Patient, Ally & Educator

October 26, 2020
Tara Van Leuven, MD, Associate Professor of Obstetrics and Gynecology

Tara Van Leuven, M.D., Associate Professor of Obstetrics and Gynecology at the Medical University of South Carolina (MUSC) embraces her role as an educator and ally for the women in her care. "Each patient is different," says Van Leuven. "So, while I might know the medical 'answer' that can 'fix' a problem, I think it's really important to understand the person and to figure out what's the best way to address the issue in that particular patient."

Van Leuven comes to MUSC from Georgetown University Medical Center in Washington, DC . After graduating from medical school at Georgetown and completing her residency there, Van Leuven accepted a fulltime position as an attending physician, serving on the Georgetown Medical Center staff for the next eight years. Her long-time roots at an academic medical center are part of what attracted her to MUSC. "Being at an academic center is my normal–it's all I know. I really enjoy teaching residents, and being in education keeps me on my toes. I have to be sure I have the most up-to-date information. I also enjoy the patient population. Teaching hospitals are the big referral centers, so I get to see more rare and complicated cases which are interesting to work on."

While she will see clinical patients for the majority of each week, Van Leuven will also bring a valuable surgical skill set to the operating room. "My focus is on minimally invasive gynecologic surgery– things like hysterectomy, endometriosis treatment, and myomectomy (fibroid removal)," says Van Leuven. Laparoscopic myomectomy is not as widely available as traditional open surgery due to the specialized skills it requires. "Many health centers aren’t able to offer a laparoscopic approach to this type of surgery. I had the opportunity to develop that particular skill set through my training and practice at Georgetown," says Van Leuven. Uterine fibroids are non-cancerous tumors that can lead to problems when they become large or multiply, pressing on nearby organs and causing heavy cyclical bleeding.1  The traditional procedure to remove fibroids requires a much larger open surgery than what is needed for the laparoscopic procedure. "I find that patients almost always prefer the less invasive approach, if feasible, where we just have to make a very small incision to get the fibroids out," says Van Leuven. "Avoiding a big, open surgery lets us better preserve the uterus for women who want to have children in the future, or who want their uterus to remain intact for other reasons."

Her interest in education extends into her clinical practice, where Van Leuven wants to improve health literacy among her patients to ensure they understand their health issues and options. Patient education is particularly important in South Carolina which has a long history of restricting health education in its public schools. "In just the month or so that I've been here, I've noticed there's a lot to be done regarding healthcare education for patients," says Van Leuven. "I've been surprised at how many of the women I see are not knowledgeable about their treatment options or about their own health and healthcare." She joins many other physicians nationwide and at MUSC who have worked in recent years to shift healthcare decision-making from a paternalistic model to a more patient-centered approach. "In the past, the physician just told a woman what they should do. But, I find that what patients really want is someone they can talk to about their experiences and who they can trust to help them figure out what's the best thing to do for their health," says Van Leuven.

Van Leuven also acknowledges that many patients find it difficult to discuss their reproductive health–even with their physicians–and she wants to help change that. "It's such a sensitive area of the body to examine and to talk about. I see patients who've had a prior negative experience or who are afraid or embarrassed to discuss these problems that are really significantly affecting their lives. I want to show them that there is treatment and it doesn't have to be uncomfortable to talk about. They don't have to feel like they're being judged," says Van Leuven.

She also uses her surgical skills to give more patients an opportunity to have children. For example, many women with multiple or large fibroids have traditionally been advised to have a hysterectomy. For others, uterine abnormalities prevent them from becoming pregnant or maintaining a pregnancy. "I do a lot of fertility-sparing surgeries including uterine repair procedures to fix anomalies that can interfere with a developing pregnancy," says Van Leuven. "When there's a history of infertility or a prior miscarriage, we can look for an abnormality in the uterus that may have caused it. Then, before the patient becomes pregnant, she can have surgery to correct that and have a healthy pregnancy afterwards."

From pre-conception through delivery, Van Leuven continues to be an ally and advocate for her patients. "My goal is to help them have the delivery they want, safely. Most women can have a more natural or low intervention delivery, if that's what they want. The challenge is in knowing when an intervention is necessary and being able to explain what's going on and what their options are–which may not be exactly what they'd originally planned. I want to find a way to get them the care they need without just completely messing up their goals. My job is to keep things safe while still doing things their way as much as possible."

If you would like to make an appointment with Dr. Van Leuven or refer a patient, please call 843-876-3292.

References

1 Mayo Clinic. Patient Care & Health Information: Uterine Fibroids. Available at: https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/symptoms-causes/syc-20354288

2 Orekoya O, White K, Samson M, Robillard AG. The South Carolina Comprehensive Health Education Act Needs to Be Amended. Am J Public Health. 2016; 106(11): 1950–1952.

3 Arora KS, Castleberry N, Schulkin J. Obstetrician–gynecologists’ counseling regarding postpartum sterilization. Int J Womens Health. 2018;10:425-429


About the Author

MUSC Women's Health

Keywords: Womens Health, Obstetrician