By DENISE GRADY JAN. 30, 2014
Daniel Davidson, in a system to help him use his laptop, had an appointment to treat his pelvic pain canceled because of a ban. Rajah Bose for The New York Times
After months of protest from doctors and patients, a professional group that certifies obstetrician-gynecologists has lifted a ban it imposed in September and now says its members are free to treat men.
The decision, announced Thursday by the American Board of Obstetrics and Gynecology, was a reversal of its September directive, and followed partial concessions the group had made in November and December in an effort to mollify critics.
Board members refused to be interviewed, butissued a statement in which the executive director, Dr. Larry C. Gilstrap, said: “This change recognizes that in a few rare instances board certified diplomates were being called upon to treat men for certain conditions and to participate in research. This issue became a distraction from our mission to ensure that women receive high-quality and safe health care from certified obstetricians and gynecologists.”
The uproar began last fall soon after the board, based in Dallas, posted on its website what it called “a more expanded version of the definition of an obstetrician-gynecologist.” A notice in a red box near the top of its home page stated that members were “expected to practice consistent with this definition,” and warned, “Failure to do so may result in loss of certification.”
The directive prohibited treating male patients, except in certain circumstances like circumcising newborns, treating transgender people or helping couples with infertility or genetic problems. The board also said members had to devote at least 75 percent of their practice to obstetrics and gynecology.
Doctors take such requirements seriously. Although board certification is voluntary and not required by law, doctors need it to work because most hospitals and insurers insist on it, as do many patients.
In an interview in November, Dr. Gilstrap said the board’s action in September was meant to protect patients and the integrity of the specialty because some gynecologists were practicing other types of medicine, like treating men for low testosterone or performing liposuction and other cosmetic procedures on women and men. And some, he said, ran ads offering those services and describing themselves as board certified, without specifying that their certification was in obstetrics and gynecology, an omission that could mislead patients into thinking they were certified in plastic surgery or some other specialty.
The first reaction against the September directive came from gynecologists who were screening men at high risk for anal cancer, using techniques similar to those used to detect cervical cancer in women. Few doctors had expertise in screening men for anal cancer, those gynecologists said, and they feared the ban would interrupt patient care and interfere with a major government-funded study aimed at finding out whether screening for precancerous growths can prevent the cancer.
The board initially refused to change its position, but in November, it relented on that point and gave members permission to continue screening men for the cancer.
More protests erupted. Doctors, patients and physical therapists implored the board to make another exception, this time for gynecologists who had expertise in treating men for chronic pelvic pain, a poorly understood condition that can be severe enough to leave patients unable to work.
RECENT COMMENTSJHL 23 hours agoAs a practicing Gyn who also performs other services, I applaud ABOG's decision to reverse its policy on not treating men. I am...
Ian Sankey 23 hours agoI actually know 2 Gynecologists and I can say for a fact they'll never treat other men, we've joked about this many times while discussing...
Bill 23 hours agoThey should move the American Board of Obstetrics and Gynecology out of Texas. Texans have crazy notions about women, sex and reproductive...
At first, the board denied the requests. Then, in December, it saidgynecologists could continue to treat men already in their care for pelvic pain, but they were not allowed to take on new cases.
The board’s troubles were still not over. On Jan. 10, a lawyer wrote, threatening to sue unless the prohibition against treating men was withdrawn. The lawyer, Tom Curtis of Nossaman LLP, based in Irvine, Calif., suggested that the ban violated antitrust laws. His client was Dr. David Matlock, an obstetrician-gynecologist in Los Angeles who performs a variety of cosmetic vaginal operations and also does liposuction on men and women. In an interview, Dr. Matlock said 4.7 percent of his patients were men.
A lawyer for the board replied to Mr. Curtis on Jan. 21, stating that the group was considering another revised definition — one that would delete the prohibition on treating men. The lawyer, Stephen L. Tatum, of Cantey Hanger LLP in Fort Worth, asked that Mr. Curtis “consider the revised definition before taking any further legal action.” Mr. Curtis provided copies of the correspondence to The New York Times.
On Thursday, the board announced its decision. The ban on treating men is gone, as is the requirement that members devote at least 75 percent of their practice to obstetrics and gynecology. Now, the board says members must devote “a majority” of their practice to the specialty.
David Margulies, the head of a public relations firm and a spokesman for the board, said in an email that the threat of a lawsuit had nothing to do with the board’s decision, and that “the changes were in the works prior to correspondence from Mr. Curtis.” Mr. Margulies said the board had begun considering the issue in November, after a New York Times article described doctors’ worries about patients at risk for anal cancer.
Stephanie Prendergast, a physical therapist in San Francisco and a past president of the International Pelvic Pain Society, a professional association, said by email that the ban on treating men had interrupted treatment plans for men with pelvic pain, and that Thursday’s decision was “a victory for patients.”