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Most people don't call the doctor unless they are sick, experiencing unusual pain or discomfort, or due for annual exams. These days, especially when it comes to the specialized care women often seek from an OB-GYN, there are alternatives to seeing multiple doctors. In these cases, the prescription for easier access to professional care may be an appointment with a primary care physician.
Rachel Kroencke, MD, is an internal medicine doctor at University of Utah Health. In her practice, she suggested that "A lot of women think they need to specifically see a gynecologist for common healthcare concerns affecting women. Many don't realize that they can see their primary care provider, such as a family medicine provider or a general internist, for routine gynecologic care."
This common view of the types of patients and range of women's health services available through internists and family medicine doctors does not offer a clear picture of who they treat and the care they can offer. Kroencke said, "As internists we see patients 18 and older. We do cervical cancer screenings, so we are trained to do pap smears. I think that is often one thing that patients need, but they don't realize we can provide. We can also help patients access mammograms and other imaging for breast cancer screening."
A lot of women think they need to specifically see a gynecologist for common healthcare concerns affecting women. Many don't realize that they can see their primary care provider, such as a family medicine provider or a general internist, for routine gynecologic care.
–Rachel Kroencke, MD, University of Utah Health
Kroencke shared that most internists like herself can also advise and provide birth control for their patients. "We can prescribe oral contraceptive pills, and other forms of contraception such as vaginal rings. It is not as common for general internists to be trained in providing long-acting reversible contraception which include intrauterine devices (IUDs) and contraceptive implants, said Kroencke. However, family medicine doctors are commonly trained in providing these forms of contraception according to Kroencke.
The demand for every type of health care service is high right now and Kroencke said doctors realize these are particularly uncertain times for some of their female patients. "I think this is a good time to educate the public about other places they can access services if they are hoping to prevent an unwanted pregnancy. I think that's the big goal to let women know that family medicine and internal medicine are more than capable of being another source of that type of care," said Kroencke.
Most family medicine doctors receive training in managing pregnancies and often perform deliveries for their patients. Internists like Kroencke do not manage pregnancies, but she does see a role for herself in helping women prepare for a safe and healthy pregnancy. "We manage patients with many chronic medical conditions, so the goal now would be to properly manage these chronic conditions to prevent poor outcomes in a desired pregnancy. So that is just another good reason to get established with a primary care provider," said Kroencke.
Once a female patient forms a relationship with a primary care doctor they trust, Kroencke believes it will become easier and more comfortable to ask for specialized care and medical advice. For instance, Kroencke said, "We diagnose and treat most vaginal infections and sexually transmitted infections. Internists work with patients who are experiencing symptoms associated with menopause and treat conditions associated with menstrual cycles like abnormal cycles, and heavier or painful menstrual cycles."
Katie, a U of U Health patient, was recently looking for a consult to address heavy menstrual cycles. Once Katie realized she could consult with a primary care doctor about her concerns, it was a relief. "It was so nice to know I had a choice for this service because I already had an existing relationship with an internist, so that became the logical place to start my care," said Katie.
In Kroencke's practice, time is always an issue when visiting with her patients and assessing their health care needs and concerns. As doctors navigate a growing demand for their services, Kroencke hopes to put more emphasis on informing her female patients about the variety of care she can offer.
"I know I have patients that automatically default to seeing a gynecologist for services that I could have provided during their physical exam. So, just letting people know that we can provide that care and making sure they are good advocates for themselves is the goal," Kroencke said. Knowing where and who to turn to for care can empower patients to access important medical services when they are most needed.