Health
Guidelines For Women
News
From The American College Of Obstetrics And Gynecology
If
you view your obstetrician-gynecologist as your primary-care physician,
make certain to let him or her know this, or you may not get all the
medical attention you need and deserve, say experts at the American
College of Obstetricians and Gynecologists (ACOG).
Some
physicians are concerned that too many women are slipping through the
health-care cracks by relying on a specialist as the gatekeeper of their
primary and preventive care, without letting that specialist know they
are in charge.
"When,
a number of years ago, managed care decided to allow women to see their OB/GYN
without a referral from a primary-care doctor, it was supposed to make
the act of obtaining reproductive and gynecological care easier," says
Dr. Steve Goldstein, a professor of obstetrics and gynecology at New
York University Medical Center.
But
over time, Dr. Goldstein says, this arrangement "morphed" into an unofficial
"subspecialty,” and the OB/GYN became the primary-care physician,
at least in the minds of many women.
"The
problem with this concept is that too often women don't tell their OB/GYNs
that they do consider them as their primary-care physicians,”
Dr. Goldstein says. “So the doctor continues to believe someone
else is in charge."
Experts
say many women are less aware of what primary screenings and evaluations
they are missing when it comes to general health and preventive care.
"The
woman thinks her gynecologist is providing primary care while her gynecologist
thinks an internist is providing primary care,” Dr. Goldstein
adds. “And in reality, no one is doing it."
Who
Is Your Primary Caregiver, ACOG Asks
To
help close that knowledge gap, the ACOG has just published
an updated set of primary and preventive care guidelines, the most comprehensive
to date. Reporting in the medical journal Obstetrics and Gynecology,
ACOG experts detail exactly what a woman should expect
in the way of screenings and preventive care, regardless of who is caring
for her.
"We
feel it's important that both women and their doctors have a clear understanding
of what constitutes primary care, and the kind of screenings and evaluations
every woman should have at various stages of her life, beginning in
her teens through her senior years," says Dr. Bryan R. Hecht. He is
chairman of the ACOG Committee on Gynecologic
Practice, and he helped draft the new guidelines.
However,
Dr. Hecht adds that what women may really need most is to have a heart-to-heart
with their OB/GYN and establish whether he or she will be the one
providing that essential primary care.
"It
is very important that a woman let her OB/GYN know that she views
him or her as the primary-care specialist, in order to ensure that she
is getting all the care she needs," Dr. Hecht says.
More
important, Dr. Goldstein says, is to give your physician the choice
about what role he or she feels most comfortable playing in your overall
health care, since not all OB/GYNs believe they are qualified to
act as the mainstay of your health care.
"The
truth is, not all OB/GYNs feel equally confident about providing
primary care, and many are not even really qualified to do so," Dr.
Goldstein says. "So if your doctor says he or she would prefer that
you see an internist for your non-gynecological needs, pay attention,
and realize that this suggestion is being made in the best interest
of your health."
Regardless
of who is providing your primary care, both Drs. Goldstein and Hecht
say it is still vital to see your gynecologist for a yearly visit, even
if you are not due for a regular screening, such as a Pap test.
Always
consult your physician for a diagnosis.
Live
Longer, Healthier
The
National Women's Health Information Center offers the following 10 things
you can do to help live longer, live better, and live happier:
Be
Informed. Learn about health promotion and disease prevention
and ask your physician for specific information regarding your needs.
Be
Good To Your Bones. For healthy bones, be sure to replenish
your stock of calcium every day with plenty of foods such as milk and
dairy products, tofu, leafy, green vegetables, canned salmon or sardines,
and calcium-fortified juices or breads. Speak with your physician about
calcium supplements.
Avoid
Illegal Drugs and Alcohol. For women, the definition of moderate
drinking stops at one glass. And, where illicit drugs are concerned,
there is no such thing as "moderate" use.
Take
Medicine Wisely. Read the labels, follow the instructions carefully,
and remind your physician or pharmacist about any other medicines or
supplements you might be taking that could interact with your medication.
If you have any questions about possible side effects, call your physician
or pharmacist.
