There are moments in our practice when Dr. Howell and I realize that some of our patients do not realize the full scope of what we do on a daily basis. I have seen more than one patient who needed a surgical procedure, and after a full evaluation and discussion about scheduling, the patient asks, “And who will be doing the surgery?” Dr. Howell relates that patients have stated, “I see several pregnant patients in your waiting room…do you deliver babies too?” We both wear different hats, changing many times during a day at the office.

First and foremost, we are both doctors for women. We do not have male patients, though we work with many couples that include a woman and a man. One of the hats we wear is the obstetrician hat. We take care of women from the start of their pregnancies to the final postpartum visit. The care we provide involves prenatal visits, genetic screening, the ordering and interpretation of labs and ultrasounds, and seeing our patients through the entire process of labor and delivery. Dr. Howell and I have delivered well over 4,000 babies each, and it has been an extremely fulfilling part of our careers.

Another “hat” we wear is that of a gynecologist, and it involves many facets of women’s health. We provide primary care to our patients, teaching them preventative strategies that will hopefully enhance their lives. These strategies include cancer prevention, improved cardiovascular health, and ways to keep bones strong and free from premature deterioration. As women progress into the season of menopause, we are available to help them understand what they are going through, and recommend ways to navigate through this transition, including the use of hormone replacement therapy. We provide counseling and provision of contraception to women who need it. There are many who are unaware that a women has a 15 times greater chance of a mishap when getting pregnant versus being on a contraceptive. We strive to provide the best information so that our patients can be informed and make good decisions for themselves.

One unique gynecology hat we wear is the surgeon’s hat. We provide surgical solutions for women who need them, including minimally invasive ways to remove abnormal growths, stop irregular and worrisome bleeding, and recommend and perform procedures that lead to an accurate diagnosis when needed. We perform pelvic reconstructive procedures that lead to better bladder function and lessened prolapse issues. Many of our surgeries include the use of special scopes placed through extremely small incisions, either manipulated manually or with the use of robotics. Other than the head-and-neck region of the body, the pelvis (our area of expertise) is among the most complicated anatomical areas in which to operate. Dr. Howell and I are among the few gynecologists trained to perform vaginal surgeries to avoid large abdominal incisions if at all possible. We both find that this is becoming a “lost art” that newer doctors coming out of training are not equipped to do.

Many couples are burdened with the problem of infertility, having tried to conceive for over a year with no success. Counseling, diagnosing, and treating couples with this problem involves both of us putting on the infertility hat. We realize that 45% of infertility problems are due to the female, but 45% are due to the male (the remaining 10% are what we call “head scratchers”…no real explanation exists for the problem). We are one of the few practices in the entire Western Slope of Colorado that provides insemination procedures in our office whenever needed, including weekends and holidays. We are both experts in the diagnosis AND treatment of endometriosis, a disease that not only causes infertility, but can be a leading cause of pelvic pain for women.

I have attempted to summarize the many hats that we wear every day. Many are amazed to know that we are involved with so many areas in the treatment of women. The main reason that I chose to practice obstetrics and gynecology is the great variety of office-based and surgical practice. Both Dr. Howell and I have openings in our schedules to care for you and your loved ones and friends that may need our assistance. Please do not hesitate to give our office a call and let us help you!


–Dr. Pevoto