A board ruling in September left some doctors flabbergasted: Why on earth had gynecologists been barred from seeing male patients? This wasn't just a "hmm, maybe not" thing: the American Board of Obstetrics and Gynecology told gynecologists that they could lose their board certification if they treated men. Now, the organization has backpedaled on its decision, since someone pointed out that gynecologists are typically better at detecting a rare type of cancer in men.
Anal cancer in men is usually sexually transmitted, and, like cervical cancer, is caused by the human papillomavirus. For these reasons, gynecologists are the medical professionals best trained to screen for it. It's a rare cancer, so when the board's September ruling came down, gynecologists scrambled to find other doctors who knew how to treat their existing patients. This past year, experts estimate that about 7,000 new cases of anal cancer, and 880 deaths from the disease, are expected in the United States, particularly amongst people with HIV.
After a group of doctors protested the new restrictions, the board reconsidered. Dr. Kenneth L. Noller, the board’s director of evaluation, says that the ban was lifted because they didn't want to upset doctors' relationships with their patients. Also, a federally-funded study on anal cancer is in the works, and men wouldn't have been able to take part in any research for it. And when $5.6 million of funding is at stake, it's probably not a good idea to limit the research to half of the population.
The September decision allowed gynecologists to only treat men "if they’re engaged in 'active government service"; if the treatment is the course of the "evaluation of fertility," or the "expedited partner treatment of sexually transmitted diseases;" or, in the case of a "newborn circumcision." Because it makes perfect sense for a government employee to get treatment while a common citizen can't.
Some doctors are calling out to ease the strictness of gynecology in general, especially procedures that are related to HPV. Since its inception in 1935, it is the only gender-specific practice in the United States' 24 medical specialties.
Dr. Elizabeth Stier, a gynecologist at Boston Medical Center, sees mostly female patients at her practice, but has treated more than 100 men at risk for anal cancer in the past year. If the board's decision would have been upheld, she would've lost all her male patients, some of whom she's been seeing for years.
“Cool heads have prevailed," says Dr. Mark H. Einstein, a gynecologic oncologist at Montefiore Medical Center in the Bronx. "This is the best decision for our patients.”