FORT LEE, Va. (Jan. 18, 2013) -- You may have heard about the new model in providing care – the Patient Centered Medical Home. At Kenner Army Health Clinic, this model was implemented to help patients develop a consistent relationship with their primary care manager and their associated team, who together coordinate the medical care each patient may need. Whether you are on active duty or are another eligible beneficiary, this care is available to you.
How does the Women’s Health Program fit under the Patient-Centered Medical Home? Some PCMs at Kenner do not provide gynecologic services, and some women prefer to have their GYN care provided exclusively by a female provider. The Women’s Health Program has three specialized staff who partner with a patient’s PCM to ensure all of a woman’s annual GYN needs are met. The women’s health appointment and exam is often a woman’s first entry into the health care system, but she should get a routine GYN exam yearly.
The well-women’s exam (GYN exam) includes a breast exam, pelvic exam with possible collection of a PAP (papanicolaou) smear, and thorough review of the medical and surgical history. Preventive or diagnostic testing such as mammograms, ultrasounds or colonoscopy will be ordered if appropriate based on clinical findings and evidence-based guidelines. If fasting labs or screening labs have not been done recently, your team will order the tests so they will be available for discussion with the patient’s primary care manager at their next visit. The clinic staff will discuss and offer contraception options such as birth control pills, the ring (Nuvaring), Depo-Provera injections, implantable contraception (Implanon/Nexplanon), intra-uterine devices (Mirena and Paraguard) and even female and male sterilization (Tubal ligation and Vasectomy). All visits include some educational discussion tailored to each patient. Topics could include: depression symptoms and treatment; OB referrals for our pregnant patients to the community for prenatal and delivery services; changes that occur in menopause and treatments; bone health with emphasis on prevention; STD testing and treatment: infertility testing and referral; polycystic ovarian syndrome; or one of many other medical topics.
Adolescents make up a large part of the population served by the women’s health program, and this group needs counseling tailored to their unique needs. The team discusses the need for a first PAP smear at age 21, sexually transmitted infections and testing, safe sex and birth control counseling, managing menstrual issues for teens, and consideration for immunization against the human papillomavirus, which has been shown to be linked to cervical cancer in adult women. Adolescents are legally allowed to receive confidential GYN care and counseling without parental consent, but we encourage open communication between teens and their parents, and often a parent, guardian or friend accompanies adolescent patients to their visit.
The Women’s Health Program has expanded to include colposcopy services, which will ensure that patients with abnormal pap smears can get their follow-up care at Kenner. If further evaluation or surgery for advanced conditions is recommended, patients will be referred to one of the readily available and excellent community resources.
In summary, female patients at Kenner should regularly see their primary care manager, and the opportunity is available to receive gynecological care by our specialized staff. Women should always have yearly visits for GYN care. For women who have never had a prior abnormal PAP smear, current guidelines recommend getting a PAP every 2 years between the ages of 21-30 and every 3 years between age 30-65. PAPs are no longer recommended after ages 65. Women who have had a prior abnormal PAP smear should consult with our providers for continued screening requirements. Please do not hesitate to call with questions or to make an appointment with the Women’s Health Program at Kenner through the appointment line by calling 1-866-LEE-KAHC (1-866-533-5242).
Kathleen Moffitt, Certified Nurse Midwife Kenner Army Health Clinic