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“Centres of excellence” and “specialist
care” are terms that are being brandished around
a lot at the moment, especially for endometriosis care.
And the terms are appealing, because we all want to
be treated by a specialist who works in a centre of
excellence to make sure that we get the very best care.
But, who is a “specialist”,
and what is a “centre of excellence”?
Most importantly: who decides if they are what they
say they are?
The answer is that no accreditation
system for endometriosis includes definitions of a “specialist”
or a “centre of excellence”. There are many
excellent physicians and surgeons who care passionately
about the welfare of women with endometriosis, but none
of them are accredited as specialists or centres of
excellence when it comes to being accountable to an
official body for the quality of the care they deliver.
Officially accredited centres or networks
of excellence may be the way of the future to ensure
that women with endometriosis receive consistent, multi-disciplinary,
evidence-based care that is peer reviewed regularly
[1]. Such centres would allow for continuity of care,
training of more (accredited) specialists, and form
the basis for clinical and scientific research into
the disease. Centres that focuses on all aspects of
endometriosis treatment would potentially also reduce
the prevalence of “hit and miss treatments”
and health care costs [2].
Today, “centres of excellence”
like this do not exit. At the moment, an endometriosis
specialist is someone who understands the disease and
its impact on a woman's life, and is prepared to discuss
and offer all the available treatments. An "endometriois
specialist" would not hesitate to refer women to
other professionals who are more skilled in advanced
laparoscopic surgery, assisted reproduction, pain management,
etc, to ensure that their patients get the utmost care
[3]. Using a network for specialist referrals can be
as important as having a physical centre.
We must also acknowledge that specialist
care is not just the responsibility of physicians: it
is also our responsibility. We must ensure
that we get the treatment we need and deserve. We can
do so only by taking charge of our own health.
Below are ten things to consider before
choosing your treatment”. When you are satisfied
that these criteria have been met, you will be ready
to choose your specialist or centre of excellence.
At this point, you will be working
with your physician (specialist!) to ensure
that your long-term treatment is the best option
for you. This is when the best outcomes occur
and we towards excellence: physicians and women with
endometriosis working together for the best long-term
results!
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