December 2, 2013

Should gynecologists treat men?

Daily Briefing

    The American Board of Obstetrics and Gynecology (ABOG) recently barred certified ob-gyns from treating male patients, but an outcry from gynecologists has forced the board to reverse its ruling, the New York Times reports.

    Background on the initial ruling

    On Sept. 12, ABOG posted on its website a new, stringent definition of an ABOG-certified ob-gyn. Among other things, the definition limited the amount of time ob-gyns are permitted to spend on non-gynecologic procedures and insisted that members, with few exceptions, only treat women.

    The notice specifically barred ob-gyns from performing an examination called anoscopy on men. Anoscopies are performed the same way for men and women and involve using a tube and light to examine the anal canal for abnormal, potentially cancerous growths. Anal cancer, like cervical cancer, is usually caused by the human papillomavirus (HPV). Experts say that gynecologists are the quickest to learn the anoscopy procedure because of their experience in screening women.

    Survey: Women appear more willing than men to get preventive screenings

    Some doctors and other experts had pressed the board to reconsider its position, raising concerns that the new rule would prevent the most highly skilled doctors from treating male patients in an eight-year clinical trial on preventing anal cancer that involves 5,000 men and women. Patient advocacy groups had also called for a reversal, saying the new rules would make it harder for men to access screenings and treatment.

    Details of ABOG's reversal

    Last week, Kenneth Noller—ABOG's director of evaluation—said board members had reconsidered the rules and determined that ob-gyns had a long-standing tradition of treating both women and men for sexually transmitted infections, including HPV and its related problems.

    Further, Noller said the board recognized the importance of the trial and did not want to interfere. He also said the board did not want to "disturb the doctor-patient relationship."

    Boston Medical Center gynecologist Elizabeth Stier, who sought to participate in the study and had to stop treating male patients, said she is pleased with the board's revision. Stier said the male patients she was forced to drop would "be very happy" that she could "un-cancel them."

    Mark Einstein, a gynecologic oncologist at Montefiore Medical Center who also stopped treating male patients, said the revision is "the best decision for our patients" (Grady, New York Times, 11/26; Grady, New York Times, 11/22).

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    1. Current ArticleShould gynecologists treat men?

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