Hysterical medicine

Hysterectomy (the surgical removal of the uterus) is often recommended and performed inappropriately.

An assessment to determine the appropriateness of recommending hysterectomies was conducted by the Department of Obstetrics and Gynecology at UCLA and published in the journal Obstetrics and Gynecology. The assessment reviewed the medical records for 497 women from Southern California who had hysterectomies between August 1993 and July 1995. Two sets of criteria for the assessment were used: an expert-physician panel, using the RAND/University of California-Los Angeles appropriateness method, and the American College of Obstetrics and Gynecology criteria sets for hysterectomies. The results were shocking. They revealed that 367 of the 497 women (70 percent) had hysterectomies performed that did not meet the level of care recommended by the expert panel and were judged to be recommended inappropriately. The most common reasons the hysterectomies were deemed inappropriate were lack of adequate diagnostic evaluation and failure to try alternative treatments before hysterectomy.

In a separate study, researchers at the University of North Carolina's Department of Medicine compared hysterectomy rates with the age of the gynecologist and discovered that younger gynecologists, educated more recently, performed far fewer hysterectomies than older doctors.