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Petitioning ACOG to Change the Standards of Care for Endometriosis Patients


The American Congress of Obstetricians and Gynecologists is being challenged by members of the endometriosis community, both patients and excision surgeons alike, in a new petition this week written by Casey Berna, a social worker, and patient advocate. Delays in diagnosis, ineffectual and impartial treatments of the disease, and a failure to update coding to include excision techniques, create unnecessary suffering for patients. In his March 2017 article, ACOG’s Tom Gellhaus, MD shared that up to “63 percent of general practitioners feel uncomfortable diagnosing and treating patients with endometriosis, and as many as half are unfamiliar with the three main symptoms of the disease.” This is a systemic problem.

Dr. Tamer Seckin has been an outspoken advocate for patients when it comes to changing the standards of care for endometriosis. He feels that part of the issue is that “ACOG is financed by drug companies.” ACOG admits on their website that “Developers and manufacturers of pharmaceutical agents and medical devices assist physicians in the pursuit of their educational goals and objectives through financial support of various medical, research, and educational programs.” They go on to say that “Physicians have a primary responsibility to act as protectors of the interests of their patients.” As many practitioners push palliative hormone treatments over excision surgery, the complete removal of endometriosis lesions, the question that must be answered is why? Do pharmaceutical interests outweigh the best interest of endometriosis patients?

ACOG very much focuses on obstetrics. They focus much less on preparing practitioners to do minimally invasive gynecologic surgery, never mind supporting the extensive training needed to perform endometriosis excision surgery. It is important to focus on training doctors to provide early diagnosis and advocating complete excision of the disease that is then sent to pathology to be verified.”
-Dr. Seckin
Co-founder of the Endometriosis Foundation of America

Dr. Seckin feels strongly that, “ACOG very much focuses on obstetrics. They focus much less on preparing practitioners to do minimally invasive gynecologic surgery, never mind supporting the extensive training needed to perform endometriosis excision surgery.” He goes on to say that “it is important to focus on training doctors to provide early diagnosis and advocating complete excision of the disease that is then sent to pathology to be verified.”

If patients, advocates, and surgical experts are calling for change, it is hoped that ACOG can make further improvements to ensure that patients suffering from endometriosis can better receive the minimally invasive treatment that they both need and deserve. Dr. Seckin remembers a time when laparoscopic surgery was considered too experimental by leaders in ACOG. While that has since changed, it wasn’t easy. In an article dating back to 2008, former SLS President William Kelley Jr., MD, wrote, “Authoritative institutions must be convinced of the safety and efficacy of the changes relative to the comfortable status quo. Momentum always favors inertia. Fears must be overcome: fear of making mistakes, fear of failure, fear of established procedures becoming obsolete, and fear of established authorities losing control. Successful change requires timing and a force more powerful than the status quo.” [Kelley, William E. (2008) The Evolution of Laparoscopy and the Revolution in Surgery in the Decade of the 1990s JSLS. 2008 Oct-Dec; 12(4): 351–357].

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