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Gynecologists Run Afoul of Panel When Patient Is Male
Submitted by Matt on Sat, 2013-11-23 19:57
Article here. Contact info for taking action is in the first comment. I have also made this item "sticky" so it stays the top-listed story until Tues. Nov. 26. Newer stories will still appear below it. Excerpt:
'But in September, the American Board of Obstetrics and Gynecology insisted that its members treat only women, with few exceptions, and identified the procedure in which Dr. Stier has expertise as one that gynecologists are not allowed to perform on men. Doctors cannot ignore such directives from a specialty board, because most need certification to keep their jobs.
Now Dr. Stier’s studies are in limbo, her research colleagues are irate, and her male patients are distraught. Other gynecologists who had translated their skills to help male patients are in similar straits.
And researchers about to start a major clinical trial that is aimed at preventing anal cancer, with $5.6 million from the National Cancer Institute, say the board’s decision will keep some of the best qualified, most highly skilled doctors in the United States from treating male patients in the study. The director of the planned study and Dr. Stier have asked the gynecology board to reconsider its position.
...
“We haven’t heard of any compelling reason to change anything,” said Dr. Kenneth L. Noller, the board’s director of evaluation. He said there were plenty of other doctors available to provide the HPV-related procedures that some gynecologists had been performing on men.
Dr. Larry C. Gilstrap, the group’s executive director, said the specialty of obstetrics and gynecology was specifically designed to treat problems of the female reproductive tract and was “restricted to taking care of women.” Of the 24 medical specialties recognized in the United States, he said, it is the only one that is gender-specific, and it has been that way since 1935.
...
The board had always regarded the treatment of women as its mission, Dr. Gilstrap said, but felt a particular need to emphasize it now because the specialty’s image was being tarnished by members who had strayed into moneymaking sidelines, like testosterone therapy for men, and liposuction and other cosmetic procedures for both women and men.
...
On Sept. 12, the board posted on its website a stringent and newly explicit definition of obstetrician-gynecologists, limiting the proportion of time they could spend on nongynecologic procedures and noting that, with few exceptions, members must not treat men. The notice specifically prohibited gynecologists from performing an examination called anoscopy on men.
...
Anoscopy involves using a tube and a light to examine the anal canal, which is about 1.5 inches long. ... Cancers usually require surgery, but doctors can burn off precancers in hopes of preventing cancer.
A similar approach led to a tremendous decline in cervical cancer in the United States, and doctors hope to accomplish the same for anal cancer. About 7,000 new cases of anal cancer, and 880 deaths, are expected in 2013 in the United States; the incidence has been increasing by 2.2 percent a year for the last 10 years.
...
If the trial shows that cancers can be prevented, it could change the standard of care, Dr. Douglas R. Lowy, a deputy director of the Center for Cancer Research at the National Cancer Institute, said in an interview.
Doctors planning to participate in the trial have had extensive training in high-resolution anoscopy. People with various types of medical training can learn the procedure, but experts say that gynecologists are the quickest to master it because of their experience in screening women.
...
Dr. Stier had been treating men for more than 10 years, and expected to enroll about 100 in the study. Now, she will be able to enroll only women. She is the only person with the special training at her hospital, so now another hospital will have to sign up more men.
But what really worries her is what will become of the men she has been treating. ... “My main issue here is that I don’t think my patients are going to get the follow-up that they need, and I think they’re going to be lost to care, and we take care of a very vulnerable patient population,” Dr. Stier said.
Dr. Einstein had also been treating some male patients and had planned to enroll men in the new trial. Like Dr. Stier, he was blindsided by the gynecology board’s notice.
He said only three doctors at his hospital had special training in high-resolution anoscopy, and that was nowhere near enough. Now two of those doctors, including himself, have to stop treating men.
“I think we’ll see significant setbacks,” Dr. Einstein said.'
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Comments
Contact info for ABOG
Am Bd of Obs and Gyn:
http://www.abog.org/
The To-Hell-with-men policy is
here. Note it specifically allows Board MDs to circumcise infant males. That's one of their few exceptions. Lovely.
"About Us" page here. They should add a section mentioning they're also fine with MGM and misandry generally. I mean, if the shoe fits! How about a Java applet that just blinks "MEN SUCK!", too?
