For straight-up down-there medical problems—a yeast infection, say, or a positive at-home pregnancy test—there’s no question you should call on your OB/GYN for care. But what if you have a nasty cough, or need a flu shot? If you’re like many other women in America, you’ll also turn to your OB/GYN. In fact, research shows nearly half of all OB/GYNs consider themselves primary care physicians.

But could women be doing themselves a disservice by cutting out the traditional gatekeeper of their overall health?

Not necessarily, according to Rabiya Suleman, MD, an OB/GYN at Overland Park Regional Medical Center in Kansas.

“A lot of women don’t have a primary care physician until they develop multiple medical issues,” she says. “For someone who’s otherwise healthy, that’s generally okay. OB/GYNS are trained to address basic things like blood pressure, high cholesterol and thyroid status.”

Dr. Suleman notes that OB/GYNs also help with women’s health issues that crop up at the far end of the reproductive cycle, such as changes that come with menopause along with other health risks that increase with age.

In fact, the American Congress of Obstetricians and Gynecologists (ACOG), has established recommendations for what OB/GYNs should offer at yearly “well-woman” exams, based on age and risk factors. These include screenings, laboratory services, evaluation and counseling.

Suleman says her practice sees patients for well-woman exams on a yearly basis.

“During that time we address blood pressure, smoking status, exercise and diet. We usually will offer a yearly set of labs to check thyroid, cholesterol, hemoglobin and blood sugar.”

When to see a primary care physician or specialist

Women also can get certain key vaccinations at their OB/GYN’s office. This isn’t new, but ACOG released updated guidelines for offering immunizations to women as a way to boost lagging vaccination rates among adults.

“In our office we do flu shots, the Tdap vaccine and the HPV vaccine,” says Suleman. “We don’t offer hepatitis B or pneumococcal vaccines, though. For those, a woman would need to see a PCP.”

She also would need to see a primary care doctor, internist or specialist for any beyond-basic care she might need for a problem uncovered by her OB/GYN.

“If your cholesterol is high, I can start you on dietary measures, but I’ll also set you up with another doctor,” she says. “If I see a strange mole on your skin, I can say it looks irregular, but I’m not going to do a biopsy. I’ll refer you to a dermatologist. And even though screening for post-partum depression is an important focus for us, when it comes to treating depression of any type there’s only so far we might go. I may try a few rounds of medication, but if that doesn’t work I’ll send a woman with depression to a psychiatrist.” In many ways, she says, “we’re like a sieve, or screening tool for specialists.”

The bottom line, according to Suleman, is if you have a chronic condition such as diabetes or lupus or some other long-standing illness, you absolutely should regularly see an internist or family practice doctor. But if you don’t have one, seeing your OB/GYN is better than seeing no doctor at all.

March 22, 2017
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