The Gynecology Visit

Candace Cooley’s experience takes in routine gynecological examinations, and toward the later part of her career more of her work went to preventive care for women and to gynecology in the office; this index collects the entries on the routine visit and the conversations inside it. In 2012 guidance from the American College of Obstetricians and Gynecologists set out the parts of an annual well woman visit, from counseling on healthy living to vital signs, body mass index and an examination of the abdomen, and recommended a yearly pelvic exam for women from age 21.¹

That recommendation drew debate. In 2017 NPR reported that the U.S. Preventive Services Task Force had found too little evidence to recommend for or against routine pelvic exams in women without symptoms, while its advice on Pap smears was unchanged.² How choices are made at such visits has a literature of its own. The Agency for Healthcare Research and Quality defines shared decision making as a collaborative process in which patients and clinicians decide together, drawing on evidence, the care team’s knowledge and experience and the patient’s values, goals and circumstances.³

The six entries are The Well Woman Visit, The Routine Pelvic Exam Debate, Shared Decision Making, Continuity of Care, Health Literacy and Family Health History.