Elsevier

Women's Health Issues

Volume 12, Issue 3, May–June 2002, Pages 138-149
Women's Health Issues

Article
Are two doctors better than one? Women’s physician use and appropriate care

https://doi.org/10.1016/S1049-3867(02)00134-2Get rights and content

Abstract

This study examines nonelderly women’s concurrent use of two types of physicians (generalists and obstetrician-gynecologists) for regular health care and associations with receipt of preventive care, including a range of recommended screening, counseling, and heart disease prevention services. Data are from the 1999 Women’s Health Care Experiences Survey conducted in Baltimore, Maryland, using random digit dialing (N = 509 women ages 18 to 64). Key findings are: 58% of women report using two physicians (a generalist and an ob/gyn) for regular care; seeing both a generalist and an ob/gyn, compared with seeing a generalist alone, is consistently associated with receiving more clinical preventive services, including screening, counseling, and preventive services related to heart disease. Because seeing an ob/gyn in addition to a generalist physician is associated with receiving recommended preventive services (even for heart disease), the findings suggest that non-elderly women who rely on a generalist alone may receive substandard preventive care. The implications for women’s access to ob/gyns and for appropriate design of women’s primary care are discussed.

Section snippets

Data source

Data are from the Women’s Health Care Experiences Survey conducted in Baltimore, Maryland in 1999. This survey instrument was developed to provide a more comprehensive description of nonelderly women’s health care access, utilization, and quality than is available in other surveys.8 The survey was developed through several phases, including a content comparison of national surveys, identification of key domains in women’s health care, expert feedback, and cognitive testing of a draft instrument

Sample characteristics

Table 1 describes the sociodemographic, health status, and health care utilization characteristics of the sample. Because needs for reproductive and non-reproductive services are expected to be associated with age, we present these results for two age groups: ages 18–44 (the so-called “reproductive years”) and ages 45–64 (“midlife”). Midlife women are significantly more likely than younger women to be white, to have lower educations, to have the highest household incomes ($75,000 or more), and

Key findings

Seeing two physicians for regular care (a generalist and an ob/gyn), compared with seeing a generalist alone, is consistently associated with nonelderly women’s receipt of more recommended clinical preventive services. In this study, we were able to examine receipt of a wider range of clinical preventive services than previously studied, including screening services, counseling on a variety of topics, and services related to prevention of heart disease. The relationship between the pattern of

Acknowledgements

Funding for this research was provided by the Maternal and Child Health Bureau (HRSA, DHHS) to the Johns Hopkins University Women’s and Children’s Health Policy Center [U93-MC00101]. Jillian Henderson was also supported by a predoctoral training grant from the National Institute on Aging [T32-AG00134]. Opinions expressed do not necessarily reflect the views of the Bureau, HRSA, or the Department of Health and Human Services.

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