[Update, 11/27/13: Denise Grady of the Times reports that the American Board of Obstetrics & Gynecology has reversed its position, meaning that its members may now be "permitted to treat male patients for sexually transmitted infections and to screen men for anal cancer." Here's a clear example of a story that made a difference. Congratulations to Grady.]
How many medical organizations would order their doctors not to treat certain patients, or else risk losing their jobs?
Thanks to a story by Denise Grady at The New York Times, we now know of one: The American Board of Obstetrics & Gynecology.
"To remain certified by ABOG, the care of male patients is prohibited," the board says, except in a few special cases. (The emphasis is the board's, as is the dangling modifier.) A obstetrician-gynecologist who loses certification can lose his or her job.
And do you know why we dare not allow obstetrician-gynecologists to treat men?
The board doesn't say.
Grady asked a couple of board officials, and their answers amounted to what my kids sometimes say when I ask why they don't want to go to bed: "Because."
“We haven’t heard of any compelling reason to change anything,” said Dr. Kenneth L. Noller, the board’s director of evaluation. Dr. Larry C. Gilstrap, the group’s executive director, said the specialty of obstetrics and gynecology was specifically designed to treat problems of the female reproductive tract and was “restricted to taking care of women.”
None of this would be of much interest to anyone other than gynecologists, except for this: Some of them have used their acknowledged expertise in treating cervical cancer to treat anal cancer in men, which is often caused by the same, sexually transmitted virus, Grady reports. She interviews one doctor who was shocked to discover that she could no longer continue her research on anal cancer in men, using techniques similar to those used to screen women for cervical cancer.
She and the director of a new study planned by the National Cancer Institute have asked the board to reconsider its position. "But the board, based in Dallas, has not budged," Grady reports.
Aside from its use of un-grammatical English, the board's statement would seem to allow treatment of men with anal cancer. The opening paragraph says that obstetrician-gynecologists "possess special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders…" This time, the emphasis is mine. Would not anal cancer in men be an associated disorder? It's caused by the same virus as cervical cancer and screened for in the same way.
Happily, one of the board's few exceptions is to continue to allow obstetricians to perform circumcisions. They can also deliver emergency care, but only if required to by their hospitals. An obstetrician-gynecologist who finds a male accident or crime victim dying in the street is apparently not allowed to touch him.
It's hard to imagine a reason for this strange behavior. But when people do something as crazy as this and won't say why, the explanation usually has something to do with money.