Ms. Berna, Ms. Cohn, and others have also expressed concern that ob.gyns.’ management of endometriosis – and the development of guidelines – is colored by financial conflicts of interest. The petition, moreover, calls upon ACOG to help create coding specific for excision surgery; currently, because of the lack of reimbursement, many surgeons operate out of network and patients struggle with treatment costs.In a statement issued in response to the protests, ACOG chief executive officer and executive vice president Hal Lawrence, MD, said that “ACOG is aware of the sensitivities and concerns surrounding timely and accurate diagnosis and treatment of endometriosis. We are always working diligently to review all the available literature and ensure that our guidance to members is accurate and up to date. It’s our aim that [diagnosis and care] are both evidence based and patient centered. To that end, we recognize that patient voices and advocacy are an important part of ensuring we are meeting these high standards.”
In an interview before the protests, Dr. Lawrence said the Committee on Practice Bulletins–Gynecology will revise its guidelines on the management of endometriosis, which were last revised in 2010 and reaffirmed in 2016. He said that he had spoken at length with Ms. Berna on the phone and had passed on a file of research and other materials to the Committee for their consideration.
On April 5, ACOG also joined the American Society for Reproductive Medicine and seven other organizations in sending a letter to the U.S. Senate and House calling for more research on and attention to the disease. NIH research dollars for the disease have dropped from $16 million in 2010 to $7 million in 2018, and “there are too few treatment options available to patients,” the letter says. “We urge you to [prioritize endometriosis] as an important women’s health issue.”
*This article was updated June 5, 2018. An earlier version of this article misstated Dr. Ken R. Sinervo’s name.