All-Woman Independent Practice Heartland Fertility Grows to Five Physicians

Dr. Stephanie Gustin Says She’s Not Selling, Encourages Other Docs to Buy Practices

This article was originally published on Aug 29, 2024.? To read Inside Reproductive Health news as it's released, you must be subscribed. Subscribe for free here.

BY ROSEMARY SCOTT

As more fertility clinics and chains are bought up by investment firms across the U.S., reproductive endocrinologists who choose to own their own practices are becoming more of a rarity.?

Stephanie L.F. Gustin, M.D., is one of the few who chose to take the leap into independent ownership. She is now managing partner at The Heartland Center for Reproductive Medicine in Omaha and Lincoln, NE, and has grown her all-women physician team from one reproductive endocrinologist to a total of five in five years.?

Gustin told Inside Reproductive Health that after she finished her fellowship program at Stanford University, she knew she wanted to work either in an academic setting or at a private practice. As a University of Nebraska School of Medicine-affiliate, Heartland was a mix of both, and she started working there shortly after her fellowship ended.

Heartland offers a partnership track to its doctors, which is how Gustin was eventually able to become a partner and partial owner in 2019 and purchase the practice entirely from the previous owner, Dr. Victoria Maclin, in 2021. She said that once a doctor has a patient load that is similar in quantity to the other partners, that doctor will also have an opportunity to purchase part of the practice.

Gustin said the biggest changes she made upon purchasing the practice were in an area she still prioritizes today–recruitment. Shortly after she became the owner of Heartland, she hired Barry R. Behr, Ph.D., who was formerly the IVF laboratory director at Stanford.?

“He was one of my mentors [at Stanford] and someone that I have a profound respect for,” Gustin said. “And I felt really confident that our practice, in terms of our success rates, was going to evolve quickly with his help.”?

“When it comes to egg banking, there are technologies and protocols that are on the horizon that you need to know about.”

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Gustin said that though she believed recruitment may be difficult given the clinic’s more rural location, she has now hired a total of four reproductive endocrinologists in five years. She said she built relationships with the new staff before offering the job through advocacy, collaboration and mutual connections, and after introducing her business model, they each decided to make the leap.?

The staff, Gustin said, has made all the difference.?

“We all work really hard, but it's easy to do that when we really love who we work with,” she said. ”I don't think many people have the kind of job that I have.”?

Though all five of Heartland’s reproductive endocrinologists are early or mid-way into their careers, and the IVF market is only getting more lucrative, Gustin said they have no interest in selling the practice, as they value the autonomy of private ownership and the ability to prioritize patient care over profits.

“We really enjoy the autonomy of creating the culture and running the practice in a way that feels authentic to us,” she said.?

Gustin said she thinks the business side of owning a private practice might deter some doctors, especially those without a background in business. Still, she emphasized the importance of being confident in one’s own skill set to learn along the way and hire experts to fill any knowledge gaps.?

“I haven't heard a single person [who has bought a private practice] say that they regret it,” Gustin said. “It’s something that I wish more people coming out of training would seek out.”

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The New Technology in Egg Banking: Improved Protocols, Automation, and AI, oh my!

BY: KATHRYN WOZNIAK, MS SENIOR EMBRYOLOGIST & LEAD CRYOBIOLOGIST AT ASIAN EGG BANK

No matter the area of life or business, the newest and most notable advancements are ?often cause for excitement. When it comes to egg banking, there are technologies and protocols that are on the horizon that you need to know about. Here are three in particular that are worth your attention.

The overarching expectation is that technology moves fast and is constantly improving. While that’s certainly the case in some areas, the opposite can also be true. Over the past decade, there's been minimal progress made towards improving oocyte freezing techniques. At Asian Egg Bank, we are researching and reviewing the current processes of oocyte vitrification and warming, and this work is showing very promising results in the field with blastocyst embryos. While current methods have an over-90% survival rate, this new ultra-fast vitrification and rapid elution protocol gets outcomes much closer to fresh eggs, with survival rates close to 100%. It's still very new in terms of oocyte cryopreservation and the protocol will need to go into clinical trials to be implemented across the country, but we are very excited for the increased reliability of frozen oocytes so that they can be accessible to patients worldwide.

Like many industries, the field of ART is moving into an era of AI. This technology is going to be particularly relevant in the egg banking space because it will allow us to remove technologist bias and subjectivity from the egg selection process. It may also be able to provide additional information that is not visible with the human eye. AI uses images and markers, which will allow us to grade and group oocytes before the vitrification process, according to the likelihood that they'll produce the viable blastocysts. This is extremely valuable information for egg banks and for intended parents, so that they can make better decisions on their family planning.

While a little further out on the horizon, we could eventually see automated oocyte freezing. Oocyte vitrification can be a very tedious and lengthy process and automated vitrification could potentially alleviate the manual labor, and also help to standardize the outcomes by removing some of the operational error. And less manual labor could mean lower cost as well. We will have to wait and see on this one.

In addition to conducting our own research, Asian Egg Bank team members attend regular educational conferences and workshops to stay on top of new information. The fertility industry is so dynamic, and it’s growing every day. We need to have the most up-to-date techniques and technology in order to provide our patients with the best care.

Discover how Asian Egg Bank is leading the industry in new technology. Visit asianeggbank.com/for-professionals to learn more.

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