12/2 LARC, Healthcare, & Fertility Ethics: Top 5 Women's Health Articles

By Eva Martin, MD of Elm Tree Medical Inc.

In addition to celebrating the wonders of leftover Thanksgiving dinner (how is it possible everything tastes even better 4 days later?), this week was marked by some excellent Women's Health articles. This week's most popular health articles include: ultrasound and IUDs, the Commonwealth Fund healthcare report, ethics and ART, sales reps in the OR, and vaccination requirements.

1. Ultrasound & IUDs

LARC (long-acting reversible contraception) use has increased 5-fold over the last ten years, with ever more women choosing these long-lasting, effective, and easy contraceptive options. IUDs are the most popular form of LARC, but they can become malpositioned in the uterus, causing pain or bleeding. A great article on using ultrasound for identifying IUD position revealed this interested factoid: Using 3D ultrasound instead of 2D ultrasound can identify 19% more cases of IUD malpositioning.

2. Commonwealth Fund Healthcare Report

The Commonwealth Fund is a non-partisan group that surveys people across the world to determine the state of healthcare. Their newest survey included 11 high-income countries and 27,000 adults. Of all the countries surveyed, the US was the only one without universal healthcare. Their findings showed that Americans are sicker than citizens of the other countries, with 28% of Americans reporting two or more chronic illnesses. In comparison, the lowest rate of multiple chronic conditions was 14%. 

3. Ethics & ART

Assisted reproductive technology (ART) may be one of the most obvious meetings of humanity, healthcare, and cutting edge technology. Advances in reproductive technology have made pregnancy possible for thousands of women who could not previously conceive. However, reports of "three-parent" babies and "designer babies" remind us that the ethics of ART are not without nuance. A well-written article about leaders in Reproductive Endocrinology & Infertility at Harvard brings to light these questions, with the apt comment from Dr. Louise King, "The ick factor in ethics: What makes you uneasy demands to be examined."

4. Sales Reps in the OR

Medical device sales representatives are usually welcome additions to the OR team. They know everything about how to use and troubleshoot new technologies, and they are universally very nice people. However, watchdog groups are starting to question if these sales representatives have too much influence at the point of delivery of care. I am obviously biased, but my experience has shown that they are incredibly helpful in getting a team trained on a new device. I remember well the wonderful sales rep for our surgical robot; she always knew how to overcome all the little hiccups. Nevertheless, medicine has moved towards decreased involvement from industry, a move which many think has improved objectivity. 

5. Vaccination requirements

When I was a kid, we didn't worry about getting measles. However, a growing percentage of concerned parents are foregoing measles-mumps-rubella (MMR) vaccination for their children. Unfortunately, the lower vaccination rates are resulting in the re-emergence of diseases like measles. Now, pediatricians are starting to require that their patients get vaccinated after the 2015 Disneyworld outbreak of 131 cases of measles. Pediatricians feel responsible to care for all their patients, including those who cannot get vaccinations for medical reasons. Keeping the waiting room safe means maintaining the "herd immunity" that keeps measles at bay.

We want to hear from you! What was your favorite health article this week? What percentage of your patients have more than 2 chronic conditions? Do you require your patients to get certain vaccines?