Who provides gynecologic care?

To determine who provides gynecologic care for women who see internists, we interviewed 474 women who had return appointments at an academic primary care internal medicine center (PCC). Interview data indicated that 241 patients (51 percent) received gynecologic care in the PCC, 145 patients (31 percent) received gynecologic care from a non-PCC source, 48 patients (10 percent) did not receive needed care, and 40 patients (8 percent) did not require gynecologic care. Among the 145 patients who received gynecologic care from a non-PCC source, 121 (83 percent) received routine services that were readily available in the PCC. After completion of the interview, 28 (23 percent) of these 121 patients indicated that they did not plan to return to their non-PCC gynecologic provider. An economic analysis revealed that the savings to the patients and their insurers that could be realized by providing gynecologic care in the PCC for patients who were willing to switch from a non-PCC source would nearly offset the cost of providing routine gynecologic care to those patients who are in need of such care but are not now receiving it. Because internists are being trained to provide most routine gynecologic services, they often should be able to save their patients the cost and inconvenience of an extra visit to another physician.