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 Women who saw primary care doctors for their annual checkup tended
to receive a broader range of services, compared to those who saw
obstetrician/gynecologists (OB/GYNs), researchers found.
“I think (primary care providers) and OB/GYNs can play an important
role in clinical preventive services,” said Dr. Mona Saraiya, one of
the study’s authors. “I think it’s important to be aware where there
might be deficits.”
Saraiya is an associate director within the Division of Cancer
Prevention and Control at the Centers for Disease Control and
Prevention in Atlanta.
She and her co-authors write in JAMA Internal Medicine that
well-woman preventive care visits are a core service supported by
the U.S. Health Resources and Services Administration (HRSA).
Well-woman visits should occur every year for women to get the
recommended preventive services, which include blood pressure
checks, tests for sexually transmitted infections and cancer
screenings, according to HRSA.
For the new study, the researchers analyzed medical records from
between 2007 and 2010 to see what services women typically receive
during a well-woman visit with a primary care doctor compared to an
OB/GYN.
They had data on about 281 million medical visits that occurred
during that time. Of those, about 63 million were for preventive
care.
The researchers found that 44 percent of preventive care visits were
to OB/GYNs and 56 percent were to primary care doctors.
Women who were 50 years old or older were more likely than younger
women to see a primary care doctor for their preventive care.
Saraiya and her colleagues found that women who saw OB/GYNs were
more likely to get screened for cervical and breast cancers,
Chlamydia and osteoporosis, compared to those who went to primary
care doctors.
Those who went to primary care doctors were more likely to get
screened for colon cancer, high cholesterol and diabetes and to be
counseled about diet, exercise and obesity, however.
The researchers could not assess how often doctors counseled women
about contraceptives because of limitations with the data.
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Counseling for other health matters, such as smoking, was low among
women who went to either OB/GYNs or primary care doctors.
Because women who went to primary care doctors tended to receive a
wider range of services, the researchers write that “women of
reproductive age who see OB/GYNs only for preventive care may not be
receiving the full spectrum of recommended screening and
counseling.”
Saraiya said there could be room for OB/GYNs to provide more
services to fill in any gaps. Also, primary care doctors in rural
areas may be able to provide more services when OB/GYNs are not
easily accessible.
The American Congress of Obstetricians and Gynecologists (ACOG) does
not have an official statement about whether OB/GYNs should also
serve as primary care providers. It does endorse annual well-woman
visits, however.
A spokesperson for ACOG wrote in an email to Reuters Health that
most state Medicaid programs recognize that OB/GYNs play a part in
primary care.
Saraiya said it will be useful to go back and look at additional
data to see if there are changing trends in the preventive services
women receive.
“We want to make sure we document where there could be room for
improvement,” she said.
SOURCE: http://bit.ly/1n8GLAW
JAMA Internal Medicine, online July 7, 2014.
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