Monday, July 9, 2012

Update on bill, and promised award

Update on bill: the legislation is currently under review by Governor Cuomo's office. After researching the issue, Cuomo's staff will make a recommendation and then Cuomo will decide whether to sign. This is standard for any legislation.

The American Congress of Obstetricians and Gynecologists (ACOG) continues to do everything in their power to keep the bill from becoming law.  I hope they have the same success preventing signing of the bill as they had preventing the bill from being passed.

You may remember my open letter to ACOG chastising them for their lack of decorum while lobbying against the bill last month. To quote ACOG's own account of their visit: "The laughter from one of our tables could be heard throughout the Capitol Deli." I pointed out the gross insensitivity of broadcasting gaiety on the occasion of lobbying against legislation that will prevent unnecessary late stage breast cancer diagnoses. There is no more literal example of adding insult to injury.

ACOG District II Chair Dr. Eva Chalas's response to my open letter: Nada. Zip.  Is this surprising?  In her organization's calculus, we—the late-stage survivors and grieving families—are collateral damage. We are a hindrance to her organization's desire to maintain the current (sub)standard of care in New York. We and our late diagnoses are to be ignored.

ACOG says "The reaction to direct patient notification regarding a dense breast finding could result in
unintended consequences, such as unnecessary additional testing and invasive procedures."

First of all, are biopsies from suspicious mammograms unnecessary? Not all biopsies from mammograms are positive, but they are not called unnecessary. Biopsies from suspicious sonograms, which has doubled the detection rate for invasive cancers for women with dense breasts in Connecticut who opt for the screening. Unnecessary?

Second, isn't that for the patient to decide? Why is Dr. Chalas arrogating that decision for herself and other doctors? The intended consequence of this legislation is increased rate of early invasive cancer detection, and as cited above, it does this. Dr. Chalas omits mention of this. Again, women who could be diagnosed early don't matter.

You may also remember that I promised to confer the Dense Boob of the Month Award for June on a deserving recipient.

To be honest I really hoped to reserve it this award to a man, but I have decided to put aside my gender biases. Both men and women can be boobs.

And Chalas had little competition. (However, in the spirit of egalitarianism, I urge her to share the award with her laughing lobbying companions of District II. A list of them is below, from their newsletter.)

Two images of an extremely dense boob: left, and Dr. Eva Chalas at a Fall Fashion Festival on right.

This award is not as funny as it sounds. As many women have found out the hard way, dense boobs are a threat to public health.

I have more upcoming media appearances (including TV) and will keep you posted. 

The Laughing Lobbying Ob/Gyns (runner up boobs)
Matthew Blitz, MD
Ana Cepin, MD, FACOG
Eva Chalas, MD, FACOG, FACS
Cynthia Chazotte, MD, FACOG
K. Michelle Doyle, CNM, LM
Leah Kaufman, MD, FACOG
Nicholas Kulbida, MD, FACOG
Ellen Landsberger, MD, FACOG
MaryAnn Millar, MD, FACOG
Howard Minkoff, MD, FACOG
Allen Ott, MD, FACOG
Lawrence Perl, MD, FACOG
Hartaj Powell, MD, MPH, FACOG
Mary Rosser, MD, FACOG
Naomi Ufberg, MD
Ronald Uva, MD, FACOG
Mary Margaret Wilsch, MD, FACOG

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