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ACOG recommends initial Ob.Gyn. visit at ages 13-15: committee opinion outlines topics, coding.(Gynecology)
WASHINGTON -- Teenage girls should have their first visit with an ob.gyn. between the ages of 13 and 15, according to a recommendation from the American College of Obstetricians and Gynecologists.
This initial visit should be focused on preventive services and education, and may include a discussion on topics such as adolescent development, normal menses, sexual orientation, healthy eating, injury prevention, and prevention of pregnancy and sexually transmitted diseases, according to an opinion from the ACOG Committee on Adolescent Health Care (Obstet. Gynecol. 2006:107:1215).
"The goal of this key visit is to help teens identify an ob.gyn. and then get acquainted with their ob.gyn. before they need to seek care for a specific health issue," Dr. Marc R. Laufer, chief of gynecology at Children's Hospital Boston, said at the annual meeting of the American College of Obstetricians and Gynecologists. Dr. Laufer is the immediate past chair of the ACOG Committee on Adolescent Health Care.
Officials at ACOG have been advocating for an initial reproductive health visit around age 13-15 years for a number of years, but the new committee opinion provides details on what topics should be included in the visit and coding suggestions for payment of the visit.
The initial visit does not need to include an internal pelvic exam and may not even include a physical exam, Dr. Laufer said. An "age-appropriate pelvic examination" can be performed if problems are identified during the medical history such as abnormal menstrual bleeding or pelvic pain, according to the committee opinion. In cases where a speculum or bimanual exam is needed, physicians should first give the patient a full explantation of the exam and obtain consent.
The initial visit is generally more of an "information session," Dr. Laufer said. For example, the visit is a chance for teens to get a better understanding of normal development and menstruation. It also is an opportunity to talk about issues that may need early intervention ...
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