
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: WEDNESDAY, November 2, 1994                   TAG: 9411020063
SECTION: NATIONAL/INTERNATIONAL                    PAGE: A-12   EDITION: METRO 
SOURCE: ASSOCIATED PRESS
DATELINE: WASHINGTON                                LENGTH: Medium

DOCTORS DEBATE WHETHER WOMEN NEED SPECIALIZED MEDICAL CARE

Complaints that women get poor or fragmented care from their physicians are feeding a debate over whether women's health should be a new medical specialty.

``Should we have a new practice focusing just on women's health?'' Dr. Sally Guttmacher of New York University asked Tuesday. ``Or do we then let the guys off the hook?''

But Guttmacher, initially an advocate of a women's health specialty, said she has decided such a change may not be a good move. A new specialty would take time to spread, and may give general practitioners little incentive to improve the care they give to women, she said.

Still, she said, ``It's a debate we really need to have.''

Questions abound on whether women would benefit more by holding current doctors to better standards, agreed Linda Holmes of the National Women's Health Network. ``There are lots of concerns about what that [specialty] really means.''

Several studies presented at the American Public Health Association this week reflected growing concerns about women's health care, such as the fact that doctors don't have enough time for women's cancer screenings or forget them outright.

The problems have prompted ``a substantial movement'' to create a new specialty that would cover women's health needs, explained Guttmacher.

Women need integrated care from doctors as qualified to perform Pap smears and breast exams as they are to recognize heart disease and other ailments that attack women differently than men, she said.

Experts already are devising new guidelines for medical schools that call for better training of general practitioners, and are pushing gynecologists to expand their services to patients who have no other doctor.

Among the findings presented at the APHA meeting:

More poor and minority women are getting the long-lasting contraceptives Norplant and Depo-Provera without ever being told those drugs have risks and significant side effects. Holmes' group, the National Women's Health Network, was so concerned that it met with Food and Drug Commissioner David Kessler on Tuesday to call for mandatory explanation of those risks before a woman gets the drugs.

About 10 percent of American women have no regular physician, 37 percent use only a general practitioner and 16 percent use only a gynecologist, reported Dr. Carol Weisman of Johns Hopkins University. Yet general practitioners may not provide top reproductive care while gynecologists aren't trained to detect other diseases.

A study of 142 North Carolina physicians found doctors who said that during routine exams, they often didn't have enough time or just forgot to examine women's breasts for tumors or give them a Pap smear to detect cervical cancer.

Male doctors are less likely than females to suggest Pap smears and mammograms.

by CNB