From 2007 to 2010, an average of 281,406,600 medical visits occurred annually in the USA according to data from medical records of national representative visits to office-based physicians and visits to outpatient departments. The current study analyzed 63 million preventive care visits, of which 44% were visits to OB/GYNs and 56% were to primary-care doctors . Women 50 years or older had a higher percentage of preventive care visits to general practitioners (GPs) than younger women: for age 30–49 years, 55% of women saw OB/GYNs vs. 45% who saw GPs; for age 50–64 years, 38% vs. 63%; and for > 65 years old, 19% vs. 81%, respectively ([i]p[/i] < 0.001). The OB/GYN visits focused predominantly on reproductive health-related services, whereas visits to GPs provided a wider range of services and higher volume of counseling, even among women of child-bearing age. 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. Contrarily, 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. To note that the majority of the total medical visits (about 82% of visits to OB/GYNs and 74% of visits to GPs) did not report on counseling. Because physicians have had little to no incentive in most payment systems to document counseling performed during clinic appointments, counseling services may have been underestimated.
Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Stormo AR, Saraiya M, Hing E, Henderson JT, Sawaya GF. Womens clinical preventive services in the United States: who is doing what? JAMA Intern Med 2014 Jul 7. Epub ahead of print
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