Special Concerns for Women

Types of Primary Care Providers

Primary care refers to a basic, general form of caregiving that emphasizes prevention as well as continuity and coordination of care. Ideally, a primary care provider will get to know you and your health history over time, allowing him or her to provide high-quality, individualized care. Many insurance companies require that you have a primary care provider as your entryway to the health care system; the PCP can then refer you to a specialist if necessary. Primary Care Providers (PCPs) may be nurse practitioners, physician assistants, or physicians.

Nurse Practitioners or Certified Nurse-Midwives

Nurse practitioners (NPs) and certified nurse-midwives (CNMs) obtain advanced nursing or graduate level degrees and are trained to assess patients and make decisions about routine, episodic or chronic health problems. They provide such services as the ordering and interpretation of diagnostic and laboratory tests and prescribe medicines and other non-pharmacological therapies. Both NPs and CNMs emphasize health promotion and disease prevention. Although they always work in consultation with doctors, some have agreements that allow them to work mostly on their own. Others are in daily consultation with doctors and work within doctors' offices, managed care plans, hospitals, nursing homes or clinics. Practitioners may be trained in a specialty area such as women’s health, or they may be trained more broadly to provide a range of primary care services in an adult, pediatric, family or gerontological practice.

Physician Assistants

Physician assistants (PAs) are trained to carry out certain routine patient care tasks normally performed only by physicians or surgeons and not, in general, by nurses. Some are also trained to provide annual check-ups and evaluate acute problems. Virtually all PAs apprentice to physicians as part of their training. They usually work with a particular physician or in a practice with one or more physicians. This model frequently offers more time for counseling and questions. In many states, PAs can make referrals and write prescriptions.

Medical Doctors

• Family Medicine Physicians are specialists, different from old-time general practitioners in that they have gone through a residency in family medicine. Most have also taken a specialty board examination in family medicine. Family physicians treat families and individuals of all ages. Some may deliver babies, frequently with fewer interventions than OB/GYNs. All residents in family medicine learn to do obstetrics and are taught about women's health.
  
  
• Primary Care Internists are specialists with residency training in internal medicine. General internists (those who do not have a subspecialty in a particular type of medicine) are trained to provide primary care and manage chronic illness. Some receive women’s health training during their residency or complete women’s health fellowships after residency. Women may have serious non-reproductive medical problems that an internist is specifically trained to treat. For instance, heart disease can be prevented or treated early with appropriate care by a primary care internist. Primary care or general internists are capable of providing comprehensive, non-surgical and non-obstetrical care to women.
  
  
• Obstetrician/Gynecologists (OB/GYNs) are surgical specialists, trained especially to diagnose and treat diseases of the reproductive organs, to manage normal and complicated childbirth, and to perform gynecological surgery. Many women use OB/GYNs not only for reproductive care but also for primary care; however while many provide well-woman reproductive health care, they are not trained to deliver general primary care.

Written by: Our Bodies Ourselves. Special thanks to Karen Wolf.
Last revised: April 2005

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