Ja Hyun Shin

5 Questions With Dr. Ja Hyun Shin

Getting patients quicker diagnosis and treatment with comprehensive gynecological care

Ja Hyun Shin

In April 2020, just weeks after COVID-19 was declared a national emergency, Dr. Ja Hyun Shin began her role as Director of Minimally Invasive Gynecologic Surgery at NewYork-Presbyterian/Weill Cornell Medicine. With elective surgeries suspended, Dr. Shin and her team dove instead into laying the groundwork for new patient programs to treat a full range of gynecological conditions, from uterine fibroids to endometriosis, in the least invasive way possible.

“During that time, we formulated our ideas for establishing truly comprehensive programs, meaning that we would work very closely with a network of specialists to provide multidisciplinary care,” says Dr. Shin, who is an expert in advanced laparoscopic and robotic surgeries. A patient’s care team could include gynecologists, minimally invasive surgeons, interventional radiologists, reproductive endocrinologists, pelvic floor disorder experts, physical medicine and rehabilitation providers, pain management experts and more, depending on their condition and personal health goals.

Today, under the leadership of Dr. Shin, the Fibroid and Adenomyosis Program and the Endometriosis and Pelvic Pain Program provide patients with individualized care for conditions that can be common — up to 80% of women have fibroids, for instance — but often complex to diagnose and treat. “Patients walk away from our appointments feeling as though they’ve had comprehensive counseling,” says Dr. Shin, noting that patients are consulted on surgical and nonsurgical forms of treatment. “They have increased confidence that they understand what’s going on in their bodies and the decisions that need to be made with their doctors.”

Dr. Shin sat down with NYP Advances to discuss her vision for the programs and their impact thus far.

When did you know you wanted to pursue OB-GYN, and specifically gynecologic surgery, as your specialty?

I knew early on with my first case as an intern in residency. I performed a hysteroscopy for a polyp, which is a minor procedure but appropriate for an intern to scrub into. The case was so simple, but to me, it was fascinating. I really enjoyed the whole process of learning about the patient and her disease, reading the radiology report and seeing the images, and then visualizing with a camera the pathology that was the culprit of her symptoms. Then there was the incredible satisfaction of removing the problem. The part about surgery that I find most rewarding is that you can improve the health and quality of life for someone so immediately. That experience and the rest of my residency really cemented that the operating room was where I belonged.

Having doctors who can provide such a high level of care and a thorough explanation of their options gives patients a sense of empowerment.

As a surgeon who can operate by all approaches, when do you prefer to do a surgery robotically?

I assess each patient, their symptoms, and the stage of their disease individually before deciding on an approach, but generally I prefer robotics for more complex surgeries because of the improved dexterity, which greatly facilitates the surgery, and magnification of the surgical field. These are important for cases of deep infiltrating endometriosis and surrounding adhesions. I also prefer the robot for cases where a lot of suturing will be involved, such as a myomectomy for large uteri with multiple fibroids.

What was your goal in building the Fibroid and Adenomyosis Program and the Endometriosis and Pelvic Pain Program, and what do you think makes these programs unique?

Our main goal was to provide comprehensive care and be able to offer our patients all treatment options, from interventional therapies to newer minimally invasive procedures to advanced surgeries for complex disease. What makes us unique is our collaborative approach across the specialties for the treatment of pain and bleeding disorders, such as endometriosis, fibroids, and adenomyosis. By having a clearly defined network for referrals, we’re able to facilitate patients being seen in a timely fashion by the providers.

This is especially important for conditions like endometriosis and pelvic pain, conditions that impact up to 15% of reproductive-age women but, because of the many different organ systems involved and the spectrum of wide-ranging symptoms, can go undiagnosed for a very long time. It’s been stated that it can take, on average, 10 years from the time a patient starts experiencing the symptoms of endometriosis to establishing the diagnosis. Our collaborative approach can help expedite this whole process to decrease their suffering and improve their quality of life. We know that multidisciplinary care can lead to better outcomes and improved patient satisfaction, and one of our current research projects around fibroids and endometriosis includes studying the impact our approach has had on the treatments we provide, the procedures that are performed, the efficiency of our patient referrals and patient satisfaction.

Audio file
Dr. Shin, who has a 7-month-old son, shares how becoming a new mom has shaped her work and home life.

It’s been about three years since you launched the programs. What accomplishments are you proudest of so far?

What I’m most proud of is that we’ve really expanded, both in terms of faculty and the significant increase in patient volume and surgeries for these conditions. Only a year after starting the Endometriosis and Pelvic Pain Program, we saw a nearly threefold increase in outpatient office visits for these conditions. On top of the incredible network of talented providers we collaborate with, we expanded our surgical team to five fellowship-trained minimally invasive gynecologic surgeons who provide the best specialized care.

I think these patients are coming to us in increasing numbers because many of our patients do their research before making appointments and learn about our expert providers, all the treatment options that are possible, and that we work as a team to coordinate their care. I frequently see family members, friends, and colleagues of patients I have treated before who are looking for the same experience after years of frustrating medical misadventures. Sometimes it can be emotional for them because they’ve gone on an extensive journey, so it’s been personally rewarding to see that they finally feel like they’re being heard. Having doctors who can provide such a high level of care and a thorough explanation of their options gives them a sense of empowerment. As we expand as a division, our goal is to reach more patients through our Queens, Brooklyn, and downtown Manhattan offices.

A big part of your role involves training the next generation of minimally invasive surgeons. What advice do you like to give them?

One thing that I can’t stress enough is seeking mentorship early on in your career. That can be with a peer or someone in senior leadership. Early on, I felt like I had to figure out everything on my own, and it wasn’t until I worked with mentors later in my career that I realized it helps to have someone by your side helping with some of the more difficult decisions. So, identify a mentor you can seek advice from and discuss challenges with openly, and who can help you with career decisions. This can really help cope with the stresses that are inherent to the profession we are in.

Another simple piece of advice I give is to focus on how you can be a good doctor and care for the person you’re treating. My goal is to provide the quality of gynecologic health care I would want my mother and sisters to receive. Not cutting corners and going the extra mile are principles by which I practice, and I hope those are instilled in my trainees early on. Everything stems from this attitude. A genuine desire to help and heal will sustain you throughout your career and help you succeed personally and professionally.

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Ja Hyun Shin: Getting patients quicker diagnosis and treatment with comprehensive gynecological care

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