Dr. Rodney J. Halvorsen completed his undergraduate education at the University of California – San Diego, and received his medical degree from the Medical College of Wisconsin, in Milwaukee. He also completed his internship and residency in OB/GYN at the Medical College of Wisconsin. He is a board certified obstetrician/gynecologist, and a fellow of the American College of Obstetricians and Gynecologists. While at the Medical College of Wisconsin, Halvorsen researched the use of hysteroscopy to diagnose causes of uterine bleeding versus the gold standard D&C. He is currently in private practice at Holy Family Memorial’s Lakeshore Women’s Health in Manitowoc, Wisconsin.
Uterus1: When did you first know you wanted to be a doctor?
Dr. Halvorsen: My interest in becoming a doctor started in early childhood. I fractured my wrist at age 10 while skateboarding. The doctor fixed something that, to me at that time, seemed impossible to fix. He took my pain away. Doctors are so often warm and caring. They often help us feel better and support us through the many stages of life and illnesses that we encounter.
Uterus1: What was it that attracted you to this particular field?
Dr. Halvorsen: During medical school, my OB/GYN rotations made a lasting impression on me. At the first delivery I was involved with, the attending physician allowed me to do the delivery so I had the experience of placing a new baby on the mom’s tummy. The joy that it brought her as well as her husband, was tremendous. I learned with my other rotations how OB/GYNs could practice medicine and do surgery, as well as give emotional support and most of all, help women through the many changes in their lives with dignity, respect and compassion.
Uterus1: What do you find the biggest challenge right now in your field?
Dr. Halvorsen: The biggest challenge at this time is delivering high quality healthcare with the continued improvements in medical technology and ever increasing health care costs. There is an important balance between improving the quality of life for our patients with limited healthcare dollars that continues to challenge all of us. However, new technology is really important for decreasing recovery time, improving outcomes for our patients, and reducing complications of the side effects.
Uterus1: Do you think we expect more from our doctors because of all the new technology?
Dr. Halvorsen: Medicine has become more challenging for physicians and certainly the bar has been raised with all these new technologies. There are constant changes in this profession, and we may be required to do technical surgery that was not part of our original training. We are also required to learn more minimally invasive surgeries and do them well so we can improve the patient’s outcome. Sometimes the strengths and gifts each physician brings with them may not correlate with these surgeries required. I feel that I was fortunate to have skills with my hands. I used to have an orthodontic lab, so I was able to do three-dimensional work, and laparoscopic/hysteroscopic procedures have always been a little easier for me. But as technology changes, I think we are going to see a lot more demand on physicians for physical skills, not necessarily their diagnostic skills. A lot of people are book smart, but don’t really have the technical skills.
Uterus1: When your patients come to see you what is their number one concern?
Dr. Halvorsen: I think all of us want to be healthy and live productive lives. So when patients come to me for their annual examination, they want to be screened for certain diseases that they are aware of in their family. It can be anything from heart disease to osteoporosis as well as breast or ovarian cancer. They want to be reassured they are healthy and don’t have any of these diseases. When the patient has an illness, she wants reassurance that her problem can be fixed. Fortunately, the art of medicine lets doctors develop a unique set of skills to work with patients. We spend years studying, but the other part is the ability to give emotional support to our patients.
Uterus1: After you have met with a patient and looked at their history, do you work directly with the patient to come up with a treatment plan?
Dr. Halvorsen: I think creating an atmosphere for communication is really important. Asking your patients about their perceptions can help greatly, since perceptions can often lead to wrong assumptions. I usually discuss their concerns and answer any of their questions and give them the American College of OB/GYN pamphlets about the disease. Then we get the test done, and in a short period of time I will have them come in to go over the test, and develop an individual plan for her. I want to develop a trusting relationship with each one of my patients and show her that I am involved in her care, that I care about her problem, and that she is personally important to me, as is the outcome of her illness.
Uterus1: With all the information out there, particularly on the Internet, are you finding your patients are better informed than 10 - 15 years ago?
Dr. Halvorsen: Absolutely. They are much better informed through the Internet, magazines, direct advertisements by pharmaceutical companies, radio, and TV. However I would give a word of caution. There are very good Internet sources about medical diseases that are very reputable. Patients can ask their doctor about them. But there are some that are not very well regulated, and the articles may contain incorrect information. Patients are particularly misinformed about drugs, and sometimes they see the material and think the drug can treat their particular problem. Patients should bring all this information up in their discussions with their doctor about their disease. They should look at all the information out there so they can make an informed decision.
Uterus1: Are you seeing more patients interested in alternative medicine?
Dr. Halvorsen: I would say there is a great interest in herbal medicines and non-traditional medical approaches. People often come to me with different drugs and herbal medicine treatments that are of interest to them. I think you have to have an open mind to that. There are things such as acupuncture and pressure point treatment that can help with certain types of pain. There are definitely some herbal drugs that a lot of my patients have told me were wonderful for their problems. In terms of estrogen replacement therapy, there are a lot of soy-based products that certainly work well for them. I think those of us working in modern medicine have to understand the desires of our patients, and that there are other options than just traditional medicine or surgery for treatment.
