Wednesday, May 17, 2017

Women’s Health: Challenges and Advancements

By Raymond Moss Hampton, MD 
Midland Obstetrician-gynecologist; regional chair and professor, Department of Obstetrics and Gynecology, 
Texas Tech University Health Sciences Center at the Permian Basin

Women’s Health Week began this Mother’s Day, which presents a great opportunity to consider some issues facing women’s health care. Women’s health care is in the midst of some exciting, yet challenging, times. So much is changing, and so many good things are happening for women!

For example, advances in minimally invasive surgery, contraceptive options, prenatal diagnosis (diagnosing a fetus’s illness before birth), and preimplantation genetic testing (testing embryos for genetic disorders before implanting them in the mother during in-vitro fertilization) are now prevalent. Ultrasound capabilities show us pictures of the fetus we once never dreamed possible! Therapeutic options for gynecologic cancer, pelvic prolapse (when a pelvic organ drops and pushes against the vagina), urinary incontinence, or infertility issues give patients more choices with better results than ever before. Vaccines, such as the HPV vaccine, have now been shown to prevent not only cervical cancer but also vulvar cancer, anal cancer, and several head and neck cancers.

Advances in patient safety, quality improvement, and collaborative care are producing encouraging results in better patient outcomes and better care.

Of course, the challenges are significant at all levels, as well. Women in third-world countries face numerous health care disparities. In many places, there are no doctors or hospitals. Infectious diseases such as Ebola and Zika are significant threats. There are few vaccination programs, blood banks are found only in large medical centers, and free standing emergency departments are a dream. Given those obstacles, how can we help those people achieve basic levels of care?

Even here in the United States, we are not immune; women have their own set of health care challenges. The national health care debate and the repeal of the Affordable Care Act will directly affect many women’s access to care. Reproductive rights, in its many forms, is another hot topic on the national level.

In Texas, severe maternal morbidity (illness) and mortality (death) rates are unacceptably high. Access to care is threatened, and health disparities across our state are significant and affect most adversely those who are underinsured or uninsured. The unequal distribution of physicians and health care providers continues to affect health care adversely in our rural areas. Hopefully, our lawmakers will come together and pass legislation that will improve access, advance new technologies, and effectively address the unique challenges facing our state, so that we are able to give all of our patients the high-quality care they need and deserve.

We physicians face challenges too, as we attempt to care for our patients. We are all adjusting to bundled payments and electronic health records, and wondering how we will be affected by programs such as the Medicare Access and CHIP Reauthorization Act of 2015, which outlines how physicians are paid for caring for Medicare patients. Patient satisfaction scores, workforce shortages, and rising insurance premiums weigh heavily on most of us.

All of that said, Women’s Health Week offers a great opportunity to stop and ponder the next generation of women’s health care; there is so much to think about! Are we up for the challenge? I think so, because we physicians are all dedicated to the patients we serve. And we remember and are motivated by the many wonderful women in our lives, and the challenges they have faced and overcome.

Let us all work together to improve their health in every way we can. They deserve our best.

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