Physician Spotlight : R. Keith Huffaker, MD
Physician Spotlight : R. Keith Huffaker, MD | R. Keith Huffaker, ETSU Physician and Associates, Department of OB/GYN, urinary incontinence, female pelvic medicine and reconstructive surgery, urogynecology

Physician brings new pelvic-floor treatments to region

Sometimes it can be lonely, being the only practitioner of a specialty branch of medicine. Not so for R. Keith Huffaker, MD, whose services are very much in demand by women throughout East Tennessee and the surrounding region.
Huffaker is the area’s only fellowship-trained physician in the practice of female pelvic medicine and reconstructive surgery, or urogynecology. And as such, he is opening up a whole new range of treatment options for women with pelvic-region disorders, and helping this branch of medicine get a toehold here.
He finished medical school at ETSU’s James H. Quillen College of Medicine, and then completed a three-year fellowship in his specialty at Scott & White Hospital and Clinic in Temple, Texas. After that, he returned to ETSU and set up shop in the summer of 2009, and began offering his services.
“Some of the common things I treat are pelvic-organ prolapse, the latter dropping of the uterus, urinary incontinence, all sorts of bladder dysfunctions,” Huffaker said. “I also deal with fecal incontinence, urogenital fistulas such as ones between the bladder and vagina, rectal fistulas, chronic urinary-tract infections, a whole range of pelvic issues.”
Huffaker’s vaginal and pelvic reconstructive surgery uses the patient’s own tissues to make repairs, and also uses procedures and technology to minimize invasive procedures. It didn’t take long for word of his specialty to get around, and for the referrals to begin coming in.
“I’m the only guy in East Tennessee right now, although there’s someone else coming to Knoxville this summer,” he said. “This is a fairly new fellowship field. The first official fellowship was in 1995, and there are only 25 of 30 spots a year in the United States, so there aren’t a whole lot of us out there yet. We do a lot of overlapping with gynecologists and urologists, so we’re getting referrals from them, and also working with them in some cases.”
The rewards of moving into a new field of medicine are many, and Huffaker says that he enjoys both the procedures themselves as well as the quick and complete recovery that patients usually enjoy.
“I like the reconstructive process, putting things back where they belong,” he explained. “So many of these patients demonstrate a quick turnaround, and are feeling remarkably better within a few weeks. If I were in something like gynecological oncology, you’re dealing with patients who are much more ill, and you don’t see that rapid recovery.
“I like to see a patient come in with a complaint, do a surgery and get a relatively quick response,” he continued. “I like to see them feeling much better, having a marked improvement in their quality of life and going on about their business.”
Huffaker also steers many patients away from the operating room, utilizing pelvic-floor therapy or a combination of treatment and therapy to get a positive result. He also has brought interStim, a form of sacral nerve modulation, to the area. This treatment for overactive bladder and urinary retention has been around for several years, and modifies the nerve input to the bladder.
“A lot of people from this area have been having it done at other locations, but now they don’t have to travel since I am performing these procedures here,” he said. “We’re building that patient population as well.”
Growing the specialty, and finding new ways of offering treatment within it, keeps Huffaker as busy as he wants to be—which is to say, pretty well occupied.
“I’m hopefully providing something that hasn’t been here before, and I like to think that there are benefits to offering minimally invasive vaginal surgery,” he said. “I am getting a lot of referrals, but also going out and meeting primary-care physicians and letting them know I’m around. And once I’ve seen someone and made a good impression, then I can build on that as well. I want to take good care of folks so they’ll tell their friends and family.”
Next up for Huffaker is robotic surgery, utilizing the da Vinci Surgical System® already in place in Johnson City. This will allow him to broaden his repertoire, so to speak, and add even more options for less-invasive surgeries and the resulting quicker recuperation periods. He also is keeping abreast of current research—and doing his own.
“We have everything that’s necessary here, so I’m working on all that has to be done to move forward with those,” he said. “There’s a lot of ongoing work in urinary and fecal incontinence, studies that are going on that are identifying new treatments and modalities. I read a lot of journals and conduct some studies myself. I had several papers published while I was working on my fellowship, and go back there twice a year to speak at conferences.”
By working with medical students both in Texas and Tennessee, he’s also able to ensure that more specialists in this new field are in the pipeline, so that he can continue to practice or delve more fully into research down the road. And, importantly, ensure that patients’ needs are met.
“A lot of people in this area didn’t even know this field,” Huffaker said. “I want to continue to grow this practice and offer patients a variety of services. My ‘pie in the sky’ dream is to have a standalone women’s clinic with a pelvic-floor center, incorporating services not only from me but also from urologists, physical therapists, and offer all the related surgeries and treatments that these patients need. It would be a totally different perspective for how we approach these things and would be really nice to see.”