In This
Issue:
Everything You Need to Know About ARHP’S Annual Meeting
CLICK
HERE FOR PRINTER FRIENDLY VERSION
Joint
ARHP/NFPRHA/PPFA Annual Conference Features Clinical and Policy Tracks
The 2004 annual conference is scheduled for September
8–11, in Washington, DC—just seven weeks before the national
election. Register now online at http://www.arhp.org/conferences.
Reproductive Health 2004 will feature a combination
of clinical education on new technologies and practice trends, plus
the latest in reproductive health policy and advocacy.
More than 30 featured speakers include
Daniel Mishell, MD
Anne MacGregor, MD
Herbert Peterson, MD
The Honorable Henry Waxman (D-CA)
Other speakers include respected experts in the field
of reproductive health, such as Kurt Barnhart, MD, MSCE, Mitchell
Creinin, MD, Andrew Kaunitz, MD, Jeanne Marrazzo, MD, MPH, Susan Wysocki,
RN-C, NP, and many more.
Scheduled for September 8–11, 2004, at the Omni
Shoreham in Washington, DC, Reproductive Health 2004
will offer presentations on current research and clinical reproductive
health issues on a clinical track, and a special policy track sponsored
by the National Family Planning and
Reproductive Health Association that will include in-depth political
analysis, updates, and discussion of congressional, administrative
and state family planning issues. We expect more than 500 reproductive
health care providers, administrators, educators, and health policy
advocates to attend. We hope you will join them. We look forward to
seeing so many of our colleagues here in Washington, DC, in September.
[back to table of contents]
· Complete conference
agenda
· Online registration
form
· Hotel
and travel information for the Omni Shoreham
· Planning
committee and faculty
lists
· Learning
objectives and accreditation
information
If you can’t find what you’re looking for,
send an e-mail to ARHP staff at conferences@arhp.org.
[back to table of contents]
This is a must-attend event for those committed to the
health and well-being of women and their families. We look forward
to seeing you in September in Washington, DC.
Sincerely,
Emily Godfrey, MD
Chair, Reproductive Health 2004 planning committee
Wayne C. Shields
ARHP President & CEO
Judith DeSarno
President and CEO
NFPRHA
Vanessa Cullins, MD
Vice President for Medical Affairs
PPFA
[back to table of contents]
Member
Spotlight: Emily Godfrey, MD, MPH
Emily Godfrey, MD, MPH, became involved with ARHP by
attending Reproductive Health 2000 in Chicago. Later, she
was a recipient of the New Leaders in Reproductive Health Award,
sponsored by Wyeth-Ayerst, at Reproductive Health 2001. Since
then, she has been involved with many ARHP-sponsored programs, including
the annual meeting.
Dr. Godfrey has a strong commitment to family planning
issues and to women’s health: “As I went through medical
school, I knew that I wanted to work with women in ways that would
empower them. My introduction to reproductive health was when I worked
with Bob Hatcher as a fourth-year medical student, which was an amazing
experience for me. On this rotation, I was surprised, however, to
see that abortions were performed in the operating room, where the
experience for the patients seemed so lonely, impersonal, and detached.
As a family physician, I wanted to offer this procedure in ways that
were more personal, caring, and supportive for the patient. I chose
to do a fellowship in reproductive health so that I could learn not
only how to perform terminations but also other aspects of family
planning. I wanted to have training with which I could afford all
women the right to control their fertility so that having children
could be a choice.”
After completing a family planning fellowship in Rochester,
New York, Godfrey became an assistant professor in the Department
of Family Medicine at the University of Illinois and an adjunct professor
at the University of Illinois School of Public Health. Her responsibilities
include general patient care, research, and teaching a graduate-level
course in family planning to public health students.
“My main mission in coming to Illinois, however,
was to start a reproductive health training program for primary care
attendings and residents. Illinois is much more conservative than
New York, and I have had challenges in getting family physicians to
consider this training opportunity. I am confident, however, that
the Midwest will have its training program, and its importance will
be recognized.”
Dr. Godfrey has been involved in the planning committee
for the annual meeting for the past two years. Currently, she chairs
the planning committee for Reproductive Health 2004.
“Amy Swann and other ARHP staff help make the
planning process so easy. Thanks to them, planning committee members
can concentrate on sharing ideas, finding dynamic speakers, and including
innovative topics. This year, I am looking forward to experiencing
our collaborative planning with the National Family Planning and Reproductive
Health Association. I am excited that the conference includes a strong
political component and am eager to attend the Capitol Hill visits.
