How many times do I really have to get on the scale this year?

November 14, 2006 1:59 PM

What sort of doctor should a young woman have as her primary physician?

Until now, I've always had a limited doctor choice through an HMO. So, I've always picked an gynecologist as my primary physician--and seen that doctor for everything from pelvic exams to allergy issues. Now, I have a honest-to-goodness "real job" with great health insurance. I don't even need to pick a primary care physician--I can see who I like.

So, do I pick a general practice doctor as my usual doctor? And if so, will they do my annual lady-type exam and dole out birth control pills? Or should I pick a gynecologist for my usual doctor. And will they not do general practice medicine (basic physical, etc.) usually on a PPO plan? Do most women end up using multiple physicians?

(FYI, I have no major health issues other than an impressive list of allergies. Also, if anyone lives in the Bethesda or Rockville, MD area and has doctor recommendations--please share.)

posted by divka to health & fitness (16 comments total)

I like having a (female) internist who is also well-equipt (equipped?) to do the annual lady stuff. In my anecdotal experience, the younger, female internists tend to be up for the annual lady stuff and related matters, whereas the older, male internists tend to refer that stuff out. Not sure about the younger males, older females.
posted by ClaudiaCenter at 2:06 PM on November 14, 2006

I second going with an internist, and with recommendations from local people whose judgment you trust. That's how I found my previous (much missed) young male gay doctor. I didn't know he was young and I didn't know he was gay -- I just knew some people, both men and women, who thought he was great -- and he was. He also did my well woman exams and it was fine.

If you have any special health concerns or chronic conditions that should also influence your choice, but it doesn't sound like you're in that boat.
posted by melissa may at 2:14 PM on November 14, 2006

I have a female internist/endocrinologist as my main doctor (I have to have regular thyroid tests, so that combo is necessary for me), and she's fine with handling routine pelvic/birth control stuff and referring out for the non-routine stuff. Most of my friends have a similar set-up with their internists.
posted by scody at 2:16 PM on November 14, 2006

If I were you I would choose a primary physician who is an internist and have a separate gynecologist.

Anecdotal experience also, but I find sometimes OB/GYNs don't want to focus on the whole person. I have been bleeding like no tomorrow for the last three months and my gyn doctor neglected to order a simple test to determine if I was anemic or not, even though he was concerned I may be anemic. It's no biggie, I am not that concerned, but it was sort of strange that he didn't include this lab.

If you want one doctor I would recommend a female primary physician that does paps, breast exams, etc. as Claudia suggested. I couldn't imagine my very busy GYN focusing on anything else besides reproductive health.
posted by LoriFLA at 2:21 PM on November 14, 2006

I go to a regular GP for everything, including the "annual lady stuff," and it works well. She's seen me though pelvic exams, cholesterol screenings, skin care/dermatological issues and pneumonia, and handled all very well.

I chose a woman in her mid-40s, because I'm more comfortable being naked in front of women. Mid-40s sounded like she'd be young enough to be on top of new developments in medicine and experienced enough to know a thing or two. I also "interviewed" the scheduling nurse about the doctor's personality to make sure she sounded like a good fit. She's great!
posted by croutonsupafreak at 2:52 PM on November 14, 2006

My primary care is a GP with an expertise in women's and family health, and she is the best doctor I've ever had. She does my gyno exam, discusses birth control, and is very comprehensive. When she sends me test results she always writes really sweet notes on them (like "It looks like your hemoglobin is looking better this time! Happy Holidays!")

A vast improvement over the woman I went to before, who was an old Scottish pediatrician with a weird hangup about helmets. ("Yes, I always wear a helmet when I ride my bike...yes, I wear it when batting in softball too. No, I don't skateboard. No...I don't wear one skiing...um...I'm sorry?")
posted by nekton at 3:14 PM on November 14, 2006

My primary care is provided by a physician's assistant in a family practice clinic (which is itself in a major teaching hospital). She does the annual GYN exams, monitors my diabetes & hypertension, and has helped me through some depression spells (mercifully gone) along the way. While I am sure there are wonderful physicians who would do as well, I really like working with a PA -- they seem to spend more time with me as a person; when I see doctors it seems like they've got one foot out the door the whole time. And I like that she's called by her first name by everyone.
posted by redheadeb at 3:47 PM on November 14, 2006