Play
It Safe. Avoid injuries. Buckle up. Wear a bike helmet. Use
smoke and carbon monoxide detectors. Wear sunscreen and UV protected
sunglasses. Use street smarts and common sense. Practice safe sex.
Get
Checked. Get regular checkups, preventive examinations, and
immunizations. Do not forget self-examinations, too.
Do
Not Smoke. Smoking is the leading preventable cause of death
in our country.
Eat
Smart. It is the secret to good health. Eat plenty of fruits,
vegetables, and grains. Enjoy a variety of foods, balance foods from
each food group, and exercise moderation.
Get
Moving. The other secret to good health: just 30 minutes of
physical activity, accumulated over the course of each day, can radically
improve the way you look and feel, both physically and mentally.
Be
Happy. Take time for yourself. Get connected with family, friends,
and community. Do things you enjoy!
Online
Resources
American
College of Obstericians and Gynecologists
Centers
for Disease Control and Prevention (CDC)
HealthierUS.Gov
National
Institutes of Health (NIH)
National
Women's Health Information Center
Office
of Research on Women's Health
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February
2004
Health
Guidelines For Women
Who
Is Your Primary Caregiver, ACOG Asks
Live
Longer, Healthier
ACOG
Recommendations
Online
Resources
Other
Resources:
Find
a St. John's Mercy Physician
Women's
Services at St. John's Mercy
Women's
Health Information
St.
John's Mercy Classes and Programs
ACOG
Recommendations
Highlights from
the recommendations of American College of Obstetricians and
Gynecologists (ACOG) experts include:
Ages 19
to 39
-
An initial
health screening at 19, featuring a complete health history, including
your health status; dietary/nutrition assessment; level of physical
activity; use of complementary or alternative medicines; tobacco,
alcohol or drug use; sexual practices; abuse or neglect; and urinary
or fecal incontinence. This screening should then be updated annually.
-
An annual
physical exam, including height, weight, blood pressure, mouth/dental;
check of the neck for swelling/thyroid problems; and examination
of breasts, abdomen, pelvis, and skin.
-
Yearly evaluation
and counseling on issues concerning sexual activity; fitness and
nutrition (including folic acid and calcium intake); interpersonal
and family relationships; domestic violence; work satisfaction and
lifestyle stress; cardiovascular risk factors (including family
history, cholesterol profiles, obesity, diabetes); personal hygiene;
high-risk behaviors, including occupational and recreational hazards;
breast self-exams; skin exposure to ultraviolet rays; suicidal thoughts;
depressive symptoms; and drug or alcohol use.
-
Lab testing
should include Pap test (annually, beginning no later than age 21;
after age 30, every two to three years after three consecutive negative
tests and no signs of disease); and a tetanus booster every 10 years.
-
High-risk
groups (or those with symptoms) may also need: hemoglobin (red blood
cell) assessment; bacteriuria testing; mammograms; a fasting blood
sugar test; sexually transmitted disease testing; HIV testing; genetic
testing/counseling; rubella assessment; tuberculosis skin testing;
lipid profiles (for cholesterol); thyroid stimulating hormone testing;
hepatitis C testing; colorectal screening; and bone density screening.
-
High-risk
groups may also need the following vaccines: Hepatitis A and B,
pneumonia, varicella and measles, mumps, and rubella.
Ages 40
to 64
All of the above,
plus:
-
Mammography
every one to two years beginning at age 40; yearly at age 50.
-
Lipid (cholesterol)
assessment every five years beginning at age 45.
-
Yearly fecal
occult blood testing for colorectal cancer or flexible sigmoidoscopy
every five years, or yearly fecal occult blood testing plus sigmoidoscopy
every five years, or double contrast barium enema every five years
or colonoscopy every 10 years beginning at age 50.
-
Fasting glucose
testing every three years beginning at age 45.
-
Thyroid stimulating
hormone screening every five years beginning at age 50.
-
Counseling
and evaluation on hormone therapy.
-
Influenza
vaccine annually beginning at age 50.
Ages 65
and over
All of the above
from both groups, plus:
-
Yearly urine
analysis, mammogram, bone density screening.
-
Evaluation
and counseling on visual acuity, hearing, depression.
Always consult your
physician for more information.
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