Improving well-woman preventive health care in internal medicine clinics

Background: The traditional separation of reproductive from non-reproductive health care has resulted in many women not receiving appropriate preventive care. The 2005 Kaiser Women's Health Survey found that fragmentation persists-- about half of all women seek care from more than one provider and many do not receive recommended screening tests and do not have important conversations with physicians. Our research in an internal medicine clinic found that the internists did not routinely talk with women of child-bearing age about cervical cancer screening, contraceptives, folic acid, or calcium, and that contraceptive use was particularly low, especially among women with chronic disease. Objectives: Identify clinician and patient preferences for strategies to improve well woman care in internal medicine clinics. Methods: Focus group interviews with patients, residents and nurses. Results: Patients identified the importance of receiving personalized health information from their physicians as opposed to generic health education materials. Residents expressed concerns about patient's low interest in preventive care, their lack of education about their own conditions, and the difficulties in providing preventive care to patients with multiple medical needs during short visits. The nurses identified the importance of having physicians' “buy-in” for any intervention. Conclusions: An intervention to provide patients with personal health education materials addresses both patients and clinician concerns and needs.