Many women, from adolescents to the elderly, believe that the Well Woman Exam is about a yearly pap smear. This couldn’t be further from the truth.
Recent changes to screening guidelines, such as the extension of pap smear screening to every 3 years, has created confusion about the need for an annual examination. The truth is, the annual examination has never been more important.
The Well Woman Exam, also known as the Annual Physical Exam, Periodic Health Exam, Health Maintenance Exam or the Annual Wellness Exam provides an essential opportunity to focus on the prevention and early diagnosis of disease and the promotion of optimal health and wellbeing.
This thorough history and examination varies by age group, depending on the health risks and disease prevention issues appropriate for each period of life. A complete medical, family and social history allows the clinician to determine risks of disease and guides the choices and intervals of screening tests, preventive services and counseling priorities.
The health and preventive screening issues covered during a Well Woman Examination are generally recommended by professional organizations and are based on evidence of their effectiveness. Not all organizations agree about the optimal interval of the exams or screening tests. There is evidence, however, that a yearly Well Woman Exam increases the likelihood that patients will get the preventive services that they need. In addition, the risks and benefits of screening tests can be discussed, allowing the patient to make educated decisions about the screening tests that are recommended. Clinic visits for acute medical problems or for follow up of chronic conditions are generally brief and do not allow enough time to address prevention, assess disease risks or examine issues deserving of counsel. Many clinicians believe that the yearly history and physical exam provides an opportunity to enhance the doctor – patient relationship and also address time consuming issues about lifestyle, mental health, family relationships and end of life issues. Studies have shown that both doctors and patients think a yearly examination is both necessary and important.
Some of the important health and prevention issues that are addressed during the Well Woman Examination are noted below. Adolescent annual examinations include additional issues specific to their age group, such as normal growth and development, peer pressure, bullying and injury prevention.
Well Woman Examination:
- past medical, surgical & family histories
- blood pressure, cholesterol, diabetes & obesity screening
- exercise, nutrition, safety concerns
- sexual practices, sexually transmitted infections, contraception
- pre-pregnancy counseling & family planning
- use & misuse of tobacco, alcohol & other substances & their consequences
- depression & intimate partner violence
- immunization recommendations
- cervical & breast cancer risks & prevention
- colorectal cancer risks & prevention
- skin cancer risks & prevention
- heart disease & stoke risks & prevention
- infectious disease risks & prevention
- osteoporosis risks & fracture prevention
- chronic disease prevention & management
- menopause issues
- end of life / advanced directives issues & counseling