Obstetrician-gynecologists' approach to well-woman care

To estimate obstetrician-gynecologists' attitudes and management practices regarding well-woman care.

A questionnaire was mailed to 1,000 members of the American Congress of Obstetricians and Gynecologists, 600 of whom participate in the Collaborative Ambulatory Research Network.

The response rate was 57%. Of these, 513 (91%) respondents provide routine gynecologic care and are the focus of the study. Most obstetrician-gynecologists include an examination of the abdomen (97%) and thyroid and neck (92%) during a well-woman examination, although fewer conduct skin (73%) or mouth (19%) surveys. Asked how they would most likely treat several conditions in nonpregnant patients, respondents would prescribe medications for menopausal issues (69%), hormone therapy (73%), and for generalized anxiety disorder (39%), and they would refer patients to a primary care physician for high blood pressure (73%) and high cholesterol (65%). Female and younger respondents were more likely than male and older respondents to refer patients for several nonreproductive health conditions and were less likely to personally treat them. A majority (61%) of obstetrician-gynecologists define well-woman care within the context of gynecologic practices as care related to overall health and primary care rather than care limited to reproductive health (39%); this majority was less likely to agree that obstetrician-gynecologists should limit their care to reproductive health (15% compared with 62%) and more likely to personally treat most nonreproductive health issues than were those who see care as limited to reproductive health.

The majority of obstetrician-gynecologists define well-woman care as overall health and primary care, and their opinions and practices reflect this.

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