07/11/2025
You won’t find many doctors more compassionate than this one. We’ve been lucky to have him for all these years in MA and are so grateful for the work he continues to do to improve the standards of care for endometriosis 💛
Statement to the Joint Committee on Public Health, Dr Malcolm “Kip” Mackenzie, July 10, 2025
Dear Senate Chair Driscoll, House Chair Decker, and members of the Public Health committee,
My name is Malcolm Mackenzie, MD and I have practiced Obstetrics and Gynecology for over 30 years with the last 15 years spent working at Mount Auburn Hospital in Cambridge with a focused engagement in the treatment of endometriosis.
I strongly support all three of the bills proposed today, H.2527/S.1564 — An Act relative to the creation of an Endometriosis Task Force and S.1638 — An Act relative to endometriosis awareness.
I want to thank those who have authored and signed onto the bills related to endometriosis and thank those who form this Joint Committee on Public Health.
I submit this letter in support of legislation to address a disease that affects 10% of women, has devastating impact on their lives and where our paradigms of treatment, anchored to flawed theories from 1927, continuing to add to already a century of medical harm.
I have three points to make:
1) I have a practice experience that allows me to say that we in medicine have this all wrong. That ObGyn's particularly continue to fail as a specialty in treating endometriosis.
2) There is desperate need for a comprehensive strategic blueprint to address this disease, not just for the suffering of patients, but for the impact on their communities and on a health system that continues to pay for ineffective care. We need to elevate this to the public health issue it is.
3) My third point is that there is precedent for the legislative initiative proposed in today's House and Senate Bills. There is precedent where the care of endometriosis throughout the world for large populations of women suffering from endometriosis has been righted.
For the first 15 years of my practice, I treated patients with endometriosis, based on what I was taught in residency. What I had learned about diagnosis and treatment of endometriosis was wrong — evidenced by the fact that doing what I had been taught provided no relief to my patients and actually made things worse for them. I committed all the sins I now identify and criticize.
Motivated by failure, I read about the few Gynecologic surgeons throughout the world reporting effective treatment and durable relief based on an enlightened understanding of endometriosis and an advanced surgical skill set. What a concept: if a patient has a disease that causes pain and dysfunction and I take all of it out, not just some, not just burn it, not just try to suppress it with hormones, take all of it out, then they get better. What a concept! The excision surgery I performed, commonly had life-transformative, life-restorative effect. The good news is that there is a highly effective treatment option. The bad news is that like me for 15 years, healthcare writ large, moves too slowly to that goal. There are few surgeon experts in endometriosis, only a handful of training programs in advanced endometriosis, and up to 70% of ObGyn Resident graduates express a lack of confidence in managing the disease.
And what is the goal? And what is the direction that healthcare needs to take towards addressing and rectifying its failures?
• There is no strategic blueprint for guiding endometriosis research.
• There is no strategic blueprint for raising public awareness of endometriosis as the major national health issue that it is.
• There is no strategic coordinated training strategy to expand best surgical practices and specialized care.
• There is no comparative evaluation of the impact that various treatment approaches to endometriosis have on health care spending.
WE, as ObGyn's have failed as a specialty to provide comprehensive strategic leadership in the care of endometriosis. Mired in wrong paradigms we keep doing the same thing even though we know it doesn't really help. We need your HELP to help our patients with endometriosis.
The good news is that there is precedent to what is proposed in these three bills. Great Britain enjoined a task force to evaluate its approach to endometriosis. The recommendations included amplified advocacy, improvement in the patient experience, guidelines for treatment improvement, curriculum for provider skill development, rigorous systems for vetting endometriosis surgeons and rigorous clinical outcomes assessment. Never perfect but much better with method now in place for continued improvement. Australia in 2018 convened its own task force with similarly comprehensive conclusions. Denmark, Germany, France — The increasing focus on endometriosis at a global level emphasizes the growing recognition of the need for improved understanding, diagnosis, and treatment of this debilitating disease. And how about Massachusetts?
I hope we can listen to those patients who speak — but also hear those who suffer in silence — and convene a task force with teeth or a commission with comprehensive mandate to improve the quality of endometriosis care perhaps for ourselves but definitely for our daughters.
I am grateful for the opportunity to testify and ask that the Public Health committee report this legislation favorably as soon as possible. Thank you.
Sincerely,
Malcolm Mackenzie, MD
Mount Auburn Hospital
Founding member TEAM (The Endometriosis Alliance of Massachusetts)
