Pros and Cons of dropping GYN for Family Dr

[barkley1]

Title says it all. My friend just mentioned the other day since she's done having babies, she just lumps the pelvic exam/pap smear/breast exam into her yearly physical with her family doc. Saves one more copay. I'm considering b/c my GYN(who is also OB) is insanely hard to get in with, even though I've been to her for 5 years. Seems like she's booked 3 months solid, and her books for the next 3 months don't open for another month whenever I call. Is this pretty common? Pros/cons?

[nfowife]

I see a family practice dr and had my well women exam there. No issues.

[belovedgandp]

I'm looking to go back. Until I was pregnant with my first I'd always used my internist. Then I went to an OB/GYN and have stuck with her annually, but yes, I'm done having kids and the office is always so crazy. My youngest is also almost 5, so I'm looking to move away from our pediatrician also. Trying to find a good family doctor for all of us, but it's a real pain.

[Liziz]

I only used my family doc for routine well-woman visits until I started having kiddos. I even went back to the family doc for the pap between kids. Way easier to get in with and less wait when I'm in the office.

[Katigre]

There are no copays for yearly well woman visits, so her reasoning doesnt make sense.

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[Philly Mom]

There are no copays for yearly well woman visits, so her reasoning doesnt make sense.

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I have a co pay for annual visits.


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[trcy]

I have a co pay for annual visits.


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For annual wellness visits? My understanding was with the new healthcare laws, wellness visits are 100% covered.

[Philly Mom]

For annual wellness visits? My understanding was with the new healthcare laws, wellness visits are 100% covered.

Not with my insurance. I pay my co pay with every visit, even well visits and my annual. I thought the same thing. Our insurance is very good so I assume it falls within an exception.


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[TwinFoxes]

Another option is GYN without OB. That's what my doctor is. No long wait. I think it's all those unpredictable pregnant ladies that cause the waits. ;)

I'd just rather see someone who's trained specifically in GYN. A lot of GYN diseases are easily missed, from my understanding.

[carolinacool]

Another option is GYN without OB. That's what my doctor is. No long wait. I think it's all those unpredictable pregnant ladies that cause the waits. ;)

I'd just rather see someone who's trained specifically in GYN. A lot of GYN diseases are easily missed, from my understanding.

Yeah, I've had issues before and after DS was born, so I'm more comfortable seeing my GYN (fibroids, polyps, irregular paps), but the wait is INSANE because it's also an OB's office. But I really like my doctor. Blech.

My well visits are covered 100%.

[Kindra178]

There are no copays for yearly well woman visits, so her reasoning doesnt make sense.

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I have a copay for annual visits too, excellent insurance as well.

[MelissaTC]

I go to a practice of NPs that only see women. They are awesome. I go there for everythibg except for routine visits for my PCOS. I see a specialist for that.

[StantonHyde]

Heck, I went to Planned Parenthood for all my well woman checkups until I was 36 and looking to get pregnant! I would have gone back there but at my age, I knew I would be headed for menopause soon and I wanted to stay on so my OB/GYN could manage any of that. I don't see the MD now, though. I just see the NPs--and that's fine with me. If I start having complications etc, then I will get in to the MD. Until then, I will just await the hot flashes-ugh.

[citymama]

I really love having my GYN too. She's a lot further than our family doctor but it's worth it to me for the annual visit. She's just MY doc, not my DH's, and she knows her lady parts. ;-) I had a misdiagnosis with my family doc looking at what she thought was yeast, treated me for yeast. It could also be that I LOVE my GYN and am lukewarm about my family doc.

[pinkmomagain]

I use a Mirena for contraception so I can't imagine not using a GYN for insertion/removal. Also, with menopause coming starting to come into play in the next decade, I am more comfortable sticking with a specialist to navigate it.

[fauve01]

There are no copays for yearly well woman visits, so her reasoning doesnt make sense.

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Maybe there aren't for you, but there are for me. we have a co pay for every dr visit, well visit or not.

[american_mama]

Off topic a little, but did anyone go to or know someone who went to a family practitioner for their prenatal care? My family doctor is the one family practice in our town that does OB; it's a fundamental part of their practice, from what I understand, and they have kept providing ob services despite a lot of turnover in the younger half of their staff. I probably would have gone to them for my OB if I hadn't gotten in with the one CNM in town.

If your birth control is something like an IUD, implant, or you desire a tubal ligation, you might need to ask how an family practice doctor handles that. I was shocked to discover that a friend who is a gyn nurse practitioner at a local student health clinic has done barely any IUD insertions, and they refer out any student desiring one. I'm not surprised that IUDs are uncommon in a student population, but I didn't expect that none of the clinic gyn staff, not even the gynecologist apparently, will do them.

I would ask how a family practice does other common GYN procedures.. colposcopy, any sampling of suspicious cervical lesions, availability of in-house ultrasound (like for cysts), menopause management, incontinence treatment, atypical but healthy breasts (i.e. dense or lumpy), PCOS, heavy periods/ablation, etc. I mention the ultrasound because I've never been to a obgyn with inhouse ultrasound, so I assume many family practice docs don't have one either, but some here may expect it as standard.

[Katigre]

Maybe there aren't for you, but there are for me. we have a co pay for every dr visit, well visit or not.

That's bizarre to me b/c part of the Affordable Care Act law was to make preventative care 100% paid by insurance.

[TwinFoxes]

That's bizarre to me b/c part of the Affordable Care Act law was to make preventative care 100% paid by insurance.

Some plans are grandfathered in. But you're right that non grandfathered plans, and all plans in the exchange cover well visits with no co-pays.

