Up until 2021, Drs. Winnie Henderson and Chris Kollmorgen were part of a surgical specialist group, here in Lane County for many years. In their daily work, they always set their sights on providing the best in medical care. Over time, they developed a growing concern with their more tangled and bureaucratic health care delivery environment. As generalists, they performed all kinds of general surgery, but gradually, they sub specialized, developing a primary focus as breast surgical oncologists. They also noticed that their patients had become more anxious, more medically complex, and more often disadvantaged due to their social determinants of health. After years of watching this unfold, they began their journey of finding a better way. Here in their own words, they identify solutions to these intricate problems.
How can we minimize stress to our patients and promote healing while finding our interactions more rewarding? “The surgical aspect of breast oncology is often traumatic, stressful, and too rushed. To help these patients through their journey in a “minimally invasive” way, we realized soon that we needed to form a dedicated team of specialized medical assistants, a nurse navigator, data collection specialists, and evidence-based integrative care specialists. Our team approach is key to patient wellness. Our new team environment is called Oregon Surgical Wellness.
How do we track our data to ensure we offer the very best reproducible care possible to our patients? “Quality data reporting is a commonplace conversation. Payers have threatened doctors repeatedly over the last decade, claiming that they must produce quality data to receive payment. As it turns out, producing quality data is not so easy. Most independent practices and nonacademic centers, either don’t have the time or lack the financial incentives to collect data. Thankfully, we don’t have those issues. Our highly trained data collection specialists have registered over 3800 patients on breast, endocrine, hernia and general surgery national quality outcomes registries. We compare it to wearing a fit bit that tracks your physiology over time. You begin to see what works and what does not work regarding your health. The same goes for data tracking in the medical field. These registries are invaluable to us, as they help us understand our trends in care. We go this extra mile because it makes us better.
How do we support the whole patient during treatment and promote the highest quality of life for them in the future? “Personal choices are a huge part of the healthcare continuum. When a patient receives a life-threatening diagnosis, such as breast cancer, they are faced with some hard choices to make on how to treat their cancer best. Oftentimes, patients don’t have a lot of time to decide and are plunged into an overwhelming sea of information that may or may not even be pertinent to their situation. As breast surgical oncologists, it’s up to us to educate them on their choices, and it is our goal that they select not only a healthy choice but also one driven by science and sound medical data. We use a method called “patient shared decision making,” serving as a research site for the Dartmouth-Hitchcock Center for Shared Decision Making. patient’s satisfaction with their outcome is greater when they decide based on their personal needs, not the doctor’s. Most doctors stop there and leave out one of the most crucial parts; preventative care and survivorship. By the time the patient has a disease that requires surgery, the problems that promoted that disease’s manifestation have been there for quite some time.”
How do we: Maximize the healing potential before, during, and after treatment while also helping to prevent patients from getting a similar illness in the future? “Our surgical skill can only solve a portion of the bigger problem. Rather than merely “cutting things out,” how do we help our patients understand some of the things that led to the problem and offer prevention choices? Our surgical clinic will pioneer the offering of on-site integrative medical care. It was natural that we came together with Pacific Integrative Oncology due to our shared vision and goals. Drs. Dunn and Niesley focus on diet, supplements, acupuncture, and botanical medicine. This opportunity to focus on the intersection between evidence-based medicine from all angles of care is truly unique in our community. We are confident that this new venture will result in a more rewarding experience for both the patient and healer. While our primary focus will be breast surgical oncology, we have also used our model very successfully with endocrine surgery, hernia repair, robotic and general surgery. As we start the new year with a fresh perspective, we sincerely look forward to working with you and appreciate our medical community’s support.”
Reading Time: 3minutesWhen faced with a surgical problem, most people are not exactly sure how to find the right surgeon. We rely on our primary caregivers, family, or friends’ recommendations to help point us in the right direction. Unfortunately, friends, family, and primary caregivers never see the inside of an operating theater. They have no way of knowing what goes on in there. What is the demeanor? What is the relationship between the surgeon and the team? Is it a friendly team environment or one that is plagued by stress and “command & control” style behaviors?
The “operating theatre” was a non-sterile theater where students and other spectators could watch surgeons perform surgery, but they are no longer in use. Thankfully, contemporary operating rooms are devoid of a theatre setting and are aseptic, giving patients and surgeons the best possible environment for a successful surgery.
We assemble our team in the operating room carefully as every person has an essential and equally important role. Our surgical team methodically plans your surgery; in fact, at least 25-30 people have “touched” your surgical plan before you even come to the facility. Then, once you’re in the operating room, we take a team approach to give you the best outcome possible. We take our team seriously, invest in their wellbeing, and appreciate the work they do for you every day because we could not perform to our highest standards if we were without them.
