Dr. Steven R. Goldstein MD- Concierge Gynecologist in NYC - To HMO or not to HMO

Doctor Steven R. Goldstein MD is a Concierge gynecologist in private practice for over 25 years. Dr Goldstein had this to say regarding HMOs in volume 1, issue 1 of The Doctor’s View by New York University Medical Center. 

To HMO or not to HMO…why I don’t join HMO plans 

I am often asked “When am I going to join a plan which is offered at work?” by many of my patients. My response is “you wouldn’t like me on those plans”. My patients need to realize I am a solo practitioner.  I see patients one at a time. I take my histories by pen and by ink. I talk to every patient after every visit, no matter how trivial, dressed again in the consultation room. I do not have nurse clinicians and “Physician extenders” doing much of the work that I feel you come to see the doctor for. We do not have a ten page history intake form that is simply scanned into a computer. We do not have an answering system with “Press 1 for appointments, Press 2 for insurance”. We do not have a videotape library in the waiting room. If you have a problem I sit with you and explain for as long as I need to be sure that you understand the nuances of your particular diagnosis and treatment plan. 

This expert gynecologist in New York City goes on to say: 

Managed care medicine (HMOs) in Ob/gyn is a commitment to VOLUME. Out of financial necessity, more people need to come through the door. This is why they use “Physician extenders” in the form of videotape libraries, nurse clinicians,  pamphlets, and nutritionists and all types of paramedical assistance to make the patient feel that the visit has been worthwhile and productive although the time spent with the physician him or herself is incredibly short. 

I choose not to practice medicine that way. I urge you to attempt to maintain a Point of Service option in any plan that you may be offered. With a point of service option we can attempt to work with you and your insurance so that you can continue to see me “out of network”. 

Dr Steven R. Goldstein MD is a Concierge Gynecologist in NYC.  Dr Goldstein is is a Professor of Obstetrics and Gynecology at New York University School Of Medicine and the Director of Gynecologic Ultrasound at NYU Langone Medical Center. He is a Certified Menopause Practitioner and holds many other positions and accreditations. 

To learn about Dr Goldstein, an expert gynecologist in New York City and how he can help you, visit his website at www.goldsteinmd.com for more information on his practice.

Dr. Steven R. Goldstein MD- Menopause Doctor in NYC

Doctor Steven R. Goldstein MD is a Menopause Doctor in NYC, and a top NYC Gyn. Dr Goldstein is regarded as one of the nation’s top doctors in Gynecology and is one of the most highly recognized individuals in the field of Gynecologic Ultrasound. He is a Professor of Obstetrics and Gynecology at New York University School of Medicine, Director of Gynecologic Ultrasound at New York University Medical Center, a Certified Menopause Practitioner and President of the International Menopause Society. 

As a menopause doctor in NYC, one of the conditions that Dr Goldstein frequently encounters in his patients is Menopause Bleeding. 

In menopausal women the ovaries are no longer functioning and there is no production of estrogen or progesterone. Thus there is no stimulation of the endometrial lining so there should be no bleeding whatsoever. The medical profession takes the stance that uterine cancer must be ruled out first in any case of menopause bleeding and that any menopausal bleeding is “uterine cancer until proven otherwise.” 

Studies show that only about 3-7% of women with menopausal bleeding will actually have cancer. However, in medicine, that is a relatively large number and all women with any menopausal bleeding must have an evaluation of their uterus. In years gone by, this was often a D&C (dilatation and curettage) and for many years a simple uterine biopsy was the standard of care. This has recently changed, based much on Dr. Goldstein’s research, and such an evaluation can begin with a vaginal sonogram and may require some water instillation as described above. 

Doctor Steven R. Goldstein, a top NYC Gyn, is well qualified to evaluate any case of menopause bleeding with non-invasive vaginal sonograms and discuss the results and treatment plan with patients. 

Dr. Steven R. Goldstein, a top NYC Gyn has over 25 years’ experience as an Obstetrician and Gynecologist in private practice in New York City, where appointments are tailored to each individual and each patient is personally attended to by Dr Goldstein.

Dr Steven R. Goldstein MD- Gynecologist in NYC for Endometriosis

As a Gynecologist in NYC, Dr Goldstein uses painless, non-invasive Transvaginal Ultrasounds to diagnose whether women experiencing pelvic pain, painful periods and heavy bleeding during periods have endometriosis. 

Implants of endometriosis can occur anywhere; however the more common areas of involvement include the bladder wall, ureter, and anterior abdominal wall in patients who have had abdominal surgery such as a prior C section or laparoscopy. 

When using transvaginal ultrasounds, Endometriosis of the bladder wall appears as a fusiform solid thickening of the wall itself. A non-functioning kidney may be the result of chronic ureteral obstruction that is silent and present as a result of endometrial implants impinge on the ureter. In patients who have had prior abdominal surgery, endometriosis may present as a hard, solid mass in the anterior abdominal wall in the region of the scar. Little color flow may be present and the mass is often tender. 

