“Our findings suggest that physicians may perform hysterectomies to enrich themselves financially. The experts who led the discussion reminded us that gynecologists make the most money by doing surgery and that the highest fees we can generate come from hysterectomy,” he wrote.Ī Health Services Research study came to similar conclusions. “The topic was how to care for women in order to maximize our fee. Vincent’s Hospital in New York, cites an anecdote in his book “The Hysterectomy Hoax” (Doubleday, 1994) about a seminar on medical economics he attended. Stanley West, chief of reproductive endocrinology and fertility at St. Money may also play a role in some doctors’ decisions to perform hysterectomies, as opposed to the more time-consuming myomectomies-although the fees for each procedure are roughly comparable.ĭr. The college estimates that about 10% of those who had a myomectomy needed “subsequent treatment” for recurring fibroids. Nevertheless, another reason for favoring a hysterectomy is that there’s no chance of recurring fibroids. And the myomectomy has lower rates of infection and injury to the ureters, the tubes that carry urine from the kidney, the college said. “If he says ‘two,’ maybe you should talk to somebody with a little more experience,” he said.ĭespite that, the American College of Obstetricians says the risks of bleeding and post-op complications are only “slightly higher” with a myomectomy than with a hysterectomy. Indeed, Barad said that a woman thinking about getting a myomectomy should ask the doctor how many he or she has done in the last three years. Regardless of the approach, controlling the bleeding inside the uterus is also more difficult than with a hysterectomy, because the doctor must control bleeding in all the vessels inside the uterus and in the fibroids-not just the blood supply to the uterus. David Barad, director of the Montefiore Medical Center’s fertility and hormone center in Dobbs Ferry, N.Y., said if a woman has many fibroids, or large ones, cutting and withdrawing them by these methods can be complicated, less effective and time-consuming. Usually done with an abdominal incision, myomectomies can also be done using a laparoscope, a long skinny tube inserted into the belly button, or a hysterscope, a long tube inserted in the vagina. Diana, a 38-year-old massage therapist, recently underwent a four-hour myomectomy to remove 35 benign tumors-one at a time-embedded in the uterine wall. The operation can be done in less than an hour.īy contrast, a myomectomy can be a much longer operation. In an abdominal hysterectomy, which is the most common, the surgeon, using an abdominal incision, a “bikini cut,” detaches the uterus from the ligaments that hold it up and from the blood vessels that feed it, and then peels away the vagina from the cervix, the mouth of the uterus. There’s no question, doctors say, that in most cases a hysterectomy is a much easier operation. When surgery is necessary, there are several reasons that doctors appear to favor hysterectomies: 1) a hysterectomy is a quicker, easier operation with fewer chances of postoperative problems and no chance of recurring fibroids 2) unless a woman wants to get pregnant, many doctors do not believe a woman needs her uterus. study indicated that in some cases surgery is not necessary: Sixteen percent of hysterectomies performed among seven managed-care companies were performed for “inappropriate reasons,” and another 25% were done for “uncertain reasons,” according to the think tank’s study. Levine, vice chairman of obstetrics and gynecology at Columbia-Presbyterian Medical Center in New York City.Ī 1993 Rand Corp. “The bottom line is: Is the surgery necessary to begin with? That’s the primary question,” said Dr.
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |