|
OB/GYN Editorial March 2004
The Beginning of the End of Our Specialty?
Lee P. Shulman, MD
 |
We have witnessed over the past few months a veritable tsunami
of hormone therapy fears, malpractice and health insurance woes,
and nonstop erectile dysfunction advertisements. It doesn’t
seem to be a good time to be an obstetrician-gynecologist (OB/GYN);
indeed, the number of applicants for OB/GYN residency spots has
considerably dropped over the past several years. What was unheard
of five years ago is now a fact: Many training programs are not
filled. This must be the beginning of the end of our specialty.
We obviously have difficult issues that we need to address and
for which we need to seek assistance. The economic realities of
practicing obstetrics and gynecology have considerably worsened
in the past year—the rising malpractice premiums or the inability
to obtain insurance, declining reimbursements, increasing competition
from non-OB/GYNs—so much so that too many talented and experienced
physicians are prematurely leaving the practice of medicine. For
those who continue to practice, the challenges of incorporating
new advances while trying to allay the fears promulgated by inexperienced
and uneducated media outlets that seek to shock and self-promote
(while caring little as to the implications of their stories) are
daunting and time-consuming. Publishing corrections and apologies
two weeks later in an obscure portion of the paper do not reverse
the fear and concern brought about by the original article that
has led women to stop or fail to start effective therapies. And
at the same time, we are deluged with considerable advertisements
promoting clinical and therapeutic advancements for men and for
nongynecologic diseases.
Time to quit? Obstetrics and gynecology is finished? Absolutely
not! This is a wonderful time to practice obstetrics and gynecology.
Advances in genetics and physiology, as well as improved diagnostic
modalities, allow us to diagnose disease earlier and more effectively.
New therapies, from nondaily contraceptive options to nonoral hormone
therapies to surgical and medical bladder health interventions
make us more effective in preventing as well as treating the common
problems that face our patients. And as we better define those
problems through molecular biology and hormonal research, we are
poised, as no other specialty, to positively affect our patients
throughout their lives, from fetus to menopause.
We must aggressively seek solutions to the overwhelming problems
that face all of us, regardless of whether we are in a private
practice, clinic practice, or academic practice. I think that most
of us now realize that if “we don’t hang together,
then we shall surely hang separately.” But as we all work
to improve our practices and our practice of medicine, let us not
forget the influential role of the OB/GYN in medical developments
and clinical practice. And to this end, let us all be good ambassadors
of the specialty, encouraging the most talented men and women to
join our ranks and continue our missions and advancements.
Lee P. Shulman, MD
Associate Advisory Board Member
back to top
|
