Saturday, November 30, 2013

DALLAS: Ob/Gyns may now treat men - but could always cut boys

NY TImes
November 26, 2013

Gynecologists May Treat Men, Board Says in Switch

by Denise Grady
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, ...

The ABOG website says:
In addition, to remain certified by ABOG the care of male patients is prohibited except in the following circumstances:
  • Active government service,
  • Evaluation of fertility,
  • Genetic counseling and testing of a couple,
  • Evaluation and management of sexually transmitted infections,
  • Administration of immunizations,
  • Management of transgender conditions,
  • Emergency, pandemic, humanitarian or disaster response care,
  • Family planning services, not to include vasectomy,
  • Newborn circumcision, and
  • Completion of ACGME-accredited training and certification in other specialties (see below). [Which raises the question, if not vasectomy, which protects women against pregnancy, why newborn circumcision? It looks as though the answer is "because it is there".]

... 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.

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