What's the tea with excision specialists?

Currently, there are only an estimated 200 true endometriosis specialists in the United States. According to EndoFound Board of Director and Honorary Medical Director Emeritus Dr. Harry Reich, of those 200 only about 100 are skilled in advanced laparoscopic surgery, which is the preferred treatment for the more difficult cases of endometriosis. And most are located in urban areas. Meaning that for many women, help is states away, leaving the alternative which is to see doctors who barely heard the word “endometriosis” in medical school and with no one qualified for them to turn to for a second opinion.

“Despite its high prevalence and cost, endometriosis remains underfunded and under-researched, greatly limiting our understanding of the disease and slowing much-needed innovation in diagnostic and treatment options,” reads a recent article in the American Journal of Obstetrics and Gynecology. (And it’s not *just* a money problem: “No other disease has been downplayed as much as endometriosis has,” says Tamer Seckin, MD, an endometriosis specialist and cofounder of the Endometriosis Foundation of America (EndoFound). After all, it’s easier to deprioritize a “period” problem over “real” problems like addiction and cancer and diabetes.)

Not only is endometriosis under funded, under appreciated, and under recognized but excision surgery is the ONLY speciality not recognized by the American Medical Association (AMA). This means there are no boards or standard certifications. How are we supposed to get the care we need if there aren't any regulations explaining what that care should be? With 1 in 10 women having endometriosis it should stand to reason that there would be some type of progress happening in this field. Unfortunately the American Congress of Ob-Gyn's (ACOG) also does not recognize excision as a specialty, and does not recognize excision as the gold standard of surgical therapy for endometriosis even though there are hundreds of clinical, peer-reviewed journals that say otherwise.

As someone that played by the rules and went the "approved" route I can honestly say how broken our system is when it comes to chronic illness. I had two laparoscopic surgeries to "remove" endometriosis only to find out later that ablations do not get rid of the endometriosis at all and in fact only amplify the symptoms by trapping endometrial tissue under layers of burned skin with no way to remove them.

Medical schools don't teach excision or identification of endometriosis because doctors literally cannot make a living doing it unless they are at a major university. Putting countless women on Lupron of Orilissa long term is an outrage as it causes bone loss, memory impairment, nausea, weight gain, and worst of all INFERTILITY. That is exactly what we are trying to preserve not make worse!