Skip to Main Content

Chapter 26: Incorporation of New Treatments into Clinical Practice

Cynthia A. Brincat; Stergios K. Doumouchtsis; Dee E. Fenner

INTRODUCTION

Female pelvic medicine and reconstructive surgery (FPMRS), or urogynecology, as a field has undergone a unique evolution with recent recognition as a subspecialty of obstetrics and gynecology and urology. It has never suffered from a shortage of innovation or of innovators, and thus new treatments and therapeutic options are regularly being introduced. Who is best to perform or prescribe new, therapeutic options and their implementation in a responsible manner is controversial. In this chapter, we will review accreditation, credentialing, and the relevant training involved in the United States (Table 26-1). In addition, new product implementation will be discussed within an ethical framework. As part of the larger medical profession, FPMRS shares a commitment to professionalism that demands certain standards of safety and aims to achieve exemplary levels of care. The challenge lies in where safety and exemplary cross, and in implementing the two, we make practical our commitment to the profession and its embodiment.

Table 26-1

Summary of Approval Processes

View Table||Download (.pdf)
Table 26-1

Summary of Approval Processes

  • Accreditation

    • – Approves a field or program

    • – Driven by a more comprehensive, broader level

    • – Example of ABMS approving FPMRS

  • Credentialing

    • – Approves an individual to practice

    • – Locally driven within the constraints of licensing

    • – Example of training programs in FPMRS credentialed by ACGME and hospitals approving credentials of individuals to allow for practice

  • Privileging

    • – Approves what procedures an individual is able to perform

    • – Driven typically at the departmental level, within the constraints of JCAHO

    • – Example of a practitioner granted robotic privileges

ABMS, American Board of Medical specialities; ACGME, Accreditation Council for Graduate Medical Education; FPMRS, Female Pelvic Medicine and Reconstructive Surgery; JCAHO, Joint Commission on Accreditation of Hospital Organizations.

Incorporation of new treatments into clinical practice in FPMRS is evolving as the field evolves. Surgical practice is dictated on the personal, hospital, and national regulatory levels. Ultimately the choice of surgical treatment and incorporation of new surgical techniques and devices is driven by the desire to provide better care for patients. Surgeons are required by ethical mandates to critically self-assess skills and their individual experience in providing care for pelvic floor dysfunction. In this chapter we review the evolution of FPMRS as an accredited subspecialty in the United States, and discuss how this process has highlighted the incorporation of new therapies to treat pelvic floor dysfunction.

ACCREDITATION

Key Point

  • In 2011, the American Board of Medical Specialties (ABMS) officially recognized the field of FPMRS as a subspecialty.

Accreditation is the term used to designate the approval or official recognition of a field of medicine or specific program. In 2011, American Board of Medical Specialties (ABMS) officially recognized the field of FPMRS as a subspecialty. According to the ABMS bylaws, a new subspecialty meets the following criteria: the differentiation of a new ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.

This site uses cookies to provide, maintain and improve your experience. MH Privacy Center Close