young african american woman suffering from abdominal pain while sitting on bed

‘Below the Belt’ Exposes the Silent Crisis of Endometriosis Care

By Timothy Bonis

Premiering tonight on PBS, the film Below the Belt sheds light on endometriosis by documenting four women’s experiences with the disease.

Endometriosis is a silent crisis. One in ten women have it, yet, on average, people with the condition see seven doctors before they get diagnosed. Many experience severe pain, and the disease costs the American economy $80 billion annually in lost productivity, but the standard treatments are outdated and ineffectual.

Below the Belt exposes the failures in practice and policy that have led to the poor state of endometriosis care. Medical students usually don’t learn about endometriosis in medical school, and as a result, most general practitioners can’t recognize it. The majority of gynecologists treat endometriosis with hormones — which have serious side effects and bring little relief — and an ineffective surgery called ablation. Others continue to recommend the 20th-century approach, a hysterectomy. This dismal selection of treatments reflects the state of endometriosis research; historically, the disease has received less than $10 million in research funding per year (compared to $1 billion for diabetes, an equally common condition among women).

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an ambulance parked at the entrance of an emergency department

Psychiatric Care in Crisis

By Zainab Ahmed

Psychiatric care in the Emergency Department is all-or-nothing and never enough. Often, legal holds are the only intervention available, and they rarely are therapeutic. Upon discharge, our patients are, once again, on their own.

The ED acts as a safety-net for a failing health system, one that places little value on mental health services, either preventative or follow-up. The demand for acute psychiatric care is high; however, EDs have little physical capacity for psychiatric patients.

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Surgeon and anesthetist doctor ER team with medical clinic room background.

On Experiencing IBD as a Woman

By Amalia Sweet

At the end of last summer I stopped eating. It wasn’t that I wasn’t hungry — I was, constantly — but rather that pretty much everything I tried to put in my stomach triggered excruciating abdominal pain. 

While still in Chicago where I was working toward my master’s degree, I went to University Health Services. When tests revealed I was anemic but free of ulcers and Celiac disease, they suggested I work to reduce my stress and follow up with a gastroenterologist when I returned home to Boston later that month. 

I called every medical practice I could think of in the greater Boston area and no one had availability sooner than four months out. Without a primary care physician and desperate for a diagnosis, I went to the ER. In spite of my anemia and the fact that I had lost a scary amount of weight in a short period of time, the ER refused to provide a prioritized referral and told me my symptoms were a product of me being sedentary when in fact I was sedentary because of my symptoms. 

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AI-generated image of robot doctor with surgical mask on.

Who’s Liable for Bad Medical Advice in the Age of ChatGPT?

By Matthew Chun

By now, everyone’s heard of ChatGPT — an artificial intelligence (AI) system by OpenAI that has captivated the world with its ability to process and generate humanlike text in various domains. In the field of medicine, ChatGPT already has been reported to ace the U.S. medical licensing exam, diagnose illnesses, and even outshine human doctors on measures of perceived empathy, raising many questions about how AI will reshape health care as we know it.

But what happens when AI gets things wrong? What are the risks of using generative AI systems like ChatGPT in medical practice, and who is ultimately held responsible for patient harm? This blog post will examine the liability risks for health care providers and AI providers alike as ChatGPT and similar AI models increasingly are used for medical applications.

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Doctor wearing glasses listening to female patient.

Physician Free Speech and the Doctor-Patient Relationship Post-Dobbs

By Lynette Martins and Scott Schweikart

Laws regulating physicians’ professional speech – i.e., what they can and cannot discuss in the exam room with patients — have made a resurgence in the post-Dobbs era. These so-called “gag laws” have primarily targeted physicians’ speech around firearms, reproductive rights (predominantly abortion), and, less frequently, conversion therapy.

In the abortion context, these restrictive laws impact not only patient access to critical medical services, but also the fundamental underpinnings of the physician-patient relationship.

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Child holding paper family in LGBT rainbow colors.

Gamete Regulation and Family Protection in a Post-Dobbs World

By Courtney G. Joslin

Increasing numbers of people are forming families through assisted reproduction. Recently, there has been a push to impose new regulations on various aspects of this process. Some of these new laws open up participants to a range of possible penalties — civil, criminal, and/or professional discipline — for past “misconduct.” Other laws seek proactively to regulate the fertility care process. For example, some laws regulate the collection and dissemination of medical and identifying information about gamete providers — that is, sperm and egg donors. Other proposals seek to require gamete providers to agree to the release of their medical records.

It is surely important to assess and evaluate fertility care practices and to consider whether additional regulation is appropriate in this space. Particularly in the post-Dobbs era — an era marked by increasing attacks on reproductive health care (including access to IVF) and on LGBTQ people — it is also important to proceed cautiously and to consider how these proposals may adversely impact reproductive autonomy and family recognition.

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Anonymous crowd of people walking on a busy New York City street.

‘We Want Them Infected’: An Excerpt from Jonathan Howard’s New Book on the COVID-19 Pandemic

This excerpt from the new book titled “We Want Them Infected” is printed with permission from Jonathan Howard, MD and Redhawk Publications.  

By Jonathan Howard

On June 29, 2021, Dr. Harriet Hall penned an essay on the website Science Based Medicine titled “A New COVID-19 Myth?” in which she wrote:

A correspondent suggested I should have known that the pandemic was over months ago. That’s obviously a myth. But where did that idea come from?1

I knew the answer. Even before the first wave peaked, doctors suggested the worst was over and that measures to control the virus were more dangerous than the virus itself. This message was repeated regularly throughout the pandemic.

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Remarkable macro view through the microscope at process of the in vitro fertilization of a female egg inside IVF dish in the laboratory. Horizontal.

That’s Criminal: The Choices Fertility Specialists May Have to Make

By Gerard Letterie

Fertility care operates in a delicate emotional space that demands complete trust across the consult table. Trust that decisions will be made with the patient’s best interests. Trust that guidance will be offered exclusive of any other competing influence, be it financial, personal, or convenience.

In a post-Dobbs setting, new, restrictive laws may disrupt this delicate equilibrium. This concern is materializing with an increasing velocity as states look to further limit reproductive autonomy.

Next in the crosshairs might be the disposition of embryos in the context of IVF. Dobbs has energized the pro-life movement to expand beyond abortion to other reproductive technologies within the context of the catchphrase “life begins at conception.”

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