International Medical Conference Endometriosis 2025:
Endometriosis 2025: Your Mother Should Know, Your Doctor Should Know Better!
We Can Work It Out: Ethical Challenges in Multi-Generational Endometriosis Care - Frank Chervenak, MD
Dan Tamer. Thank you. I must say it's wonderful to be back with you again this year, and congratulations to Dan Tamer for putting this together. I know how hard it is to put a program like this together. It's an international program, not just the money, but the spirit, the enthusiasm. It's a tribute not just to these two individuals, but as Tamara said, the whole team to do this. It's a thing of beauty and we live in a troubled world, but moments like this are truly special. Now, when I got this invitation, I must admit Tamara and Dan, I was challenged. As you know, last year when I spoke, I discussed some ethical issues related to endometriosis. And there are some ethical issues working with Tamr and Amanda through the years in some clinical cases. But I learned the theme of this year's meeting was the Beatles.
And my first impression was, what the heck do the Beatles have to do with ethics? And what the heck do they have to do with endometriosis? So Tamara, you gave me some work to do, but I worked with my colleague Am Greenbaum, and we realized there's a lot to be said and I'll stay on time. First, I have to emphasize, Hippocrates was not the founder of Ethics for centuries. Medicine was a guild. All doctors were concerned about was making money. John Gregory and his contemporary Thomas Perceval in 18th century, great Britain, were the pioneers of professionalism and they had radical concepts. And this was at a time of rampant entrepreneurialism and they had fierce competition among different types of specialties. And he said, wait a minute. This is not what medicine should be. And Gregory and Perceval said, wait a minute, the patient should come first.
And we have an obligation to place the patient first. And they had global reach. Their work was translated in different languages. And indeed their own work formed the foundation of our own American Medical Association. So our debt to John Gregory and Thomas Perceval is immense. Now, let's go forward. The good news is I don't sing. I'll leave that to Tamer and the songs that'll be played in the interim. But the Beatles songs influenced so much. They have an ethical theme, and indeed they're related. Endometriosis is, I'll share. All you need is love. And some of the words are here. Core ethical principles are there, and they include compassion, integrity, and competence. Ethics explores moral principles and ethical frameworks. All you need is love and ethics. Give some direction how you give the love. It's a hard day's night and endometriosis is hard, not just at night.
The impact of endometriosis is on careers and dailies. Life is, everyone in this room knows pain disrupts daily activities. Diagnosis takes many years. Symptoms often dismissed by doctors and treatment options often remain limited. Help the classic Beatles song. And I'm telling you, there's still gaslighting that goes on as all of you who know, deal with patient, knows and dealing with Tamer and Amanda, many of the patients that they've seen. The gaslighting that goes on, even by some well-meaning doctors continues dismissing or minimizing a patient's symptoms, causing them to doubt their experience and delay seeking care. Even today, some of you in practice, often it takes months, if not years, for the patients to make them way to get to you. The hard days night, can't buy me love. Exhaustion and persistent pain, emotional and financial strain, unfulfilled desires for relief, limited understanding and support. Impact of socioeconomic status on treatment outcomes.
I'm looking through you highlighting the frequent invisibility on black women's pain and the need for healthcare providers to truly see and hear their experiences. The Beetles song captures this Delayed diagnosis, biases and misdiagnosis contribute to delayed care for black patients with endometriosis pain bias. Research shows that healthcare providers consistently underestimate black patients' pain levels, prescribing fewer pain management options, symptom documentation. Medical records frequently lack detailed documentation of black women's endometriosis symptoms impacting treatment quality and insurance coverage. This is all documented in cultural competency gap. Limited understanding of how endometriosis symptoms may present differently in black patients, plus communication barriers between providers and patients. Here comes the sun. A song that all of you know so well with the Beatles. There was the dawn of treatment that many of you in practice offer after years of pain and dismissal. Proper diagnosis brings the first raise of effective care and validation.
Warmth returns through management strategies and support activities once lost to pain become possible. Again, seasonal patterns. Understanding how symptoms fluctuate, helps predict and prepare for flare-ups and grow through pain, finding strength and advocacy and connecting with others strawberry fields forever. The chronic nature endometriosis symptoms cycle through lifelike seasons requiring ongoing adaptation, understanding that healing and management take time with both setbacks and progress. So you see, whereas forced, I thought Tamara was a little bit eccentric, I realized he had a wisdom, that there was something to be said for the Beatles. With this song Come together, this classic Beatles song is relevant to all of us. We need to build partnerships between patients, providers, and support systems for holistic treatment. Coordinating between specialists for comprehensive symptom management, such as Tam and Dan have done through the years with this wonderful organization, bringing together people of all the physicians, scientists, ethics to deal with endometriosis.
Now, you may say, what the heck do John Gregory, the Beatles and tamer section have to do with each other? They live in different centuries. What the heck do they have to do with each other? And I thought about it. They have a lot to do with each other. They're revolutionary thinking. Each brought transformative change in their feed. Gregory in ethics, the Beatles in Music, in Culture, and Tamr in Medicine, compassion and Humanity. Gregory in ethics, the Beatles message of love and peace and Tamara's dedication to improving patient care, highlight a shared focus on the wellbeing of others. So there is a commonality between what each of you are doing and the Beatles and the global impact. Each of these contributions have reached beyond their original spheres. And I emphasize Gregory with professionalism and ethics, timer and endometriosis and the Beatles with their musics and the legacy of excellence.
Each is regarded as a leader in innovator whose work has stood the test of time. And that's clear. There's a slide that's missing here. Good. Come. Good. Imagine I'll end with this song. This is a classic song. And again, this is so important. I think this is the goal of this wonderful group that Tamara and Dan and this whole society of brought together, this so much has been accomplished during the past decades that you've worked together, the physicians, the scientists, but so much more needs to be done. Yeah, this slide was glanced over that at first they weren't connected, but they are connected. The goal is to continue this wonderful work and a life free from endometriosis pain. So many patients, you've been successful, but so much more work needs to be done on all fronts, both the clinical and scientific front. And indeed, this conference will take a giant step forward to accomplish this goal. Thank you so much for the privilege of being with you this morning. Thank you.
