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Dr. Randall Gibb on the Growing Need for Access to Specialty Derived Healthcare, Specifically Gynecologic Oncology

As healthcare evolves, it has become more evident that there is a rising need for more specialized care.

Dr. Randall Gibb, a trained and board-certified Gynecologic Oncologist, sees that as our population ages and lives longer, there will be more cases of cancer than ever before.

Specialty derived healthcare will need to be put in focus to alleviate stress from primary care as the breadth of medical knowledge grows rapidly in the coming years and as new treatments are released almost daily.

Specialty Care

Specialty care is a broad term that covers healthcare services that are dedicated to a specific branch of medicine, explains Dr. Randall Gibb. Specialty derived healthcare teams are ones who primary care physicians or many times family physicians will have patients referred to for a disease-specific care that requires a higher acuity of care and support. For instance, for a patient with newly diagnosed diabetes with a fairly high

HbA1C, the primary care healthcare team would refer the patient to an endocrinologist or a physician that specializes in endocrine disorders. Many times, physicians will have

areas of expertise within their specialty and may cater their clinic time to patients fitting into a certain diagnosis. Common specialty care teams include cardiology, dermatology, oncology, psychiatry, gynecology, and Dr. Randall Gibb’s specialty, Gynecologic Oncology.


As technology and research advances healthcare, researchers are learning more about diseases and their cellular biology and pathophysiology today than they ever have before. Technology along with research has allowed for a large portion of the human genome to be mapped, allowing researchers to pinpoint exactly which genetic mutations lead to

which diseases and paving a pathway for gene therapies. Diseases that were previously not understood well are now coming to the forefront and ones that were labeled incorrectly as being part of another disease process are being identified and diagnosed separately, allowing for more targeted treatment, says Dr. Randall Gibb.

With an increase in disease process knowledge, specialty care becomes more important as it becomes difficult for primary care physicians to have the breadth of knowledge that a specialist care team would have. In addition, with the amount of new research being done and information being released, it becomes almost impossible to keep up with medical news from each specialty. Primary care on its own is an integral aspect to

healthcare teams, helping to consolidate all specialties in one visit, but with an increase in healthcare demands and knowledge, it can be clearly seen that there is a need for more diverse specialty care.


As pathophysiology and cellular biology become clearer, researchers and healthcare teams are able to provide more targeted treatment plans for patients. The International Gynecologic Cancer Society website has updates of new drugs that have been approved for various cancers and ones that are currently being researched but show promise. In a field such as Gynecologic Oncology, new chemotherapy and other treatments are

constantly being developed to help improve survival rates for patients, as well as in the future eradicate certain cancers completely.

As many cancers are caused by certain genetic mutations, especially ovarian cancers, specialty care helps ensure that patients are receiving the best treatment possible for their particular disease rather than a blanket solution used for all cancers. Targeted treatment plans being developed are significantly more effective and tolerable, allowing patients to feel comfortable with their treatments.

Randall Gibb explains that within the field of Gynecologic Oncology, many physicians have been branching out into super specialty care and defined reasearch areas, focusing on a particular group of cancers, such as endometrial cancers or ovarian cancers. With the growing amount of funding being put into cancer research and the amount of new knowledge coming from that, it is easy to see why there is a need for physicians to specialize to allow for the best care of their patients.


Technology has also allowed for vast improvements in physician communication in the past decade. Previously, paper charts and notes reduced the speed at which referrals could be made to specialists, with paper charts having to be faxed or mailed amongst physicians. With the advent of electronic medical records (EMR), physicians are easily

able to share relevant patient information in just a few clicks with those that need to be involved in the circle of care and while follow-up and feedback is almost instant, physicians can more easily be kept in the loop. This allows for a broadening of services, allowing a primary care team to focus more on acute issues and for specialty teams to manage chronic cases, with it becoming easier to have more specialty professionals. Dr. Gibb postulates that as time goes on, primary care physicians will become overrun with more acute cases with less focus on their chronic care patients, making the need for specialty training even more important.

Dr. Randall Gibb on Increasing Demand

As our population ages, there is an unequal rise in the incidence and prevalence of

cancer, especially as the number of cancer survivors increase. Oncology as a whole, no matter which specialty, will see an increase in patient load in the coming years. In a study conducted in 2007, the authors estimated that by this year (2020), nearly 70% of all

patient visits to oncologists would be for survivorship care. Furthermore, in a study from 2010, it was estimated that the cases warranting the need for a Gynecologic Oncologist

would rise close to 20% by the year 2050, says Dr. Gibb. With an increasing strain on the field, it is important that physicians train further, allowing for more specialized patient

care. Having an increase in specialty care also takes a strain off of primary care, allowing for more general follow-ups to be done in a primary care setting, allowing for a new

equilibrium in patient care. In a 2006 survey, it was found that practicing Oncologists did not believe that primary care teams would be able to aid in the shortage of practicing oncologists due to the sheer complexity of the field and cancer care treatments. Putting that into perspective, in the past 14 years, cancer research and treatment has come a long way, becoming more specialized and complex than ever, mandating the need for more specialized healthcare, especially in Oncology and Gynecologic Oncology.

This article does not necessarily reflect the opinions of the editors or management of EconoTimes.

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