I am also looking forward to a new component called The Best of Contraception.
This is an opportunity for ARHP to highlight its official journal,
while attendees learn about the latest, exemplary, cutting-edge research.”
As a newer ARHP member and an up-and-coming leader in
the reproductive health field, Dr. Godfrey brings new perspectives
and ideas to the organization.
“ARHP is unique in that it includes all disciplines
in reproductive health and maintains close relationships with many
other reproductive health organizations. Over the years, ARHP should
continue to expand its membership with advanced practice clinicians
and primary care physicians. ARHP is not just for reproductive health
gurus but for anyone looking for solid evidence-based information
on reproductive health issues. Any clinician caring for men or women
of reproductive age should know that this organization is a valuable
resource.”
[back to table of contents]
Member
Feedback with Dr. Tyrer
Q: I read in your May Clinical
Proceedings, Periodic Well-Woman Visit: Individualized Contraceptive
Care,
the recommendation to discontinue breast self-exam advice. I strongly
disagree with this. So do my hundreds of patients who, through self-exam,
saved their own lives. Oh, by the way, the women who didn’t
do self-exam can’t always comment. Some, regrettably, lost their
lives to breast cancer. I am opposed to this recommendation. Can’t
this be reconsidered?
Sincerely,
JoAnn Woodward, NP
A: Thank you for your timely question
and for the very caring voice you bring to your patients.
The idea of not teaching breast self-exam (BSE) seems
counter-intuitive to all of us who care about our patients. Unfortunately,
the evidence is now very clear that systematic BSEs do not result
in reducing the incidence of mortality from breast cancer. This disappointing
finding has been reinforced by many significant studies. In the past
four years alone, the U.S. Preventive Services Task Force (USPTF)
and the Canadian Task Force on Preventive Health Care (CTFPHC) have
stopped recommending BSE because of the lack of evidence of benefit
and some evidence of harm.
As reproductive health care providers, we’ve had
similar disappointments about other routine exams that turn out to
have more limited benefit than we had hoped: pelvic exams for detecting
cervical cancer, x-rays for detecting lung cancer, and others.
The lesson for us is that instead of spending the limited
time we have with our patients performing routine exams we now believe
won’t help, let’s spend our counseling time reinforcing
evidence-based health prevention steps that have benefits. For example,
let’s talk about what our patient should do if she notices a
lump in her breast—a very different scenario than teaching BSE—or
how she can stop smoking or protect herself from sexually transmitted
infections.
For more information about this topic, visit:
USPTF: http://www.ahrq.gov/clinic/3rduspstf/breastcancer/brcanrr.htm
CTFPHC: http://www.cmaj.ca/cgi/content/abstract/164/13/1837
[back to table of contents]
Contraceptive
Pearl
Q: I’m familiar with the impact of birth spacing
on child survival, but are birth intervals also related to the health
of the mother in the developing world?
A: Yes, although it’s only the very short birth intervals that
appear to afford higher risk. In a very large study of over 520,000
births in 18 countries in Latin America, after controlling for a number
of variables, birth intervals of less than 15 months were associated
with maternal mortality levels that were 2½ times as high as
longer intervals. These short intervals were also associated with
higher rates of third-trimester bleeding, premature rupture of membranes,
puerperal endometritis, and anemia. Interestingly, very long birth
intervals (65 months or more) were associated with higher risk of
eclampsia and pre-eclampsia.
Reference: Conde-Agudelo A, Belizan J. Maternal morbidity
and mortality associated with interpregnancy interval: cross sectional
study. BMJ 2000;321:1255-9.
[back to table of contents]
Don’t
Forget to Vote: Board Elections
Ballots are in the mail. Only members in good standing
are invited to vote. If you have not received your ballot, your membership
may be expired or we may not have your correct mailing information.
Contact Joe Rodden right away at jrodden@arhp.org
or (202) 466-3825.
Your vote must be postmarked or faxed no later than
August 27. In addition to elections for ARHP’s board of directors
and board chair, this year members are being invited to weigh in on
changes to ARHP’s by-laws, including making a change to allow
voting online beginning next year. Be sure your opinion is heard.
