Dr. Morris Wortman: Surgery Without Hospitals
Morris “Moe” Wortman, MD., is a “high flyer” in more ways than one. As a small plane enthusiast, he has logged air speed records in the United States and Europe; as a physician, he founded and has run one of the country’s most respected office-based surgical practices for more than twenty-five years.
At the Center for Menstrual Disorders and Reproductive Choice (CMDRC) in Brighton, ‘Wortman performs a wide range of outpatient surgical procedures to address abnormal menstrual bleeding, incapacitating cramps, and other painful reproductive disorders-all without patients ever setting foot in a hospital. “There’s so much than that can be done for women right in their doctor’s office,” says Wortman. “Traditional operating rooms are set up for sick people, but we’re mainly doing procedures on relatively healthy young women:’
In 1981, as the twenty-nine-year-old chief of OB-GYN at the Genesee Valley Group Health Association (GVGHA), Wortman saw firsthand the many problems that amict hospitals. He points out that the “one-size-fits-all” approach to health care at hospitals requires patients to repeatedly fill out the same forms, undergo multiple consultations or pre-screenings, and frequently experience over-sedation during surgery. A ten-to-fifteen minute procedure can easily drag out to six hours or more. “Hospitals don’t differentiate,” he says. “They put everyone through the same rigmarole:’
Moreover, large clinics tend to experience weaker doctor-patient communication and greater delays since a twenty-four-seven work environment and constantly shifting schedules mean doctors and nurses are mixed and matched, making it harder for them to establish routines together. (By contrast, Wortman notes the average employee at CMDRC has worked in the office for seventeen years.) Wortman decided to open the doors to his own practice over twenty-five years ago partly in response to these conditions.
Another chief inspiration was A. Jefferson Penfield, a Syracuse OB-GYN who was performing some of the country’s first non-hospital tubal ligations. “His practice had a profound influence on my professional career,” says Wortman, who received early-career mentoring from Penfield. “Even at GVGHA, I tried to bring as many surgeries out of the operating room as could safely be done:’
The OB-GYN field helped pioneer office-based surgery because so many procedures require no incisions, Wortman notes. This is because all operations may be performed “hysteroscopically,” or via natural bodily orifices. The speed and flexibility provided by office-based surgery makes it possible for a woman to schedule a procedure on Friday and need only the weekend to recover. Many patients who visit during the workweek even return to their jobs the next morning.
“In terms of your ability to plan your life, [faster recovery time] is very powerfull,” Wortman maintains. “There are numerous advantages, from the patients’ perspectives, the doctor’s perspective and-from the point of view of the insurance companies-the economic perspective. So this really is a ‘win-win-win’ for everyone.”
The list of gynecological procedures that can be performed within a private practice has grown significantly over the years, and now includes removal of uterine fibroids, and treatments for abscesses, infections, growths on the vulva, and cervical dysplasia. As a strong advocate for reproductive choice, Wortman was also one of the first office-based physicians to provide safe, pain medicine-assisted pregnancy terminations to women in Western New York.
A typical day at Wortman’s practice might include one major and four or five minor procedures, as well as consultations. The clinic’s most popular treatment, a technique of endomyometrial resection, was pioneered more than twenty years ago by Wortman and Amy Daggett, RN, ANP, an adult nurse practitioner at CMDRC. The operation, which stops abnormal menstrual bleeding without requiring a hysterectomy, remains the most successful of the endometrial ablation techniques.
In addition, CMDRC’s Accreditation Association for Ambulatory Health Care (AAAHC) accreditation enables Wortman to offer a wider range of procedures than many other private practices. Physicians who lack this approval are limited in the range of pain management options, which means operations either have to be stopped mid-procedure when stronger analgesics are not authorized or proceed despite severe pain or discomfort for the patient “We function like a small hospital, complete with the sort of oversight that goes along being a hospital,” says Wortman, who opened a new, larger facility in 1999. “So many more things can be done for women today quickly, safely, and using minimally invasive techniques.”