This top Gynecologist in New York is not just the Director of Gynecologic Ultrasound at NYU Langone Medical Center, but he is a skilled operator of Transvaginal Ultrasounds and personally conducts each of these ultrasounds to properly diagnose his patients. Dr Goldstein recently received the Joseph H. Holmes Clinical Pioneer Award which honors individuals who have significantly contributed to the growth and development of medical ultrasound. 

In addition to what Dr Goldstein sees on the screen, these transvaginal ultrasounds lead to the production of clear, high resolution images of the uterus, endometrial lining, fallopian tubes, ovaries and so on to allow Dr Goldstein to make a precise diagnosis and preserve the images for any other specialist who may need to see them. 

After the transvaginal ultrasound procedures, Dr Goldstein will discuss the results and diagnosis with the patient and agree on the best possible course of moving forward. 

Dr Steven R. Goldstein MD is a top Gynecologist in New York. He has been in private practice for over 25 years and is a Professor of Obstetrics and Gynecology at New York University School of medicine, Director of Gynecologic Ultrasound at NYU Langone Medical Center and a Past President of the American Institute of Ultrasound in Medicine. 

Women experiencing painful periods or heavy bleeding during periods may schedule a consultation with Dr Steven R. Goldstein MD, a top ranked Gynecologist in NYC.

Dr. Steven R. Goldstein MD- Gynecologist in NYC for Yeast “Infections”

Doctor Steven R. Goldstein MD is a top Gynecologist in NYC, in practice for over 25 years. He is regarded as one of the nation’s top gynecologists and a pioneer in the field of Gynecologic Ultrasound. 

Many patients refer to a yeast “infection”. The use of the word “infection” implies that this is something that is caught or may even be contagious. This is totally not true. The vagina is a location where normally there are a significant number of bacteria as well as yeast forms that live in harmony with each other (medical term is symbiosis). If something upsets the normal balance, a patient may end up with overt symptoms (burning, itching, etc.) of such an imbalance. Thus Dr Goldstein, a highly rated NYC Gyn, prefers the term yeast “imbalance” 

How does this imbalance occur? The most common reason is the use of an antibiotic for some other reason such as sinus infection, urinary tract infection or indiscriminate use for common colds, where patients often feel that an antibiotic will make them well “sooner.” This kills some of the normal bacteria in the vagina and allows yeast forms to flourish. There is just a limited amount of glycogen and nutrients in the vagina and when some of the competition is eliminated, yeast forms will do quite well. That patient then ends up with overt signs of itch or burning with or without a significant amount of cottage cheese-like discharge. 

When medications such as intravaginal and oral medications, which will restore normal vaginal balance of bacteria and yeast are given to restore the normal balance and the patient feels symptoms have gone away, yeast forms are still there but in the normal harmonious balance with the normal bacteria. 

Dr Steven R. Goldstein, is a top Gynecologist in NYC, a Professor of Obstetrics and Gynecology at New York University School of Medicine and a Past Chairman of the American College of Obstetrics and Gynecology, New York Section. He is also an  Honorary Fellow, Royal College of Obstetrics and Gynecology. 

Visit the website of this top NYC Gyn at www.goldsteinmd.com to learn more about him or to schedule an appointment. 

Dr. Steven R. Goldstein MD- Gynecologist in New York City for Perimenopause Treatment

 Dr Steven R. Goldstein is an expert gynecologist in New York for Perimenopause. Dr Goldstein has helped thousands of women safely navigate the perimenopause stage of life. As a certified menopause practitioner and a past President of the North American Menopause Society (NAMS), Dr Goldstein can help women experiencing various symptoms of perimenopause. 

Unscheduled bleeding in perimenopausal women, as well as any bleeding in post-menopausal women not on hormone replacement therapy, accounts for many medical interventions. Traditional diagnostic procedures performed in the office include biopsy, suction aspiration, suction curettage, and diagnostic hysteroscopy. However, dysfunctional uterine bleeding in perimenopausal patients can be caused by a lack of ovulation, which is better treated hormonally, not surgically. 

So how can a gynecologist determine whether the bleeding is caused by a lack of ovulation without doing any surgical procedures to diagnose the condition? The answer is a non-invasive, painless procedure called Sonohysterography which is performed in a few minutes right in the office. Dr Goldstein, a top gynecologist in NYC, personally performs all Sonohysterograms right in his office. 

Sonohysterography, by assessing endometrial thickness, can reliably distinguish between patients whose bleeding is as a result of a lack of ovulation and those who are in need of formal curettage and hysteroscopy. 

Dr Goldstein, an expert gynecologist in NYC for perimenopause, has found that in the vast amount of patients abnormal uterine bleeding is associated with episodes of no ovulation. This condition can be managed hormonally in premenopausal patients or endometrial atrophy in post-menopausal patients. 

