A qualitative study was conducted to understand the current and potential role of the community obstetrician/gynecologist (OBGYN) in risk factor screening and prevention of cardiovascular disease.
A total of four focus group discussions were conducted among 46 OBGYN residents and practicing physicians in the mid-Atlantic region.
Five main thematic areas were identified including scope of practice, professional knowledge and skills in non-reproductive care, potential for liability, logistical and structural barriers, medical practice community, and support for collaborative care. There were no differences between residents and those in practice within and between cities. Comprehensive care was most often defined as excluding chronic medical care issues and most likely as focusing on screening and referring women. The OBGYN recognized their common role as the exclusive clinician for women was, in part, a consequence of patients’ nonadherence with primary care referrals. Barriers and strategies were identified within each thematic area.
Additional training, development of referral networks, and access to local and practice specific data are needed to support an increased role for the OBGYN in the prevention of cardiovascular disease in women. Establishment of evidence-based screening and referral recommendations, specific to women across the age spectrum, may enable clinicians to capitalize on this important prevention opportunity. Longer term, and in concert with health care reform, a critical evaluation of the woman’s place in the center of her medical home, rather than any one site, may yield improvements in health outcomes for women.
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Deborah B. Ehrenthal, MD, is Clinical Assistant Professor of Medicine, Thomas Jefferson University, and Medical Director of Women’s Health Programs at Christiana Care Health System. Her research interests include the health and health care of reproductive age women.
Ana E. Núñez, MD, MPH, is an Associate Professor of Medicine at Drexel University College of Medicine in Philadelphia, Pennsylvania. Her research interests include a focus on medical education promoting behavior change and in community participatory health services research.
Elizabeth O’Neill, BA, is Project Director for the Community Center of Excellence in Women’s Health and The Heart Truth Delaware at Christiana Care Health System. Her interests include building community partnerships to improve the health of medically underserved women.
Candace Robertson-James, MPH, is Research Manager of the Women’s Health Education Program, Drexel University College of Medicine. Her research expertise and interests include women and minority health issues and community-based participatory research.
Sonya Feinberg Addo, MPH, is the Deputy Project Director of The Heart Truth Delaware at Christiana Care Health System. Her interests include reproductive health education, provider education, and training health care providers in techniques to promote behavior change.
Ashley Stewart, MS, CHES, is a Health Educator in the Department of Obstetrics and Gynecology at Christiana Care Health System. Her interests include women’s health education and prevention of adolescent risk behaviors.
Published online: June 23, 2011
Accepted: April 18, 2011
Received in revised form: April 18, 2011
Received: November 3, 2010
Funded by the Federal Office on Women’s Health contract HHSP 23320082207TC.
© 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.