Not only can you call the Board, but you can email some of its offices by clicking on the hyperlinked office names. (They have "click to email" next to them.) The two most important are likely the ones going to the asst. to the ED and the CFO, but it looks like the email page (http://www.abog.org/email.asp) is the same for both offices.
If you decide to call, please be polite. Make your point, perhaps pointing out how if there was a single-sex only medical specialty that served only men but whose MDs could help women in their research and treatment, it'd be aggressively condemned as exclusionary, sexist, misogynist, etc., probably reformed by now. The point is this: You know what they're doing, don't like it, and are out to stop it. That's all they need to know. As for email, not too much different.
It's pretty easy to find out where the MDs associated with the Board are practicing and their practice offices' phone numbers. Please do *not* call their offices! This will only work against the cause. MD offices are busy places and their staff is doing all it can just to keep up with the daily craziness. Their boss' poor choice of policy is not their fault, and you won't get a chance to talk to the MD anyway. But he'll find out that "those damned men's rights people are harassing the staff!" and it won't do the cause any good. In any case, the issue is not with the MDs' practices per se; it's with ABOG's policies denying men opportunities for getting the benefits of medical research that is also of great benefit to the specialty's primary target population, too. It's bad for everyone. So the right place to go for expressing disapproval is the organization itself, not members' or even its policymakers' medical offices.
Finally, you don't have to be an American to email these people. In fact, letting them know they're getting international scrutiny is very effective.
Sometimes, the NYT shows signs of decency toward men
Not often, though. And this has a PC spin: gay men, poor, non-whites. If those couldn't get worked in, would they have run it? Maybe.
Urologists' patients are predominantly male, but female patients are not restricted from seeing them at the Board level, certainly. Imagine the wailing and gnashing of teeth if they were? The ED of the Gynecology Board proudly proclaims that it's the only single-sex medical specialty in the US and by gum, we're gonna keeps it that-a-way!
Really that's something he ought to be whispering (if at all) as he heads for the nearest exit. Being Grand Poohbah of a medical credentialing authority that specifically restricts specialty-relevant health care access and research based on patients' indellible characteristics should be a source of great embarrassment, not pride. Perhaps soon enough, it will be!
a gynecologist is the last
A gynecologist is the last type of doctor I would want treating me for anal cancer especially if I were a man. I'm going to hold off on any criticism of this policy. frequently doctors want to cross over into other territories for financial reasons instead of referring patients to more qualified specialists, and patients may not get the best care. I personally believe there needs to be some oversite and regulations as to what a doctor and healthcare worker can treat.
From the article: "only three doctors at his hospital had special training in high-resolution anoscopy, and that was nowhere near enough. Now two of those doctors, including himself, have to stop treating men. "
So gynocologist who are trained to treat women, treat men with cancer because they know how to work the high-resolution anoscopy. Uh....that's a mechanical skill. That's like paying an Asian chef to cook you a French meal because he's the only one who knows how to work the oven.
This is Boston, it sounds like they need to refer their patients to another fascility if they dont have the expertise at their fascility.
OB/GYN's
OB/GYN's don't treat general health issues for women. They are specialists, their additional education focuses on conditions which effect women such as pregnancy, women's fertility, birth control, female hormonal issues, etc. I don't get what the incentive would be for MRA's to push OB/GYN's to see male patients. Men aren't getting left out, they have other docs to choose from and these other docs are probably more qualified to treat them.
Am I missing the point or something?....So far I get that you want a doctor who specializes in pregnancy to treat men?...Be careful what you ask for.
It is Discrimination!
Your analogy makes no sense, Kris. These people are trained to do anoscopies in women. It's the same procedure for men, just the gender of the patient is different. I do see this as discrimination.
I also wanted to point out how they vehemently reject working with male patients. . . unless they are infant males being forcibly circumcised. Matt beat me to the punch though. It is astounding how much cognitive dissonance it takes to defend this kind of crap.
Did you guys miss this?From
Did you guys miss this?
From the article: "there were plenty of other doctors available to provide the HPV-related procedures that some gynecologists had been performing on men."
None of the men were being denied access to care. IMO, these men should never have started treatment with an ob/gyn, but instead have been refered to a more qualified doctor.
yes, Kris, but
That same article stated that in one hospital, a female gynecologist was the only person who knew the procedure.
And she had clients who trusted her. She knew their medical histories.