Dr Steven R Goldstein MD is an expert gynecologist in New York  who can evaluate female patients who are in either perimenopause or are post-menopausal and experiencing unscheduled bleeding. You can schedule an appointment with Dr Goldstein by visiting his website at www.goldsteinmd.com

Dr. Steven R. Goldstein MD- Top Gynecologist in NYC warns on Incidental Findings

Dr Steven R. Goldstein MD is the best Gynecologist in NYC, regarded as one of the nation’s top doctors in Gynecology. Dr Goldstein is also the Recipient of the 2018 Joseph H. Holmes Clinical Pioneer Award from the American Institute of Ultrasound in Medicine (AIUM). This is in recognition of Dr Goldstein’s distinguished career in ultrasound in medicine, and making outstanding contributions to the growth and development of medical ultrasound. He is one of the most highly recognized and regarded individuals in the field of vaginal probe ultrasound. 

As a top gynecologist in NYC, Dr Goldstein wrote the second book on transvaginal ultrasound and has spent over twenty years teaching OB/Gyns in the US how to do vaginal probe ultrasounds. One of the issues that arises, is one of “incidental findings”. Patients may go for an ultrasound for a particular condition and wind up with a report of another finding, usually unrelated to the condition in question. This is called an incidental finding. 

The problem is that as more and more vaginal ultrasounds are ordered, more and more things that are variants of normal are discovered and leads to unnecessary anxiety, further testing, and even unfortunately, unnecessary surgery for things that are obviously benign. 

Dr Goldstein frequently examines patients with vaginal ultrasounds as part of their office visit. If Dr Goldstein encounters anything on that sonogram which he considers an incidental finding, he shows it to the patient on the screen and warns them that if they ever have an imaging study for another reason, this finding is not a reason for concern. 

The sensitivity of today’s ultrasounds are so great that Dr Goldstein coined a new term to describe them. Sono microscopy. It is as if a microscope were being used to examine the patient. We are seeing things that could not possibly be seen with the naked eye if one were to hold the structure in their hand and squint at it. 

So the beauty of the transvaginal ultrasound is how much can be seen. But the problem is, do we see too much? One must understand the difference between findings that are common and findings that may be ominous. 

As a top gynecologist in NYC in practice for over 2 decades, Dr Goldstein has the experience to properly diagnose the findings. Dr Goldstein conducts every transvaginal ultrasound / color doppler study personally. He does not rely on the skills or report of a technician. 

As one of the most highly recognized individuals in the field of vaginal probe ultrasounds and the best gynecologist in NYC, Dr Goldstein can easily distinguish a normal finding from one that may be considered ominous and a candidate for further study. 

So be careful if you have an ultrasound done of your pelvis and there are “incidental findings”. Make sure you are not overly tested or even worse, operated on. This would never be the case at Dr Goldstein’s practice, a top Gynecologist in NYC. 

If you have been told you have a polyp, fibroid or some other condition and need a second opinion, contact the office of Dr Steven R. Goldstein, the best gynecologist in NYC, for an appointment or visit www.goldsteinmd.com for more information. 

Dr. Steven R. Goldstein MD- Gynecologist in NYC for Uterine Fibroids

Dr. Steven R. Goldstein MD is a top gynecologist in NYC diagnosing and treating uterine fibroids. As many as one in five women develop uterine fibroids during their childbearing years. Fibroids refer to small, benign tumors that develop in a woman’s womb. 

Common symptoms of uterine fibroids include but are not limited to abnormal uterine bleeding, frequent cramping, pelvic cramping or pain with periods, the sensation of fullness or pressure in the lower abdomen, and pain during intercourse. 

Pelvic exams and ultrasounds are often used to identify the presence of fibroids in the uterus however these fibroids are like real estate – location, location, location. Only with transvaginal ultrasounds can we determine the proper location of fibroids. The ones that impact the uterine cavity will have the most effect on bleeding and/or fertility. 

Dr. Goldstein, the best gynecologist in NYC,  is an internationally recognized expert in transvaginal ultrasounds and Sonohysterography imaging, thus he is well equipped to handle the detection and treatment of uterine fibroids. Treatment and management vary based on each patient’s health, medical history, symptoms, and future plans. 

In practice for over 25 years, Dr. Goldstein provides individualized care to patients. At his practice, Dr. Goldstein is the only medical personnel you will see from beginning to end of your visit. He personally performs all examinations and conducts all procedures himself including transvaginal ultrasounds used in the diagnosis of uterine fibroids and Sonohysterograms. 

In addition to being a top gynecologist in NYC, Dr. Goldstein is also a Professor of Obstetrics and Gynecology at New York University School of Medicine, Director of Gynecologic Ultrasound at NYU Langone Medical Center, and the author of over seven books on Gynecology. He is the best gynecologist in NYC for women with uterine fibroids to see.