minimally invasive techniques: They often saw an obstetrician/gynecologist without that “sub-specialty” training.
Why is unclear, since all patients were treated at the same medical center and nearly all had private insurance.
It’s possible, Schneyer says, the doctors whom Black and Hispanic women initially saw were less likely to refer them to sub-specialists, perhaps due to “implicit biases.”
But she suspects that “disparities in awareness” might play a bigger role: White women may be more likely to know about minimally invasive options, or seek a second opinion.
Dr. Hye-Chun Hur specializes in minimally invasive gynecologic surgery at NYU Langone Hospital Brooklyn. She says that in her experience, some patients with uterine fibroids are indeed more likely to “doctor shop” and seek second or third opinions, while others accept the initial option presented to them.
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What can be done to combat this?
The onus should be on doctors, both Schneyer and Hur say, to explain all treatment options.
It’s also important for primary care doctors and general ob/gyns — the ones who refer women to sub-specialists — to be aware that minimally invasive procedures can often be done even when there are numerous fibroids or the uterus is large.
“A lot has changed in the past 20 years,” Schneyer shares. “More often than not, minimally invasive surgery is an option.”
For women who have traditional surgery recommended, Hur says, “seeking a second opinion is always a good idea.” But they should try, if possible, to get that opinion from a specialist in minimally invasive techniques, she adds.
Schneyer also stresses that non-surgical options are available, including medications that control bleeding caused by fibroids.
Any treatment, Hur says, needs to be individualized — based not only on symptoms, but a woman’s age and pregnancy plans.
Sometimes fibroids affect fertility, she notes, so some young women might consider having the growths removed, even if they are not causing symptoms.
That may be especially important, Hur says, for Black women, as they are at greater risk of developing numerous fibroids at a younger age.