An ongoing dialogue on HIV/AIDS, infectious diseases,
November 23rd, 2013
OB/GYN Board Says Their Docs May Only Treat Women
Here’s a surprising move: The American Board of Obstetrics and Gynecology has decreed that gynecologists may only treat women. From the New York Times coverage:
In September, the American Board of Obstetrics and Gynecology insisted that its members treat only women, with few exceptions, and identified the procedure [high-resolution anoscopy] 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.
Many ID/HIV specialists will immediately see this move as strange, and potentially quite disruptive. At one of my practice sites, we refer all our HIV-positive patients who have anal dysplasia — men, mostly, but also women — to gynecologists who are skilled in high-resolution anoscopy, a procedure similar to colposcopy. Plus, on a national level, there’s an important ongoing clinical study that is evaluating whether this screening strategy prevents anal cancer; at least some of the co-investigators are gynecologists.
(FYI, we’ve been wondering about the efficacy of this in screening for anal cancer prevention for years.)
It’s also a strange move because, frankly, no such other restriction exists for any specialty — it’s tough even to envision such a thing, unless there’s a dermatologist somewhere out there who will only treat patients whose last names start with the letters Z, I, and T.
With the caveat that as an ID specialist, I’m far from the center of this debate, this action by the OB/GYN Board seems extreme. It’s doubtful that the relatively small number of gynecologists who perform this procedure on men will distract them sufficiently to negatively impact the health of women.
Perhaps it’s a “waiting room” phenomenon? My local expert says that women have grown comfortable seeing only other women at gynecology practices, and might find it strange to share the waiting room space with men. And we men do have a tendency to yuck things up — “boy slime,” is how my wife described the effect of sharing bathrooms with guys during college.
But she offers this logical solution: Let the gynecologists who are currently providing this clinical service and participating in research continue doing so. A statement from the board that such treatment is discouraged (but not forbidden) will certainly decrease the number of new gynecologists taking male referrals.