Thread: Gynecologists may treat men
11.27.13, 09:26 AM #1
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Gynecologists may treat men
A professional group that certifies obstetrician-gynecologists reversed an earlier directive and said on Tuesday that its members were permitted to treat male patients for sexually transmitted infections and to screen men for anal cancer.
The statement from the American Board of Obstetrics and Gynecology eased restrictions announced in September, which said that gynecologists could lose their board certification if they treated men. Exceptions were made to allow certain procedures, but screening men who were at high risk for anal cancer was not permitted, so the September decision left some gynecologists struggling to find colleagues in other specialties to treat their male patients and to track those who were enrolled in studies.
Like cervical cancer, anal cancer is usually caused by the human papillomavirus, or HPV, which is sexually transmitted. This type of cancer is rare, but its incidence is increasing, especially among men and women infected with H.I.V.
Experts in anal cancer asked the board to reconsider its position, and some started letter-writing campaigns. Patient advocacy groups expressed worry that the prohibition would interfere with research and make it harder for male patients to find screening and treatment.
The board had said it wanted to protect the profession as a female specialty and limit the nongynecological work performed by its members. But Dr. Kenneth L. Noller, the board’s director of evaluation, said board members had reconsidered and realized that gynecologists had a long tradition of treating sexually transmitted infections in both men and women, and that HPV and problems related to the virus fell into that category.
In addition, he said, the board recognized the importance of an coming study on anal cancer, funded by the federal government, and did not want to interfere with it. Finally, board members said that they did not want to “disturb the doctor-patient relationship.” Dr. Elizabeth Stier, a gynecologist at Boston Medical Center who had been forced to drop male patients who had been in her care for years, said she was happy and relieved to hear that the board had changed its mind.
“Having canceled all the men out of my clinic, I now have to un-cancel them,” Dr. Stier said. “They’ll be very happy.”
Dr. Mark H. Einstein, a gynecologic oncologist at Montefiore Medical Center in the Bronx, who had also been compelled to stop treating male patients, said: “Cool heads have prevailed. This is the best decision for our patients.”
Though most of Dr. Stier’s patients are women, she also took care of about 110 men last year who were at high risk for anal cancer. Screening tests for anal cancer involve techniques adapted from those used to screen women for cervical cancer. Dr. Stier had undergone extensive training to detect cancers and precancerous lesions in the anus, and she will be involved in the federally funded study of men and women, aimed at finding out whether screening and treating precancerous growths can prevent the cancer. The statement issued in September would have barred her from screening or treating men in that study.
A version of this article appears in print on November 27, 2013, on page A14 of the New York edition with the headline: Gynecologists May Treat Men, Board Says in Switch"Watch what people are cynical about, and one can often discover what they lack.” -- Gen. George S. Patton
11.27.13, 10:04 AM #2
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Cool. I hope they all save some lives.
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