“The strength of our team allows us to combine our individual talents for the patient’s best outcome,” says Mitch Wagner, CTS, a surgical technician at Day Surgery at RiverBend. Born and raised on a cattle farm in central Oregon, he understands that your team’s success relies on the feeling that your coworkers are like your family. When you know and care about each other, it is easier to create synergy, which makes an operation like a dance. There is a blend of well-rehearsed and improvised moves. The result is fun to watch, and the patient’s excellent outcome is profoundly fulfilling.
Heather Bowles, RN, BSN, CNOR, and OR charge nurse at Day Surgery, says, “Our team, and what we do together in the operating room is magical. Our patients are in their most vulnerable place throughout their journey as they enter our world. They aren’t able to fight or advocate for themselves, but we are, and we do, with excellence. We unite as their voice and fight for them. For me, it’s the most rewarding part of being in the operating room.”
We, at OSW, could not be more proud of our surgical teams. They are diligent, reliable, talented, and kind. They are accountable to each other, but most importantly, our patients can count on them. They help us do our best. So when you are contemplating your surgical needs, rest assured, if you choose an Oregon Surgical Wellness Specialist, you will not just be in the hands of your well-trained surgeon; the ever essential hands that you don’t see are there for you too.
(1.) Investigating Teamwork in the Operating Room, Engaging Stakeholders and Setting the Agenda Surg. 2017;152(1):109-111
Trust is at the heart of one of our core values: Integrity. And we firmly believe that you cannot build trust without transparency.
To improve our community’s health, we must serve all people from all backgrounds. As care givers, we want this commitment to be apparent to every patient with every touch and interaction. We believe that the health and wellness of all of our patients matter, and as a medical group, it is essential that we display this belief in our actions and deeds. Along those lines, OSW is committed to the following:
As we continue to grow, we promise to create the most talented and compassionate Wellness Team possible seeking well trained, energetic and compassionate members to join our team.
We commit to being mindful of our patients’ cultural origins and identities so that every patient, no matter their background, feels heard and understood.
We promise to create dialogue around healthcare’s social determinants to encourage measurable progress that significantly impact our community’s health as a whole.
We do not and shall not discriminate on the basis of race, color, religion, gender, gender expression, age, national origin, disability, marital status, sexual orientation, military status, or political affiliation in any of our activities or operations.
If you feel that we are not living up to our promises, please have a conversation with us; we’re committed to our growth. We appreciate your patience as we learn and grow as a new practice.
After stocking the boat with supplies and raising the mast, Dr. Christine Kollmorgen and her husband Dr. Charles Zachem, are ready to point their bow toward the lake and set sail.
Gliding across Fern Ridge Reservoir, they look out and see the sights and sounds of the lake. Birds swooping down to grab a fish out of the water, the wind whistling through the trees, and fog rolling off the reservoir during early morning’s light.
To be outdoors for them is not a rare occurrence, but rather a lifestyle that drew them together.
“We love the accessibility of the outdoors in the area,” Kollmorgen says. “One thing we love about living here is the great quality of life.”
In order to accomplish all her activities in a given week, Dr. Winnie Henderson seems to defy the laws of time and space.
Henderson, a surgeon with Northwest Surgical Specialists, serves on local boards, fundraises for charities, participates in surgeon registries, and travels on volunteer missions to donate her surgical skills. When asked how she makes time for it all, she laughs.
“You have to find the time if you’re passionate about things,” she answers, “so I do.” Also, she concedes, “I have lots of energy.”
Earlier in her career, Henderson earned a bachelor’s degree in chemistry, a master’s degree in biochemistry, and a Ph.D. in molecular microbiology and immunology. She spent seven years conducting scientific research, but ultimately decided to become a surgeon, graduating from medical school at OHSU in 2004.
Henderson, her husband, Bill, and their two sons have lived in the Eugene area for about eight years. Henderson says she feels lucky to be a part of the Lane County community, and she believes in giving back.
“I love doing what I do,” she shares. “I just came back from a surgery where I removed cancer from someone – it’s just a wonderful thing that I get to do.”
Henderson leans over her computer screen as she brings up consented images of breast cancer patients, eager to talk about her work as an oncoplastic breast surgeon.
Oncoplastic surgery, she explains, is a state-of-the-art surgical technique that not only removes cancer from the breast but also reconstructs the breast tissue to restore natural appearance after a surgical procedure.
Pointing at an image of a reconstructed breast, Henderson describes how the patient received hidden incision surgery, with cuts made in such a way that it’s difficult to tell which breast had been operated on.
“A lot of breast cancer patients ask me, ‘How am I going to look?'” Henderson says. “So I feel this is very important. It’s like an art to us, to make people whole again.”