If you're willing to drive to Arlington, I could recommend the medical group I go to -- I actually found them through an old AskMe post and like them a lot. But driving to Arlington from Bethesda for a doctor would be kind of nuts (never mind that I drive to Rockville to see my dermatologist -- he's awesome if you need that recommendation by the way).
posted by echo0720 at 4:18 PM on November 14, 2006

I'm 23 and I chose a female family practitioner. She does my yearly female thing (including birth control) as well as anything else I can think of. I know she doesn't have ALL the answers, but she is willing to admit when she needs to send me to see someone else. She has a list of specialists she works with (sends her patients to), so it's very easy for me to get an appointment with one as I need it.

If I were you, I would start with a general/family practitioner. This way, you can go to this doctor for anything from your yearly physical to back pain (like I did today). This should be a solid base for you, as it can be hard to become a "new patient" for an allergist and a gynecologist and...

As for picking this general practitioner or whatever kind of doctor, you have to find someone you can talk to and that you trust. In fact, no matter what kind of doctor you decide on - these are the most important factors that should influence your decision. Don't settle for someone that you can't talk to or that you're not comfortable with just because they are the "right" kind of doctor.
posted by youngergirl44 at 4:26 PM on November 14, 2006

My health plan required a primary doctor. I asked my GYN (who I adored, delivered both of my children, was a patient for 20 years) why was he was NOT a primary doctor. His answer made a lot of sense. He is specialized in his field and would not feel comfortable treating patients for high blood pressure, diabetes, allergies, etc. He also said he wound not expect a dermatologist to deliver a baby.

I have health issues (fibromyalgia) that I see my internist for. Both my Gyn and Internist confer over the phone at times. Because I am on a number of medications, only the internist writes my 'scripts.
posted by JujuB at 4:49 PM on November 14, 2006

a female primary physician that does paps...

Meant to say, a female family physician
posted by LoriFLA at 4:51 PM on November 14, 2006

Whenever I move to a new area (which hasn't been that often), I make a point of talking to colleagues and friends in the area to find out who they see. As an adult, I've gone to family practices exclusively and have found the recommendations to be fantastic. Rather than pick by specialty or crossover-convenience, I'd rather get an MD/GP who comes with an enthusiastic recommendation and one that I can talk to.
posted by plinth at 4:57 PM on November 14, 2006

Because you've got no health problems except allergy management, you might want to think about getting your primary care from a nurse practitioner. You'll get the same kind of care you'd get from an MD, and if you ever did develop a medical issue that required a doctor's attention, your NP could make a referral.

Some benefits of an NP include much shorter waiting times for appointments, longer appointments, and what many people describe as more personalized care. NPs get less pressure from insurance companies to carry a huge patient load and see a gazillion patients a day, so they're freer to spend more time with you.

There are women's health NPs who can do both your general care and your gyn care. If you get pregnant, though, they can't deliver your baby, so if you're thinking about having a baby soon, you might want to pick a certified nurse-midwife, who can do everything a women's health NP can do and can also deliver your baby.
posted by jesourie at 7:38 PM on November 14, 2006

I think I'd probably pick someone board certified in family practice.
posted by ikkyu2 at 7:56 PM on November 14, 2006

I would find a ob/gyn you really like, keep her just for that and ask her to refer you to a general practitioner that she likes and will work well with. These people are experts in certain types of medicine and I dont trust any of that 'I sorta know what Im doing nonsense'. Ive got quite the record of misdiagnoses going from situations where I talk to the wrong doctor.
posted by trishthedish at 8:59 PM on November 14, 2006

I always look for a female family practice doc. When they're young-ish, it's even better, because then it's like seeing my sister (who's in family practice, halfway across the country--so, yes, I'm biased). Someone in family practice should do all the annual lady-type stuff, but you could certainly call the office to double-check.

My doctor in Austin was certified in both family practice and sports medicine, which was pretty cool--she and her partners had built a practice around the combination.
posted by paleography at 10:13 AM on November 15, 2006