And now the hospital is going to have to send these men out to new doctors who will necessarily order new tests; and this will take necessary time due to our litigious society and medical precautions. But they will not send the female patients out, even though the procedure is not directly related to gynocological issues.
And some of these men are dying.
And they started the procedure with her because it has been an N.I.H. approved grant.
And this is happening due to an anachronistic rule that arrogates health care under approved specialites.; a rule that, today, really makes no sense in light of the overlapping of skills in an era with contraints on medical care expenses; a rule that, indirectly, establishes one form of care only for women (without a corollary specialty for men dealing with prostate cancer or testicular cancer)
And, yes, I am aware that "birth" is an exceptional case in need of heightened specialities. But the issue is the "systemic" nature of the sexism: some of these men are dying and the system will not allow relief due to gender.
Finally, I do not know all about medical policy, but I would hazard a guess that if a woman, dying of breast cancer, was finding assistance with, say, a pediatrician or a psychiatrist experimenting with brain altering drugs, that an excpetion would be made.
The sexism here lies in the systemic resistance to better health care for men.
It's bigger than this study, or even the use of an analscope
Consider Doorknob Hospital, serving a geographically dispersed community. It serves a pop'n of, say, 100,000, but the area they are dispersed in is 1,000s of sq. mi. The closest other hospital is 1 or 2 hrs. away in some smaller city. To get to Doorknob Hospital, many ppl in the area may need to travel an hour or more anyway. To get to the city hospital, another hour. There is only one Ob-Gyn at Doorknob H. and the hospital has only 10 FT MDs anyway. This is reality for many ppl in rural areas, not theory.
Now, to keep his/her Ob-Gyn cert, the MD needs to limit the no. of men they see. For such a situation, it can easily mean deferred treatment for a man who may well need to be seen quickly but doesn't realize his symptoms can indicate a serious problem.
What could that be? Any number if things. How about a lump under his left pectoral muscle, something an Ob-Gyn would be esp. sensitive to. But the Ob-Gyn is also a just-plain MD. He or she's abilities are needed no matter. Denying men access to an MD for any reason simply because they're men is simply wrong. Specialties don't enter into it.
Or to take it in the other direction, arguing that a female having urological issues could go see an Ob-Gyn or "any other competent MD" and has no fundamental right to equal access if access is possible to her chosen MD simply because she's female would in essence be a form of "inexcusable sexist discrimination". But since urology doesn't insist it be for men only, it's not a problem for women.
But ABOG's stance *is* a problem for men. Any way you slice it, ABOG is advocating a fundamental violation of men's human rights: deny healthcare based on the patient's indellible charactristics.
I'm sorry Thomas, but I
I'm sorry Thomas, but I believe you are wrong, I think a pediatrician or psychologist would have their licence taken away if they were treating a woman for breast cancer.. (assistance from a psychiatrist would be ok as long as s/he was only treating her psychiatric issues, but not the cancer)
And just so you guys know, women cannot use gynecologists like regular MD, even if it during the course of a regular gynecologist visit. You can't say,"oh by the way, could you take a look at this..." (I tried that once)
"some of these men are dying and the system will not allow relief due to gender." -Thomas.
I didn't get that at all. I got that the men were dying, but no one is denying them relief or access to care. This "special procedure" is anoscopy, other doctors in the area are qualified. It is a shame the men have to switch doctors, but the OB/GYN's should not have started treatment with them or promised them care beyond what's permitted. I even supsect the OB/GYN's or hospital are motivated by the $5.6 grant money.
I disagree with many of the comments from you guys, I wrote out a long rebuttal to your points, but decided it was too long. So I'm just going to say I disagree, but respect your opinions.
If I thought allowing OB/GYN's to treat men was good for men, I would be supportive of it. So far I see it as possibly tricking uneducated or desperate/dying men into getting treatment by OB/GYN's instead of by more qualified doctors.
Yes, but
Kris, this is not standard care; it is a research study. And exceptions are in order and have always beeen made in studies.
If the rules say an OB/GYN must only treat the reproductive tract in women, why are women allowed in a study on anal cancer in the first place? Exceptions are made.
Even the chair of the group (in the article) says that excpeptions can be made. So these rules are never iron clad.
And I do think that if your OB/GYN were conducting a study on the issue you faced, AND if it were life threatening, then exceptions would be made.
Yes you are right, I think the issue involves money and the arrogance of authority. And it seems easier to flex policy muscles when the victims are men.