Uterus1: How do you handle sensitive topics such a fibroids, infertility or the need for a hysterectomy?
Dr. Halvorsen: Infertility is a very sensitive subject. Patients usually have seen multiple doctors and have had have multiple tests. They have significant illnesses or surgeries that prevented them from having that family they have always dreamed of with their partner. So physicians need to be cognitive that this is a very emotional disease. If we look at the whole picture, we can often assist the family and visit different types of additional treatments like in vitro fertilization (IVF) or even adoption if that is what works for that family. With hysterectomies, I think unfortunately, sometimes in the past they had a bad reputation for being the only thing physicians were offering. Now with a hysterectomy you have to explain to the patient why you feel there is no other alternative, particularly if there is cancer involved. Hysterectomy, when used properly, does have a role, but there are a lot of other alternatives. We didn’t have these before.
Uterus1: Uterine embolization would be considered one of these new treatments. Are we going to see more non-invasive procedures like embolization?
Dr. Halvorsen: Certainly uterine artery embolization is a viable option for patients with large fibroids. I have used it myself and referred patients to get the procedure done. There are however, other alternative treatments for fibroids that may not require embolization. It could be as simple as the endometrial ablation (a hot saline circulated inside the uterine cavity for about 10 minutes) for treating sub mucosal fibroids or fibroids on the inside of the uterus. I think technology and treatments are going to improve to where we may be able to externally treat the fibroids through the abdomen so we don’t have to put a coil into the uterine arteries.
Uterus1: Are the new treatments the biggest change you have seen in your field?
Dr. Halvorsen: I think new treatments are the biggest changes. Technology really has improved the quality of care we are able to give to our patients, particularly in helping to minimize surgery. I think that is a major trend in our specialty. Technology is helping patients with fertility issues to get pregnant, but also helps remove ovarian masses, fibroids or polyps without requiring extensive hospitalization and long recovery periods. Patients can return to their normal lives and daily activities in one to seven days, as opposed to the old hysterectomies with their extensive four to six week recovery period from a large abdominal incision.
Uterus1: Do you have a favorite technology or piece of equipment that has made your job easier?
Dr. Halvorsen: Within the last couple of years I would say the hydrothermal ablation procedure has really improved the quality of care I can give because it often replaces the need for a hysterectomy. I’m very happy with this technique, which is basically using room temperature water to do a very basic hysteroscopy (a scope used to look inside the uterus). The reason I like this one so much compared to other units is because I can directly see what I am doing. During the procedure when the water is heated up to 90 degrees Celsius (190 to 195 degrees Fahrenheit), you can actually see the lining being destroyed in front of you, along with some of the vessels. You can watch to make sure you have treated the whole surface directly. It’s a low-pressure system, so there is no spillage through the tube. I’ve used this procedure on multiple patients successfully over the last year and a half, with almost 100 percent success. Nationally, the reports are 80 – 85 percent for improving or decreasing the cycles to a normal range, or helping patients to achieve amenorrhea (the absence of periods) in about 40 to 50 percent of the cases. That has made a huge difference in the quality of life for my patients who don’t really want to go for a hysterectomy to control their bleeding that has usually been a problem for a year or two before it has been addressed. I’ve noticed that the amount of hysterectomies I am doing in my practice has decreased remarkably since I started doing this procedure.
Uterus1: What future improvement in technology or treatments would you like to see?
Dr. Halvorsen: I would like to see continued improvements on procedures like the hydrothermal ablation, so we can continue to treat patients and improve our success rate. I would like to see improvements in laparoscopic technology and instruments, in regards to the size of scars and incisions they leave on the abdomen. I’d also like to see technology that allows us to do external treatment without having to be invasive, and eventually treating problems with a combination of non-invasive treatment and medicine. Some of the things that have really made me excited about being a doctor treating women are the newer treatments out there. If we continue to offer these new and preventive treatments, we can help improve the lives of women as they go through all stages of life. Women’s health was not on the radar 10-15 years ago and now more attention is being devoted to it.
Uterus1: Even though we have all these new and wonderful technologies, do you think that communication remains one of the most important elements in medicine?
Dr. Halvorsen: I think communication is the basis of the patient-doctor relationship. Nowadays, the trend towards the large HMO providers is that some patients may not have the same choices because of the way their insurance is structured. I have seen patients for years, and then for insurance reasons they have had to switch because they could not afford to be outside of their insurance plan. So we lose that patient-doctor communication developed over the years, which I think is really important, particularly for the built in trust. That is what allows patients to feel really safe and comfortable.
Uterus1: Do you have any heroes?
Dr. Halvorsen: For me, a hero is someone who often performs selfless acts, often at great risk to themselves, for the greater good of society. Their courage and insights are often not realized until years after their actions. I feel there are many individuals who might be defined as heroes that we have all read about as children, but there are also lots of individuals who, because of their beliefs or convictions, are making the choice to better the world not just to benefit themselves, but for everyone else.
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