Samuel Metz, MD; Debra Gussman, MD
Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L14-0519.
Metz S., Gussman D.; Screening Pelvic Examination in Adult Women. Ann Intern Med. 2014;161:925. doi: 10.7326/L14-5035
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Published: Ann Intern Med. 2014;161(12):925.
TO THE EDITOR:
Both the American College of Physicians (1) and American College of Obstetricians and Gynecologists (2) agree that annual pelvic examinations for asymptomatic women offer little intrinsic value. However, both organizations would acknowledge that annual encounters to discuss safe sex, sexually transmitted and urinary tract infections, birth control, and prepregnancy counseling offer high value. Unfortunately, insurance companies disagree. Most will readily pay for annual examinations that lack clinical value but withhold payment for discussions providing high value. As a consequence, women seeking counsel from their gynecologists to discuss safe sex and other issues must endure an unwanted, unindicated, and uncomfortable procedure or pay for the visit out-of-pocket. There is no escaping the examination: Charging for an unperformed procedure is fraud.
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