It’s hard to believe that it’s been half of a century since President Lyndon B. Johnson signed Medicaid, along with Medicare, into law. Even though Medicare more commonly provides coverage for a smaller fraction of the patients in a typical ob-gyn practice, it still is an example of a national program that works very well, providing coverage for more than 50 million people. Over the past 50 years, Medicaid has grown to cover more than 71 million Americans — nearly one in ten women relies on Medicaid for health coverage which includes family planning, screening for breast and cervical cancer, and long-term services and support. In fact, Medicaid covered 45% of all U.S. births in 2010 and plays a critical role in ensuring access to pregnancy-related care. Without Medicaid, many women would struggle to access or be unable to afford the care we provide.
Earlier this month I received an email announcing the ACOG application for Committee service and I got to thinking about all of the exciting and different ways members can get involved with our organization. I also started to reminisce about my start with ACOG as a member of the Connecticut Section Advisory Council, many years ago. About the same time, I attended several Congressional Leadership Conferences and began to get a feel for the value of ACOG as the only organization that really represents ob-gyns across the country, as well as the patients we serve. That was in the late 1980’s, which started me down the path of holding various ACOG leadership positions; about 10 years later, I became section chair and a member of the District I Advisory Council, ultimately leading to the District I chair role in 2006.
Every step of the way, I had the opportunity to meet some amazing people from an ever-increasing geographical radius. As District I chair, I served with the other District chairs on ACOG’s Executive Board. At the national level, it works in many ways like it does at the section level. There is work to do, and if you want to be involved, you raise your hand and volunteer. ACOG has been a great way to give something back to the specialty that I love and the profession that I chose as my life’s work. So I continued to volunteer, worked on various committees, task forces and work groups from time to time, and became more involved than ever. I had the honor of being chosen for the office of secretary, my first national office, and served in that role for three years, learning more about ACOG, and myself. The rest is history as they say: before I knew it, I was President!
Ah, summertime is here again and you know what that means. Warmer weather and longer days: the perfect time to remind our patients (and ourselves) to enjoy the outdoors and get active in the fresh air. Walking, riding bikes, and swimming are all ways to work out while making the most out of the season.
This is not about getting back into a swim suit, but about fighting obesity. Just last month in my inaugural address, I challenged ACOG members to join me in the fight against obesity. Why? Because, in our country alone obesity claims 300,000 lives a year. The health hazards of being obese are quite well known: diabetes, heart disease, high blood pressure and stroke. Obese women are also at a higher risk for numerous types of cancer, including esophageal, pancreatic, colorectal, postmenopausal breast, endometrial, ovarian and renal.
Approximately 36% of adult women in the United States are affected by obesity, and that number has been on the rise. Therefore, physicians have been faced with the challenges inherent in caring for these patients. As ob-gyns, we are, for many patients, the only physician a woman sees on a regular basis. Moreover, we have highly trusted relationships with our patients due to the sensitive nature of our specialty. Ob-gyns are in an ideal position to help educate women and provide counsel on the importance of a healthy lifestyle and fighting obesity.
Come gather ’round people…
…If your time to you’s worth savin’
Then you better start swimmin’ or you’ll sink like a stone
For the times they are a-changin’ ~Bob Dylan
I began my ACOG Presidency this past Wednesday by reciting some of Bob Dylan’s famous verse from the 1960’s. It rings true today, especially in medicine and our specialty as obstetrician-gynecologists.
As the times change I thank our now past-president, Dr. John Jennings, for his leadership and friendship during this past year. With the counsel of his past president, Dr. Jeanne Conry, John tackled some of the very difficult issues facing our practices and our workforce. I will continue his fine work and advance it on behalf of our patients, our specialty and our organization, ACOG.
Serving as ACOG President is indeed an honor. It is also a significant responsibility involving accountability to the 58,000 members who pay dues to our organization. We are the premier organization advocating for obstetrics and gynecology and women’s health care. As ACOG members, we are above all things dedicated to striving for and preserving our reputation of excellence, our credibility and our integrity in the pursuit of the best in women’s health care delivery.
This has been an interesting and exciting year for me to say the very least. The meetings, the travel, the interactions with other medical societies, and advocacy efforts were all expected. Yes, there have been challenges, conflicts, resolutions, and clearly, many positive accomplishments. However, I did not expect that almost every waking hour would include some activity related to ACOG.
Medicaid is an integral part of our health care system and a crucial source of coverage for many of our patients. More than one out of every ten adult women in the US (13%) are insured by Medicaid. However, the promise of timely access to care through the program is limited by low reimbursement rates across most of the country.
On average, Medicaid pays a doctor only 59% of what s/he would earn for treating a patient with Medicare for the same primary care services. In some states, payments lower than the cost of care force doctors to limit the number of Medicaid patients that they can see, or not accept Medicaid patients at all.
For some women, alcohol is an occasional indulgence – a glass of wine with dinner, a cocktail at a special event. For other women, drinking is a much more frequent and dangerous activity. Thirteen percent of women in the US consume more than seven drinks per week, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA). And according to the Centers for Disease Control and Prevention (CDC), about 1 in 8 women and 1 in 5 high school girls report binge drinking.
Once again, Angelina Jolie Pitt is shining a bright spotlight on women’s health.
On March 24, Ms. Jolie Pitt wrote an op-ed piece for the New York Times in which she announced her decision to have a risk-reducing laparoscopic bilateral salpingo-oophorectomy (removal of her ovaries and fallopian tubes.) This is following her decision to undergo a preventive double mastectomy in 2013, after learning through genetic testing she carried a BRCA1 gene mutation.
Maternal deaths related to childbirth in the United States have been rising in the past decade. According to a 2014 report published in The Lancet, the maternal mortality rate in the U.S. is now more than double the rate in Saudi Arabia and Canada, and more than triple the rate in the United Kingdom.
To address this trend, ACOG and the Society for Maternal-Fetal Medicine (SMFM) recently issued Levels of Maternal Care, the first consensus document establishing levels of care for perinatal and postnatal women. It is the second document in the joint ACOG and SMFM Obstetric Care Consensus series.
This January, National Birth Defects Prevention Month, let’s dedicate ourselves to educating our patients about the importance of preconception planning – and lifelong health.
According to the CDC, birth defects affect 1 in 33 babies in the US every year, and 18 babies die each day as a result of a birth defect. Some are caused by genetic factors such as Down syndrome or sickle cell anemia. Others are caused by certain chemicals or drugs, including alcohol and tobacco. Unfortunately, however, the cause of many birth defects is not yet known.