Latest / Becker’s Healthcare Podcast / Dr. Randi Goldman on Expanding Fertility Preservation and Oncofertility Care at Northwell Health

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Dr. Randi Goldman on Expanding Fertility Preservation and Oncofertility Care at Northwell Health · Becker’s Healthcare Podcast

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  Every year, Becker's annual meeting brings health care
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  For the agenda and event details, visit beckershospitalreview.com
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  and click on the events tab in the
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  upper right.
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  This is Laura Dierda with the Becker's Healthcare
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  podcast. I'm thrilled today to be joined by
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  Randy Goldman, associate professor at the Donald and
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  Barbara Zucker School of Medicine, Hofstra Northwell, and
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  program director of the reproductive
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  endocrinology
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  and infertility fellowship at Northwell Health, as well
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  as the chair of patient experience committee at
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  Northwell Health physician partners. Randy, it's a pleasure
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  to have you on the podcast today. Thank
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  you so much. It's great to be here.
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  Absolutely. Now I'm excited for our conversation because
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  I know, you know, health care is such
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  a dynamic field, and I in Northwell too
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  is a innovative system, and so I'm excited
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  to learn more about some of the things
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  that you've been working on in the last
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  year as well as your perspective on the
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  future. But before we dive in, can you
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  tell us a little bit more about yourself
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  and what you are up to at Northwell?
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  Of course. Yes. Thank you. So, as you
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  mentioned, I'm a reproductive endocrinologist
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  and infertility specialist
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  at Northwell Health, which is also called REI,
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  and I serve on the program as a
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  program director for the REI fellowship.
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  I also have helped to lead
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  several system level initiatives in things like fertility
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  preservation,
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  oncofertility,
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  as well as patient experience.
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  Got it. That's helpful to understand. And, you
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  know, I'm curious when you think about the
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  last year or so, what was the most
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  important initiative you led? What did you do,
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  and what were the results?
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  I think the most important initiative I led,
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  was the expansion and sort of formalization
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  of fertility preservation
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  and oncofertility
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  pathways across the system. And, you know, Northwell
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  is the the largest health system in New
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  York state. And so
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  that really gives us the responsibility
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  and the opportunity to sort of scale these
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  evidence
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  based care platforms
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  across our population.
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  Oncofertility
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  is sort of a fancy way of saying,
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  the provision of fertility
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  services
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  that we provide for patients who either have
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  an active cancer diagnosis
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  or are cancer survivors.
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  And this,
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  includes something called ovarian tissue cryopreservation
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  or ovarian tissue freezing.
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  So ovarian tissue freezing
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  is a process where we can
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  remove an ovary
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  from a patient
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  and then freeze the ovary itself
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  so that in the future, if that
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  biological child and they are unable to, it
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  is a method to
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  preserve their fertility and kind of give them
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  that opportunity in the future.
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  And ovarian tissue freezing
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  is mainly used for,
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  younger girls with cancer who don't have the
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  ability to do egg freezing. Egg freezing is
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  sort of the gold standard for patients who
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  are able to do it. And ovarian tissue
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  freezing can also be used for patients who
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  don't have the opportunity to wait about two
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  weeks before cancer treatment.
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  And so it's used in that context.
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  When developing these programs, the onco fertility pathways,
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  fertility preservation pathways,
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  we focused really on early identification
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  of patients for whom these treatments might be
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  beneficial,
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  develop very clear referral pathways that are sort
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  of easy to use.
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  And this really required multidisciplinary
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  coordination with lots of other teams like the
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  oncology teams,
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  pediatric teams, social work, navigation,
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  and it's something that I'm quite proud of.
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  The results were
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  really measurable. So we had increase in referrals,
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  shorter time to fertility counseling,
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  easier access to the treatment. So an increase
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  in the number of patients who actually underwent
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  fertility preservation
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  treatment
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  and really have expanded access for patients who
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  previously would not have had a viable option
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  before their cancer treatment.
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  And it's helpful to understand. You know, it
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  sounds like an amazing service and opportunity for
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  patients who are undergoing cancer treatment or have,
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  to make sure that they are preserving their
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  fertility and, have that kind of standard system
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  in place, to provide that access and knowledge.
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  You know, it's really great, great,
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  service to the community. Now,
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  I'm curious. When you think about the future,
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  what are some of the big priorities and
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  headwinds that you're focused on for 2026?
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  It's a great question. I think for me,
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  the major priorities would be
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  scaling these,
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  these opportunities for our patients,
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  improving and increasing access
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  and making sure that they're sustainable.
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  So what that really means is being able
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  to embed these fertility preservation
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  pathways
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  into
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  existing
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  routine care pathways,
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  expanding
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  the navigation models so that no patient falls
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  through the cracks
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  and also using data to track outcomes.
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  You know,
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  whenever you go to conferences or you read
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  about a study looking at fertility preservation and
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  oncofertility,
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  you know, the sort of dot dot dot
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  at the end of everything was, and you
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  know, we need more outcome data.
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  So being in such a large institution,
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  we really are I think we have a
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  unique opportunity to provide a lot of that
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  outcome data.
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  Some of the, you know, difficulties
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  are things like,
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  like constraints and workforce,
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  challenges of implementing
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  innovation in a large system
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  where you're not creating, like, parallel tracks, but
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  really working together, you know, not in silos
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  to make sure things come together to,
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  kind of for the betterment of patient care.
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  And you know, it's not only
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  patients with cancer. Fertility preservation
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  is an option that a lot of patients
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  would benefit from.
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  Another example of something that we're working on
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  is, an endometriosis
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  fertility program
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  because endometriosis
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  really can negatively impact infertility. Up to fifty
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  percent of patients with endo can struggle to
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  conceive in the future. So they also need,
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  you know, kind of easy access to fertility
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  preservation services.