[american_mama]

I agree, no copay due to new health care laws is what I was told at my most recent well woman exam.

Even so, maybe consolidating doctors doesn't affect copays for some people, but I can imagine other logistical benefits to consolidation... one set of reminders on the phone/mail, one office to call, one physician relationship to develop, the possibility of deepening that relationship by addressing your complete medical needs.

[daisysmom]

I still have a copay. I think it is b/c of the grandfathering.

[scrooks]

I love my Ob/Gyn. She was there for me through over 8 years of difficult pregnancies. I am planning in staying with her for now. I have a friend who is approaching menopause (and I am just a few years younger then her so it's on the horizon for me) and said she was returning to her Ob/Gyn practice (after using her family practice doc for well woman exams for a couple of years) to help her through menopause issues. I think that makes sense to me.

[AnnieW625]

When I had Kaiser my PCP did my yearly well woman visits, and my OBGYN was just for pregnancy care. Last year I finally got around to having a well woman visit as I hadn't had one in three years so I went to a local obgyn clinic that came highly recommend. I ended up having an annual physical with my new family practice PCP in July mainly because I had been diagnosed with shingles and needed a follow up, but in the future I wouldn't have an issue going to my PCP as well for an annual exam as well.

[Philly Mom]

Some plans are grandfathered in. But you're right that non grandfathered plans, and all plans in the exchange cover well visits with no co-pays.

I would guess that the "Cadillac" plans were grandfathered in. I happily pay my $20 co-pay for well visits because we have good, affordable insurance.

[Indianamom2]

Off topic a little, but did anyone go to or know someone who went to a family practitioner for their prenatal care? My family doctor is the one family practice in our town that does OB; it's a fundamental part of their practice, from what I understand, and they have kept providing ob services despite a lot of turnover in the younger half of their staff. I probably would have gone to them for my OB if I hadn't gotten in with the one CNM in town.

If your birth control is something like an IUD, implant, or you desire a tubal ligation, you might need to ask how an family practice doctor handles that. I was shocked to discover that a friend who is a gyn nurse practitioner at a local student health clinic has done barely any IUD insertions, and they refer out any student desiring one. I'm not surprised that IUDs are uncommon in a student population, but I didn't expect that none of the clinic gyn staff, not even the gynecologist apparently, will do them.

I would ask how a family practice does other common GYN procedures.. colposcopy, any sampling of suspicious cervical lesions, availability of in-house ultrasound (like for cysts), menopause management, incontinence treatment, atypical but healthy breasts (i.e. dense or lumpy), PCOS, heavy periods/ablation, etc. I mention the ultrasound because I've never been to a obgyn with inhouse ultrasound, so I assume many family practice docs don't have one either, but some here may expect it as standard.

With my DD, I had an excellent OB who was also my family practice doctor. I loved her. She was also the OB through about 30 weeks of Ds's pregnancy, but then she moved across the country and I decided to switch to an OBGYN practice. I had absolutely no problems with her and she was still my favorite.

As far as family practice physicians go, I know that I would much prefer to have an OBGYN take care of my gynecological issues/women's issues. I had a different family practice guy who wasn't all that great with women's stuff and he just wasn't a good fit where that was concerned. He was a fine general doctor for stuff that everyone deals with and I think he knew a lot about sports medicine, but he just wasn't knowledgeable enough about women's gyn. issues for me. I have a family history of breast cancer and uterine fibroids and endometriosis and I just wanted someone who did that stuff day in and day out to be my doctor.

[gymnbomb]

I am in my early 30's and since I was in grad school until 27 I saw a lot of random OB's and NP's at student health clinics for many years. I haven't had a PCP since I was about 9 due to a combination of using military health clinics, student health clinics, and walk ins. When I got pregnant with DS I chose a CNM at the same practice as the OB's I had seen for a few years and I am sticking with her for my annual exams for now. The CNMs and OBs work together so that you have someone else in house to see if something comes up that the midwife can't handle. I never knew that midwives did well woman visits for women who were not pregnant/trying to conceive or I would have probably started seeing mine sooner.

[Jacksmommy2b]

I switched to a nurse practitioner in my OB/GYN practice and have been very happy with her. I still get the benefits of specialized care with the great availability of a nurse practitioner.

[ang79]

I still see my OB/GYN at the practice I went to for DD2's birth. I really like the one doctor so always schedule my yearly visits with him. Unfortunately, he is also very well liked by everyone else, so sometimes its a wait for the appointment. But he takes his time, answers any questions, etc. I am on my second Mirena and am not even sure if my PCP could do the insert/removal for those (the insurance company was pretty picky about how things were billed so that they covered it). I like my PCP but will probably stick with the OB/GYN, due to the Mirena, as well as a family history of breast cancer.

[suzi]

Before my college coach passed away from metastatic ovarian cancer, she told me she regretted having annuals with FP rather than GYN. Perhaps the specialist would have detected a mass earlier, though that malignancy is a tough one to detect early. Urologists certainly give a better/more accurate prostate exam for guys, having more experience. Same is probably true for breast exams by GYNs. An older physician may have an aging, less fertile clientele and a smoother clinic. Maybe look for one of these?

[twowhat?]

I keep my OB/GYN for well woman exams... He also checks things like lipids, vit D, etc. So I feel it's pretty comprehensive and I decided I could deal with the scheduling issues and the drive once a year. I see an internal medicine doctor who is much closer to me for non gyn-related sick visits.

I have a fibroid and have had problems with yeast in the past and am perimenopausal so I just feel better with a specialist and I love my ob/gyn.