Because cancer plays such a big role in her work as a surgeon, Henderson is a board member of the Oregon Cancer Foundation, a local nonprofit that provides assistance to community members receiving cancer-related services in Lane County.
Henderson also sits on the board of the Oregon Cancer Alliance (OCA), a team of cancer specialists from a variety of practices who collaborate to provide coordinated care for patients. Cancer treatment requires a multidisciplinary approach, Henderson says.
Radiologists, pathologists, surgeons, oncologists, and other specialists all play a role in addressing cancer. The OCA simplifies this complex process and makes sure that all providers involved in a patient’s cancer treatment are working together effectively.
Patient navigators guide patients through the steps of cancer treatment, connecting them with the resources they need to access care.
“Lane County has a culture of independent specialty care,” Henderson explains. “Even though we are all working in individual practices, we want to come together to care for a patient and treat that patient’s disease.”
In 2015, Henderson became an OCA board member after Dr. Robert Schauer, also a breast surgeon and a mentor of Henderson’s, retired and recommended her for the position.
“Since then, we have built a lot of momentum launching the different disease branches of the Oregon Cancer Alliance,” Henderson says.
Currently, the OCA has a breast cancer team and a gastrointestinal cancer team, and Henderson says that the alliance is now working to form a team for lung cancer and gynecological cancer.
While Henderson works with cancer specialists on a local level, she also contributes on a national level by participating in the Mastery of Breast Surgery program, run by the American Society of Breast Surgeons. The registry keeps track of surgical data from participating surgeons all over the country.
Like any good scientist, Henderson has a passion for data. She brings up her statistics on the Mastery of Breast Surgery website, which displays how her percentages compare to those of other surgeons participating in the registry. Not only can she quickly see her own data on re-excision rates and rates of infection, but she can look at the national averages on those metrics.
Henderson has close to 700 patients in the registry, and within the last year, she has started collecting survey data from her patients. The survey answers contain revealing information that helps Henderson see patterns in her work.
For example, mastectomies are usually outpatient procedures. In her survey, Henderson asks patients if their pain is controlled post-surgery. According to her survey results, patients are controlling their pain well at home.
“That suggests we’re doing the right thing,” Henderson says. “They can rest at home and not be in the hospital where they risk contracting bacterial infections.”
Besides the breast surgery registry, Henderson also participates in the Americas Hernia Society Quality Collaborative, a similar registry for hernia surgeries. Northwest Surgical Specialists is one of three practices in Oregon that participates in this registry.
Henderson admits that contributing to the registries takes time, but she credits her clinical assistants and summer interns with assisting in data entry. Ultimately, she says, she wants to see more surgeons in Lane County start recording their surgical data through online registries.
“By doing this and getting the word out there, what I’m really striving for is to bring the standard up in the entire community,” she says. “If I’m able to bring the standard up, my loved ones don’t need to go out of town to have surgery. For me, I see it as challenging the community to keep up with the latest information and improve quality.”
When Henderson says she likes to give back, she doesn’t just mean locally. Every other year, Henderson joins the Cascade Medical Team on a mission trip to Guatemala. More than 24,000 Guatemalans have received help from Cascade Medical Team, which does everything from providing surgeries to installing fuel-efficient, smoke-reducing stoves.
Henderson excitedly shares the numbers from her most recent trip to Guatemala – 110 volunteers, 150 cooking stoves, 1,185 patients treated, and 118 surgeries performed (with 23 of those performed by Henderson).
She pulls up a slideshow of the trip and points at the screen. “That’s my husband,” she says with a grin. “He was part of the stove team. He’s wonderful.”
It took eight hours to reach the abandoned hospital where the team worked for about a week. Since the water there isn’t potable, the team brought in their own cooks, and all drinking water came from bottles, which made tooth-brushing a “very strategic” endeavor, Henderson laughs.
While there, Henderson treated a woman with an umbilical hernia, a girl with a tumor, a woman with a clogged milk duct, a girl with a lump above her eye, and a man with an inguinal hernia.
“It’s a lot of hard work,” Henderson says, “but we also have so much fun.”
In a video made by one the volunteers, team members can be seen dancing and hamming it up for the camera, keeping everyone in high spirits. All labor is donated by volunteers, but Cascade Medical Team uses $80,000 in medical supplies and $30,000 for the stoves. The team’s main fundraiser is called “Docs & Ducks,” which takes place this year on October 14 at Autzen Stadium.
Henderson usually goes on the mission trip every other year, but she had a special reason to sign up for next year’s trip.
“My 19-year-old son wants to go on his first trip, so I just filled out my application for next year,” she says. “He plans to go into medicine also.”
“But,” she adds with a laugh, “he has to go to medical school first!”
By Amy Klarup, Director of Communications, Lane County Medical Society