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  And patients with disorders like or diseases like
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  sickle cell
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  or thalassemia,
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  where they have the option of getting gene
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  therapy or a stem cell transplant,
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  which can effectively cure them of sickle cell
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  or thalassemia,
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  but also
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  significantly increase the likelihood of their having permanent
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  infertility.
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  These are all kind of similar,
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  ideas
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  that can benefit from pathways like this that
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  utilize existing resources just in a more,
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  kind of efficient and thoughtful way.
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  It's fascinating to hear about. And, you know,
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  to be having those types of outcomes in
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  in a position,
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  to provide more of that research
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  makes a big difference. I I know for
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  people far beyond, the Northwell
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  market, and so it's it's cool to have
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  that opportunity. And, you know, when you're looking
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  at putting all this together in the the
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  great,
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  technology I know it takes in order to,
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  make all of this happen, how do you
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  really,
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  you know, see that impact and make sure
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  that your teams are,
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  you know, continuing to be innovative,
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  while also,
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  understanding, you know, what they need to do
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  on a daily basis in order to make
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  this all work?
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  That's a really good question as well. So
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  a lot of it, I think, comes down
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  to education.
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  You know? I think our teams are really
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  dedicated to
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  not just the status quo,
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  but in innovative
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  innovative health care that can help patients sort
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  of reach their goals later on. So as
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  a fertility doc, you know, my kind of
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  focus is on is on fertility.
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  But I think when you are able to
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  engage the stakeholders and explain why things are
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  going to be important for patients,
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  they're excited to be a part of something
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  innovative and new.
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  Of course, maintaining what we do on a
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  day to day basis is is of course
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  critical
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  as well. But I think that there's a
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  way to do both and do both in
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  a very positive way.
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  And, you know, the idea is that you're
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  innovating and you're creating new pathways, you're creating
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  new workflows to get patients into treatment. And
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  then hopefully that ultimately becomes the status quo,
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  you know, and it becomes part of the
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  routine care, which obviously takes repetition and takes
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  learning.
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  But I find that
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  when you're building things that are new
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  and you're involving other stakeholders,
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  it also helps to provide
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  purpose. Right?
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  You know, we went into medicine so that
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  we could help people, and what better way
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  to help people than find innovative solutions to
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  their health problems.
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  I love that. And, you know, really truly
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  kind of grounds the mission and vision of
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  everything that you're doing. Now do you think
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  the hardest thing you'll have to do in
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  the coming year will be?
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  So this is something that I tend to
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  struggle with a little bit, and that's my
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  my initial impetus is always to say yes,
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  and I've always been that way.
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  I think the hardest part is gonna be
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  saying no to
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  good ideas
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  in order to focus on ideas that could
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  be executed well and at a large scale.
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  You know, in a in a large health
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  system like Northwell,
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  you have to have some discipline around prioritization.
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  And that can be
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  as important as innovation itself because we have
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  to recognize that resources and time
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  are finite. Right?
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  So there could be a lot of good
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  ideas, but figuring out which ones are going
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  to be the most tangible
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  and are gonna have the biggest impact
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  is is always a challenge, especially for people
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  who are sort of programmed to try to
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  always say yes to things. So it's really
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  just navigating,
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  you know, the the best of those options,
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  knowing that you can always table things. Right?
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  Just because you can't do something immediately and
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  in the next year
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  doesn't mean that it can't be kind of
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  rethought of two years or five years from
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  now.
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  Absolutely. I I love that. And I think,
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  you know, being able to push yourself and
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  challenge yourself in the,
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  especially New Year, but kind of constantly,
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  trying to make those improvements,
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  makes a big difference and can really be
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  the space where where growth happens, it seems
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  like. Definitely. Definitely. I think it's a skill
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  to have in and of itself is, kind
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  of identifying what things are are worth saying
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  yes to because
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  there are lots and lots of great ideas.
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  But sort of prioritizing them,
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  is I I I truly think is a
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  skill that is,
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  one that I've I've certainly needed to learn
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  myself.
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  Absolutely. I think a lot of us can
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  relate to that.
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  Yeah. Now before we wrap up here, I'm
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  curious, where do you see some of the
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  best opportunities for organizational growth?
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  Oh, I think
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  strongest growth opportunities
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  for me
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  are sort of at the intersection of lots
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  of things that already exist, like specialty care,
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  navigation,
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  and, of course, data. I'm extremely
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  data driven and very evidence based.
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  Programs like the ones that we've built, fertility
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  preservation programs, this endometriosis
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  program that we're starting,
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  and more of, like, complex reproductive decision making
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  really
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  benefit
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  enormously
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  from these coordinated
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  and longitudinal
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  models
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  where you're thinking about the patient's health from
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  more than a single lens.
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  And
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  health systems that are able to
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  sort of integrate,
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  like, clinical excellence
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  along with patient experience
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  and very strong positive outcomes
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  and being able to track those outcomes are
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  going to be able to differentiate themselves
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  quickly in an otherwise very competitive market.
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  And I think that that has to do
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  with finding the right people,
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  the right teams, the right infrastructure, and the
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  right resources.
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  And, you know, it's it's something that certainly
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  is, able to be learned, but I think
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  that those are probably the best opportunities for
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  sort of growth that I can see. I
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  love that. Randy, thank you so much for
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  joining us on the podcast today. This has
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  been such a fun and informative conversation, and
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  I look forward to seeing you as well
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  at our annual meeting in April. I know
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  you'll be speaking on a panel, and, we'll
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  continue to dig deeper into some of these
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  things we talked about today as well as,
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  you know, have the opportunity to connect and
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  learn from one another.
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  Thank you. I am really looking forward to
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  it. It was wonderful to speak with you
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  today.