Page 42 - Diagnostic delay of endometriosis

Collaboration between health care providers
For most women, diagnosis was confirmed shortly after referral to a gynaecologist. Some women had multiple gynaecologist consultations before (complete) diagnosis, and participants observed an inequality in knowledge and skills between gynaecologists. A few women were diagnosed with endometriosis, but the full extent of the disease, in particular deep endometriosis, was not recognized from the beginning because of incomplete examination. Several participants encountered medical specialists other than gynaecologists because of their complaints, and many of them experienced that other specialists did not consider a gynaecologic condition or there was insufficient communication and collaboration between specialists.
“I just wished an internal medicine specialist or a urologist would think of it more easily. You’d say they work in the same hospital, why don’t you just call the gynaecologist to ask if they have any idea what is going on.” [E, 30 y/o, delay 11 years]
Table 1. Interventions to reduce diagnostic delay as suggested by the participants
Suggested interventions to reduce diagnostic delay
Improve knowledge about normal menstruation and endometriosis, recognizing of symptoms by GPs
Taking symptoms seriously and acknowledgement
More publicity about menstruation and endometriosis in general
Improve knowledge in other medical specialists and collaboration
Faster referral to gynaecologists by GPs Improve quality of physical examination Faster referral to specialized gynaecologist Multidisciplinary teams
Reduce waiting lists for centres of expertise in endometriosis No fertility treatment until complete diagnosis
Improve knowledge in gynaecologists
Number of participants
13
11 9
8
6 5 2 1 1 1 1
40 | Chapter 3