Among Female Boomers
A New York gynecological surgeon wants to enlist financial advisors in a battle to protect the health and the wallets of female baby boomers by reducing the notoriously high U.S. hysterectomy rate.
The surgeon, Dr. Ernst Bartsich, says surgeons need to think twice before recommending hysterectomies and women need to think twice before asking for hysterectomies.
In most cases, “there is no need to do a hysterectomy if you dont have cancer or precancer,” Bartsich says.
For financial advisors, urging female baby boomer clients to consider alternatives to hysterectomy could be a good way to help those clients avoid disputes with health insurers over medical necessity, pressure to drain health savings accounts and complications that might lead to disability claims, Bartsich says.
Today, even though the American College of Obstetricians and Gynecologists, Washington, recommends that women undergo hysterectomies only after they and their doctors have ruled out all other options, U.S. women have a total of about 600,000 hysterectomies per year, according to a paper published by the U.S. Centers for Disease Control and Prevention.
Researchers have found that U.S. women are far more likely to have hysterectomies than women in other developed countries.
Doctors perform hysterectomies on about 0.4% of U.S. women and girls each year. The U.S. hysterectomy rate is about 3 times higher than the rate in Australia, a country where women tend to live longer than U.S. women, according to a report published in 2000 by the Organisation for Economic Co-operation and Development, Paris.
In 2000, a team led by Dr. Michael Broder, a researcher at the University of California at Los Angeles, reported that only about 24% of the 497 hysterectomies they studied clearly met ACOG criteria for determining whether women need hysterectomies.
Women who show signs that they are developing cancer of the uterus, or already have uterine cancer, do need hysterectomies, Bartsich says. But Broders team found that efforts to remove fibroids led to about 60% of the questionable hysterectomies.
Fibroids are noncancerous lumps inside the uterus, in the walls of the uterus or attached to the outside of the uterus. Because fibroids are somewhat rare in young women and even less common in women who have gone through menopause, the condition is far more likely to affect baby boomers than it is to affect women in other age groups.
Due in part to concerns about fibroids, about half of the U.S. women who are having hysterectomies are baby boomers, according to CDC data.
Wanting to deal with a fibroid is usually a bad reason to remove a uterus, Bartsich says. “It just makes sense to remove the fibroid and not the whole organ,” he adds.
Other women, including a senior female boomer in the Bush administration, Secretary of State Condoleezza Rice, are undergoing a procedure that cuts off the flow of blood to fibroids without removing any part of the uterus.
But, despite public health officials efforts to decrease the numbers of hysterectomies, too many gynecologists “are just routinely entrenched in their traditional approach,” Bartsich says.
For the brokers who sell health insurance and the health insurers that write the coverage, questionable hysterectomies translate into questionable claims.
A hysterectomy costs about $25,000. Even for women with serious health problems that do not respond to medication or other forms of nonsurgical treatment, doctors may be able to perform other procedures that cost less than $20,000, Bartsich says.
For sellers and manufacturers of group short-term disability, the unnecessary hysterectomies lead to unnecessary claims risk. Unnecessary hysterectomies add to claims risk because the women who have the procedures need at least 4 weeks to recover. In many cases, women who choose procedures other than hysterectomies, such as procedures that remove fibroids without removing the uterus, need only 48 hours to recover, Bartsich says.
Bartsich would like to see financial advisors educate boomer clients about the topic by including brochures with packets of other financial education materials and by publishing articles about the topic in their client newsletters.
Reproduced from National Underwriter Edition, April 15, 2005. Copyright 2005 by The National Underwriter Company in the serial publication. All rights reserved.Copyright in this article as an independent work may be held by the author.