Changes over the past two decades have offered many advantages in gynecologic patient care, surgery and medicine. These changes have continued the past five years, more importantly, with advances in science and technology. While most changes have been of great benefit for patients and physicians, some may have negative effects in areas related to cost, reimbursement and patient-physician relationship without overall improvement in patient morbidity. The gynecologic physician may have their greatest challenge in dealing with these changes while not forgetting basic surgical and patient care methods. Our task is to provide current gynecologic medicine that is cost-effective, quality andevidence-based care while achieving both patient and personal satisfaction.