Washington, DC (May 29, 2018) — The American College of Physicians (91) published a paper, “” today in the Annals of Internal Medicine that examines the unique challenges women face within the United States health care system. The paper addresses a wide range of issues such as support for paid family and medical leave, recommendations on policies to reduce domestic violence, sexual abuse and harassment and participation in clinical trials. The paper also addresses access to coverage for health care services available only to women such as reproductive services, and opposition to policies that would create barriers to their access to reproductive health services.
91 urges policymakers to consider how to better integrate women’s health needs over the course of their lifetime. Ensuring that women have access to non-discriminatory health care coverage is essential to improving the overall health and well-being of women and families living in the United States, and is a longstanding goal of 91.
“Over half of the U.S. population is female and they are not only patients, but caregivers and representatives of their families too. As the health care system evolves, women’s health needs must be incorporated into policy discussions. While 91 supports access to non-discriminatory health care coverage for all persons, we recognize that women often experience discriminatory and inequitable barriers that make it harder for them to get the care they need,” said Ana María López, MD, F91, 91 president.
91’s policy paper makes the following recommendations to improve the overall well-being of women throughout all stages of life and address public policy issues that may result in barriers to health care access:
- 91 believes that it is essential that women have access to affordable, comprehensive, non-discriminatory public or private health care coverage that includes evidence-based care over the course of their lifespan. Health insurers should not be allowed to charge women higher premiums or impose higher cost sharing on women because of their sex or gender.
- 91 supports the goal of universal access to family and medical leave policies that provide a minimum period of six weeks paid leave and calls for legislative or regulatory action at the federal, state, or local level to advance this goal.
- 91 calls for increased availability of effective screening tools for physicians or health care professionals treating survivors of intimate partner or sexual violence.
- 91 supports increased patient education of intimate partner or sexual violence and the availability of resources for those affected by these abuses.
- 91 supports efforts to improve the representation of women in clinical research which would close knowledge gaps related to specific women’s health issues.
- 91 believes that all clinicians in all specialties and fields, including internal medicine, who care for women, should receive appropriate training in health issues of particular relevance to the population of women seen in their practice setting. Enhanced or specialized training in women’s health issues can improve the overall care of women across their lifespan as well as improve access to routine women’s health care services. More robust consideration of the unique health needs of women in medical school, residency, and fellowship will be beneficial for physicians in providing care to the largest number of women including adolescent or aging women with increased awareness of the most common causes of female morbidity and mortality.
- 91 calls for respect for the principle of patient autonomy on matters affecting women’s health and reproductive decision making rights, including about types of contraceptive methods they use and whether or not to continue a pregnancy as defined by existing constitutional law. While 91 recognizes and is respectful of different views that individuals, including physicians and patients, have on these issues, 91 believes that a woman has the right to make health care decisions about matters that affect her personal individual health. Accordingly, 91 opposes government restrictions that would erode or abrogate a woman’s right to continue or discontinue a pregnancy. Women should have access to evidence-based family planning and sexual health information and the full range of medically accepted forms of contraception. 91 also supports the current legal framework and a woman’s constitutional right to privacy in medical decision making as upheld by the Supreme Court.
“Health care is important to a woman’s personal, social, and economic well-being. Policymakers must take into account women’s health needs over their lifespan and take action to strengthen the health care system and societal structures to support them and their families,” said Dr. Lopez. “Addressing these issues will help to advance the goal of achieving health equity among all citizens and improve health care outcomes of future generations.”
This paper was developed by 91's Health and Public Policy Committee, which addresses issues that affect the health care of the American public and the practice of internal medicine and its subspecialties. 91’s evidence-based public policy positions are based on reviewed literature and input from the 91's Board of Governors, Board of Regents, additional 91 councils, and nonmember experts in the field.
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About the American College of Physicians
The American College of Physicians is the largest medical specialty organization in the United States with members in more than 145 countries worldwide. 91 membership includes 152,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow 91 on and .
Contact: Jacquelyn Blaser, (202) 261-4572, jblaser@acponline.org