title: Do physicians address other medical problems during preventive gynecologic visits?
abstract: BACKGROUND
  The patient-centered medical home model may be a strategic approach to improve delivery of women's health care and consistently provide women with accessible and comprehensive care. We examined whether primary care physicians (family medicine, internal medicine, and hospital general medicine clinics) and obstetrician-gynecologists differ in scope and the number of medical issues addressed during preventive gynecologic visits.
  
  
  METHODS
  We analyzed data from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey to characterize visits with a primary diagnosis of gynecological examination or routine cervical Papanicolaou test between 1999 and 2008. We compared the number and type of concurrent nongynecologic diagnoses addressed by primary care physicians and obstetrician-gynecologists during visits.
  
  
  RESULTS
  A total of 7882 visits were included, representing 271 million primary visits for Papanicolaou tests. Primary care physicians were 2.41 times more likely to include one or more concurrent medical diagnoses during the preventive gynecologic visit compared with obstetrician-gynecologists (odds ratio, 2.41; 95% confidence interval, 1.63-3.57).
  
  
  CONCLUSIONS
  Primary care physicians are significantly more likely to address concurrent medical problems during preventive gynecologic visits compared with obstetrician-gynecologists. These findings demonstrate the vital role of primary care physicians in providing comprehensive health care to women, consistent with principles of the patient-centered medical home model.
authors.affiliation: The Research Institute and the Department of Family and Community Medicine, Lancaster General Hospital, Lancaster, PA.
authors.forename: Donna
authors.initials: D
authors.lastname: Cohen
authors.forename: Andrew
authors.initials: A
authors.lastname: Coco
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D058869:Gynecological Examination / Q000706:statistics & numerical data*; D006176:Gynecology / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D011314:Preventive Health Services; D011320:Primary Health Care / Q000706:statistics & numerical data*; D014626:Vaginal Smears; D055815:Young Adult
keywords: Gynecology; Medical Home; Papanicolaou Test; Patient-Centered Care; Preventive Health Services; Primary Health Care; Women's Health