Members will be asked to vote for four of the following
slate of candidates:
At-large board members:
Barbara Clark, PA*
Mitchell Creinin, MD*
Emily Godfrey, MD
Pablo Rodriguez, MD*
Michael Thomas, MD
*currently serving on the board
Board chair:
Lee Shulman, MD*
[back to table of contents]
NEWS IN REPRODUCTIVE HEALTH
Newer
Contraceptives Less Likely Covered by Insurance
In June 2004, ARHP, Black Women’s Health Imperative
(BWHI), and Planned Parenthood®
Federation of America (PPFA) released a ground-breaking survey of
health care benefits managers that examined the accessibility of newer
reproductive health options. The study findings show that newer reproductive
health options—such as contraceptive patches, rings, and new
sterilization methods—are poorly covered by insurance companies
compared with more traditional methods such as the birth control pill.
The study reveals that although these newer options and technologies
are approved by the U.S. Food and Drug Administration, many insurance
companies are not extending coverage for them as they have for procedures
and products that have been in use for years.
The survey, conducted by Greenberg, Quinlan, Rosner
Research Inc., found that benefits managers are relatively uninformed
about advances in reproductive health. Among the most surprising survey
findings was that although nearly 80 percent of benefits managers
rated their insurance coverage of reproductive health as “excellent
or good,” many newer reproductive health products and procedures
were not covered by their insurance plan.
Lack of access makes it difficult for women to have
the most effective reproductive health products and procedures available
today. Garnering coverage for new procedures is complicated by the
lack of employee requests for them and the overwhelming belief by
benefits managers that insurers make the decisions about coverage,
suggesting that any efforts to alter the scope of coverage requires
putting pressure on insurance companies rather than employees or internal
company management.
For more information or to read the full executive summary,
go to www.arhp.org/contraceptivecoveragesurvey.
[back to table of contents]
Medical
Liability Survey Reaffirms More Ob-Gyns Are Quitting Obstetrics
Washington, DC—The fear of being sued is the driving
force behind many obstetrician-gynecologists’ decision to stop
delivering babies, according to the latest medical liability survey
conducted by the American College of Obstetricians and Gynecologists
(ACOG). To read the full release, visit http://www.acog.com/from_home/publications/press_releases/nr07-16-04.cfm.
Barr
Lab Applies Plan B for OTC Status with Age Requirement
On July 22 Barr Laboratories resubmitted its application
to the U.S. Food and Drug Administration (FDA) to sell the emergency
contraception (EC) product Plan B®
over the counter (OTC) to individuals age 16 and older. Plan B, if
taken within 72 hours of unprotected sexual intercourse, can prevent
a pregnancy by 89%. Barr and other organizations believe the sooner
Plan B is taken the greater its effectiveness and having an OTC status
will provide greater access for those in need of the medication.
The FDA issued a “not approvable” letter
to Barr’s original application despite the overwhelming recommendation
from two FDA advisory committees to permit Plan B for OTC. In December
2003, the FDA advisory committees on Reproductive Health Drugs and
Nonprescription Drugs voted 23-4 to recommend Plan B for OTC status.
In May 2004, the FDA rejected the application on the basis that Barr
did not demonstrate that Plan B could be used safely by young adolescent
women for emergency contraception without the professional supervision
of a licensed practitioner. In its letter to Barr, the FDA said the
company has to prove the drug is safe for girls through research or
devise a plan that would keep Plan B on prescription-only status for
girls younger than 16.
The current application to the FDA is for the sale of
Plan B OTC for women age 16 and older. FDA has never approved a “mixed
marketing” OTC approach requiring pharmacies to check customers’
ages. Carol Cox, a spokesperson for Barr, said that FDA has “given
us every indication they’re willing to work with us on this
proposal,” adding that Barr will seek more safety data that
could eventually lead to OTC status for Plan B for women of all ages.
Dr. Scott Spear, chair of the national medical committee of Planned
Parenthood® Federation of America,
said that Barr’s new proposal is a “response to the political
realities created by the FDA,” adding that FDA’s call
for an age requirement for OTC status for Plan B is “bogus,”
adding “one could argue that younger women need [OTC availability]
even more than older women who have more resources at hand.”
Carole Ben-Maimon, head of research for Barr, said that the company
will “continue to work to increase the number of states where
Plan B is available in pharmacies without an advance prescription.”
To view ARHP’s position statement on contraception/EC,
visit www.arhp.org/aboutarhp/positionstatements.cfm?ID=30#5
For more news, visit ARHP’s Web site at www.arhp.org
and click on any of the scrolling headlines.
[back to table of contents]
CME
Opportunities: Coming Soon
Look for these Clinical
Proceedings® in
the mail and on-line in August and September:
Interstitial
Cystitis: Clinical Research and Management
New Developments
in Intrauterine Contraception
Choosing When
to Menstruate: The Role of Extended Contraception
|
