Women seeking birth control get unneeded pelvic exams

How many of YOU have been "required" to do a pelvic exam before a scrip for birth control was handed to you?  Probably most of you. 


There is no established medical need for women to have the exam before receiving a prescription for birth control pills, Sawaya said. It's just that, traditionally, pelvic exams have been coupled with contraceptive prescriptions; in many cases, it may have simply been convenient for women to have a pelvic exam as part of their routine healthcare at the same time they were seeking a birth-control prescription.

"The two just became linked," Kaunitz agreed. But while there is nothing wrong with that, he said, "women also deserve the option of un-linking those two services."

The current findings are based on a survey sent to a national sample of 1,196 ob-gyns, family doctors and advanced-practice nurses specializing in either women's health or family medicine.

Overall, 29 percent of ob-gyns and 33 percent of family doctors said they always required a pelvic exam for women seeking birth control pills. In addition, half of ob-gyns and about 45 percent of family doctors said they usually required the exam.

He also pointed out that among all providers in the study, those working in private practice were twice as likely as those in community and family-planning clinics to require a pelvic exam — suggesting that the clinic providers are more aware of current guidelines.

It's also possible that some doctors require a pelvic exam in order to get the insurance reimbursement, Sawaya and his colleagues note in their report.

Medicare pays doctors about $75 for a screening pelvic exam and, depending on geography, private insurers may pay more. Contraceptive counseling, on the other hand, may not always fall into a clearly defined reimbursement category, the authors note.

"In the absence of adequate financial incentives for contraceptive counseling as an important clinical activity in its own right," the researchers write, "providers are incentivized to conduct a physical exam with a well-reimbursed billing code.

You heard right!  So next time your doc insists on doing an exam, say 'no thanks!'

To learn more about Reproductive Health, please visit Birthologie.com


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