The evolution of women's primary health care in california: the role of the obstetrician/gynecologist.
The role of the obstetrician/gynecologist as the primary health care provider for women has evolved rapidly in the past decade. There has not always been agreement in the specialty about the directions in which it should proceed. In particular, a cognitive dissonance has arisen regarding the primary care role for any one physician. Just as there are strong advocates,1,2 so are there dissentients.3,4 Access to care for women and patient choice of physician are universally acknowledged as desirable and central to the issue. The often acrimonious debate derives from more theoretical constructs of subspecialty identity and integrity, economics, dilution of specialty training, and educational barriers to successful implementation. The practical, salutary implications of primary care obstetrician/gynecologists have infrequently been evaluated in any formalized fashion. Five years ago, the State of California designated obstetrician/gynecologists as primary care physicians. This paper is a retrospective analysis of how the designation was achieved and the subsequent experience of the specialty over this period of time.
Dickerson
V M.
VM
Division of General Obstetrics and Gynecology, University of California Irvine Medical Center, Irvine, California, USA