October 11, 2016
By Margie Coloian, MSJ
When it comes to pregnancy, giving birth and getting good gynecological care, women are not always provided with the information they need to make good health care decisions. Too many women undergo hysterectomy, ureterectomy, C-section and other procedures without knowing about less invasive alternatives. A recent study, for example, finds that about 60 percent of reporting hospitals had excessive rates for C-sections.
That’s why the Women’s Health Council of the Right Care Alliance, co-chaired by Katherine ‘Trina’ Hikel, MD, and Kim DiGioia, MSPH, is eager to find out about the care some women are receiving by asking them during Right Care Action Week, October 16-22.
Members of the council will be handing out ‘what’s your biggest worry’ index cards to patients of midwives and doulas, as well as to mothers at daycare centers and mom-and-baby support groups. Council members hope to learn where there may be gaps in care from the written responses they will collect.
Hikel says patients can sometimes feel pressured to consent to tests and treatments even when the risks and harms associated with them are not discussed, or when there is no scientific evidence backing those tests and treatments. “Too many women have been treated drastically for medical conditions that are benign,” she emphasizes.
Some of the unnecessary treatments, Hikel cites, are for menopause management. “We need to stop treating menopause like it’s a disease,” she insists. “If a woman has hot flashes, she’s told there is something wrong with her, and treatment usually follows. Everything that happens is not pathologic.”
While Hikel applauds the more recent inclusion of independent midwifes and doulas into women’s care, she notes that in some states, they are being shut out, denying women access to all provider choices. Family physicians who want to offer these services are also prohibited from doing so in some states because of regulations, Hikel said. “Primary care doctors should be allowed to practice women’s health everywhere. And every childbirth should not necessarily be in the hospital setting,” she adds.
Nevertheless, some progress is being made. Informed patients are starting to ask questions, sharing their stories, and feeling empowered to just say ‘no.’ Clinicians and researchers are also questioning many of the tests and treatments they once recommended on a regular basis, like mammograms and PSAs, which have come under greater scrutiny recently, thanks to evolving science, the media, and information from organizations like the Lown Institute.
“That’s why I love the Lown Institute. Lown created the language—the language of overuse that is now well recognized,” she said, and listening is the antidote.
Hikel acknowledges that it’s not just women’s health that needs a do-over. She hopes other aspects of health care will be reformed in time, including the end of the corporatization of health care, hospital consolidations, acquisitions of high-priced, unproven technology and exorbitant CEO salaries.