Gynecologist Takes Proactive Approach to Health Care

September 28, 2006

by Emily Brandler

Spokane Journal of Business

Urogynecology, permanent birth control procedure among doctor’s services:

Dr. Debra Ravasia, a new Spokane gynecologist with a special interest in what’s called urogynecology, has been established herself quickly here by offering health seminars and helping to introduce a permanent birth control procedure in the market.

Ravasia opened her practice, Women’s Health Connection PS, last February in a 3,000-square-foot leased space on the third floor of the Northpointe Professional Center, at 9425 N. Nevada.

She has five employees, including herself, and plans to hire three more within the next two months, including a nurse practitioner, to keep up with patient demand. She currently has about 1,000 patients.

Urogynecology is the practice of gynecology as it pertains to bladder problems that overlap between urinary organs and reproductive organs. Ravasia says she developed an interest in urogynecology and received training in it during her residency program.

The primary conditions that fall within urogynecology are incontinence; urgency, frequency and painful bladder syndrome; and pelvic prolapse, or a weakening of muscles at the base of the pelvis, she says. Ravasia says she is aware of one other Spokane physician, Dr. Linda Partoll, of Northwest OB/GYN PS, who specializes in urogynecology.

Women tend to have more bladder-related problems than men, because of damage to the bladder floor that occurs during pregnancy abdomen because women have a shorter urethra, which means more problems with the urinary and reproductive systems Ravasia says. Also, such problems often go undiagnosed and untreated because women generally don't like to talk about these problems with their physicians, she says.

For instance, interstitial cystitis, which is a condition involving breakdown and inflammation of the bladder lining, often goes untreated either as a result of misdiagnosis or because a patient doesn’t tell her doctor about the problem, she says. Left untreated, the condition, which causes chronic pelvic pain, urinary urgency, and recurrent bladder infections, can get substantially worse, she says.

"In the community, by and large, there's a great need for (urogynecology)", Ravasia asserts. "The solutions often are quite simple, but they just haven't been addressed."

As part of her focus on urogynecology, Ravasia planes to launch a program within the next month called In Control, which will involve pelvic floor rehabilitation exercise techniques that aim to correct in continence problems without surgery, she says.

One of the office-based procedures that Women's Health Connection offers is placement of Essure brand micro-inserts into the fallopian tubes in a minimally invasive procedure that provides permanent birth control and can be done in either a doctor's office or a hospital outpatient setting, Ravasia says.

During the procedure, Ravasia places the micro-inserts into a patient’s fallopian tubes with the help of a catheter-like tiny camera guided through the cervix into the uterus. The body later forms a barrier over the inserts with its own tissue, blocking the fallopian tubes and thus preventing sperm from reaching an egg. The Essure procedure, which has the same success and recovery rates as vasectomies do for men requires minimal sedation or a local anesthetic, she says.

Ravasia also provides other office based procedures, including diagnostic hysteroscopies, which evaluate the inside of the uterus; urodynamics tests to determine different kinds of incontinence problems; and endometrial ablation. That latter, minimally-invasive procedure involves destroying the part of the uterine lining that bleeds very month, and is done to relieve excessive menstrual bleeding, she says.

In addition to office-based procedures, Ravasia performs inpatient and outpatient procedures at Holy Family Hospital, Deaconess Medical Center, and Sacred Heart Medical Center. She says she recently started doing laparoscopic hysterectomies on an outpatient basis. Those minimally-invasive surgeries reduce patient recovery time to about a week, compared with conventional hysterectomies, which typically require a six-week recovery.

Standard services Ravasia provides include annual examinations; colposcopic exams, which are cervical exams; and procedures to remove pre-cancerous cells from a patient’s cervix, she says.

Ravasia also expects to start offering community education and medical-grade skin care treatments and products within the next three months, and is looking to hire a licensed medical aesthetician to provide some of those services.

Patients can schedule appointments renew prescriptions, and view some of their medical information online via the clinic’s Web site, she says. Patients also can receive their test results via secured email, she says.

Outside of the office, Ravasia has been giving lectures at Sacred Heart, Holy Family, and Deer Park Hospital. During those lectures, she provides information about bladder problems and menopause issues, such ax hormone-replacement therapies.

A Canadian native, Ravasia attended medical school at the patient University of Saskatchewan, where she met her husband, Saj, who currently is an inpatient psychiatrist at Sacred Heart. She completed her residency at the University of Calgary Foothills Medical Center, in Calgary, Alberta.

The Ravasias moved to the U.S. because they believed the health-care system in Canada was failing and that they could use their training more fully here. They got their U.S. board certifications, then worked in Fargo, N.D., for six years while trying to finalize their immigration. They moved to Spokane last fall to be closer to Debra Ravasia’s family in Calgary, she says.

Ravasia says that since she started practicing in the U.S., she has found that while patients have quicker access to health care here than they typically do in Canada, more people here are uninsured and thus “fall through the cracks” of the health care system.

Ravasia used to practice obstetrics, but says she stopped shortly after moving to Spokane because she wanted to spend more time with her family.