occur in the prevention of two of the most devastating diseases to affect obstetric patients and their families—preterm birth and preeclampsia.

JoAnn Pinkerton, MD, NCMP

New nonhormone management therapies will be available to treat hot flashes and the genitourinary syndrome of menopause. These treatments will be especially welcomed by patients who cannot or choose not to take hormone therapy. We should not allow new technology to overshadow the patient. We must remember to treat the patient with the condition, not just the disease. Consider what is important to the individual woman, her quality of life, and her ability to function, and keep that in mind when deciding what therapy to suggest.

Joseph S. Sanfilippo, MD, MBA

Artificial intelligence will change the way we educate and provide patient care. Three-dimensional perspectives will cross a number of horizons, some of which include:

• advances in assisted reproductive technology (IVF), offering the next level of “in vitro maturation” of oocytes for patients heretofore unable to conceive. They can progress to having a baby with decreased ovarian reserve or in association with “life after cancer.”
• biogenic engineering and bioinformatics will allow correction of genetic defects in embryos prior to implantation
• the surgical arena will incorporate direct robotic initiated procedures and bring robotic surgery to the next level
• with regard to medical education, at all levels, virtual reality, computer-generated 3-dimensional imaging will provide innovative tools.

James Simon, MD, CCD, IF, NCMP

Medicine’s near-term future portends the realization of truly personalized medicine based upon one’s genetic predisposition to disease, and intentional genetic manipulation to mitigate it. Such advances are here already, simply pending regulatory and ethical approval. My concern going forward is that such individualization, and an algorithm-driven decision-making process will result in taking the personal out of personalized medicine. We humans are more than the collected downstream impact of our genes. In our quest for advances, let’s not forget the balance between nature (our genes) and nurture (environment). The risk of forgetting this aphorism, like the electronic health record, gives me heartburn, or worse, burnout!

I asked our distinguished Board of Editors to identify the most important changes that they believe will occur over the next 5 years, influencing the practice of obstetrics and gynecology. Their expert predictions are summarized below.

Arnold Advincula, MD

As one of the world’s most experienced gynecologic robotic surgeons, the role of this technology will become even more refined over the next 2-5 years with the introduction of sophisticated image guidance, “smart molecules,” and artificial intelligence. All of this will transform both the patient and surgeon experience as well as impact how we train future surgeons.

Linda Bradley, MD

My hope is that a partnership with industry and hysteroscopy thought leaders will enable new developments/technology in performing hysteroscopic sterilization. Conquering the tubal ostia for sterilization in an office setting would profoundly improve contraceptive options for women. Conquering the tubal ostia is the last frontier in gynecology.

Amy Garcia, MD

I predict that new technologies will allow for a significant increase in the number of gynecologists who perform in-office hysteroscopy and that a paradigm shift will occur to replace blind biopsy with hysteroscopy-directed biopsy and evaluation of the uterine cavity.

Steven Goldstein, MD, NCMP, CCD

Among the most important changes in the next 5 years, in my opinion, will be in the arenas of precision medicine, genetic advancement, and artificial intelligence. In addition, unfortunately, there will be an even greater movement toward guidelines utilizing algorithms and clinical pathways. I leave you with the following quote:

“Neither evidence nor clinical judgement alone is sufficient. Evidence without judgement can be applied by a technician. Judgement without evidence can be applied by a friend. But the integration of evidence and judgement is what the healthcare provider does in order to dispense the best clinical care.” —Hertzel Gerstein, MD

Cheryl Iglesia, MD

Technology related to minimally invasive surgery will continue to change our practice, and I predict that surgery will be more centralized to high volume practices. Reimbursements for these procedures may remain a hot button issue, however. The materials used for pelvic reconstruction will be derived from autologous stem cells and advancements made in regenerative medicine.

Andrew Kaunitz, MD, NCMP

As use of contraceptive implants and intrauterine devices continues to grow, I anticipate the incidence of unintended pregnancies will continue to decline. As the novel gonadotropin-releasing hormone (GnRH) antagonists combined with estrogen-progestin add-back grow in use, I anticipate this will provide our patients with more nonsurgical options for managing abnormal uterine bleeding, including that associated with uterine fibroids.

Barbara Levy, MD

Quality will be redefined by patient-defined outcome measures that assess what matters to the people we serve. Real-world evidence will be incorporated to support those measures and provide data on patient outcomes in populations not studied in the randomized controlled trials on which we have created guidelines. This will help to refine guidelines and support more equitable and accessible care.

David Mutch, MD

Over the next 5 years, our expanding insights into the molecular biology of cancer will lead to targeted therapies that will yield better responses with less toxicity.

Errol R. Norwitz, MD, PhD, MBA

In the near future we will use predictive AI algorithms to: 1) identify patients at risk of adverse pregnancy events; 2) stratify patients into high-, average-, and low-risk; and 3) design a personalized obstetric care journey for each patient based on their individualized risk stratification with a view to improving safety and quality outcome metrics, addressing health care disparity, and lowering the cost of care.

Jaimey Pauli, MD

I predict (and fervently hope) that breakthroughs will occur in the prevention of two of the most devastating diseases to affect obstetric patients and their families—preterm birth and preeclampsia.

JoAnn Pinkerton, MD, NCMP

New nonhormone management therapies will be available to treat hot flashes and the genitourinary syndrome of menopause. These treatments will be especially welcomed by patients who cannot or choose not to take hormone therapy. We should not allow new technology to overshadow the patient. We must remember to treat the patient with the condition, not just the disease. Consider what is important to the individual woman, her quality of life, and her ability to function, and keep that in mind when deciding what therapy to suggest.

Joseph S. Sanfilippo, MD, MBA

Artificial intelligence will change the way we educate and provide patient care. Three-dimensional perspectives will cross a number of horizons, some of which include:

• advances in assisted reproductive technology (IVF), offering the next level of “in vitro maturation” of oocytes for patients heretofore unable to conceive. They can progress to having a baby with decreased ovarian reserve or in association with “life after cancer.”
• biogenic engineering and bioinformatics will allow correction of genetic defects in embryos prior to implantation
• the surgical arena will incorporate direct robotic initiated procedures and bring robotic surgery to the next level
• with regard to medical education, at all levels, virtual reality, computer-generated 3-dimensional imaging will provide innovative tools.

James Simon, MD, CCD, IF, NCMP

Medicine’s near-term future portends the realization of truly personalized medicine based upon one’s genetic predisposition to disease, and intentional genetic manipulation to mitigate it. Such advances are here already, simply pending regulatory and ethical approval. My concern going forward is that such individualization, and an algorithm-driven decision-making process will result in taking the personal out of personalized medicine. We humans are more than the collected downstream impact of our genes. In our quest for advances, let’s not forget the balance between nature (our genes) and nurture (environment). The risk of forgetting this aphorism, like the electronic health record, gives me heartburn, or worse, burnout!