Should Your Gynecologist Be Your Primary Care Physician?

Written by yvonnethornton on October 17th, 2013

There is an ongoing struggle between patients, physicians, and managed care plans involving whether gynecologists should be able – or be expected – to serve as primary care physicians to women. Even among each group, there is disagreement on the best course of action. Patients may like the convenience of having only one main doctor. Gynecologists, while acknowledging that they do have adequate training to function as primary doctors, have conflicting preferences, with some believing that they should be primary doctors and others preferring to remain consultative specialists. Managed care plans allow women varying levels of access to gynecologists.

So how can a women decide what is right for her? Many women visit their gynecologists faithfully but never think about an annual physical. Others request physicals from their gynecologists. Still others visit both doctors regularly. The right choice depends on your preferences, the viewpoint of your gynecologist, and the guidelines set by your insurance company. One thing is certain: you need both exams yearly – a gynecological exam and a general physical exam – to promote good overall health and catch any potential problems early.

Why You Need a Yearly Physical Exam

During a physical, your doctor will not only perform a complete physical exam, but also discuss lifestyle habits, order appropriate screening tests, and administer age-appropriate immunizations. Lifestyle issues such as weight and tobacco use are discussed and plans formed for making positive changes.

Depending on your doctor’s style, your physical may include assessment of your vital signs, your family medical history, a heart and lung exam, a dermatological exam, an exam of your head, neck, extremities, and breasts. Blood tests may be ordered to screen for anemia, kidney disease, diabetes, high cholesterol, and other conditions. Depending on your age and history, other screening tests like colonoscopies and mammograms may be ordered.

An internist is experienced in managing high blood pressure, diabetes, high cholesterol, asthma, and other chronic conditions; they may also refer you to a specialist or coordinate your care with specialists you may already be seeing.

Why You Need a Yearly Gynecologic Exam

Regular physical exams are important, but it is equally important to take advantage of the specialized knowledge of gynecologists. When you visit a gynecologist for a well-woman exam, he or she can address issues such as fertility, birth control, sexually transmitted infections (STIs), cancer prevention, and other issues.

Gynecologists are also highly trained in performing pelvic exams and Pap smears, as well as counseling women on various health issues and lifestyle habits. Gynecologists also function as your consultants for major health issues regularly faced by women, now and through every stage of your life. At every age, there is a reason for a woman to see a gynecologist. She may need to discuss contraception, fertility, or genetic testing; she may need a clinical breast exam, a pelvic exam, or STI screening.

You decision about whether to see a gynecologist alone or a gynecologist and an internist depends on your preference, your medical history, your existing conditions, and the willingness of your gynecologist to serve in this role. If you decide to make your gynecologist your primary care physician, make sure he or she knows about this choice and is comfortable with it and willing to function this way.

– Yvonne S. Thornton, M. D., M. P. H.


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