New York State Primary Care Physician Practices and Perspectives on Offering Reproductive Health Services
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J Gen Intern Med DOI: 10.1007/s11606-020-06162-w © Society of General Internal Medicine 2020
INTRODUCTION
Primary care provides an important opportunity for patients to access comprehensive reproductive health (RH) services, particularly as reductions to family planning programs continue.1 There is a lack of data on the specific RH services provided by primary care physicians (PCPs) and their perceptions of offering these services.2 Such information can aid in successfully expanding RH services in primary care. Our objectives were to determine the RH services New York State (NYS) PCPs report providing, their perception of the benefits and disadvantages to providing such services, and which RH services they felt were most important to offer.
METHODS
We recruited a convenience sample of NYS PCPs through the American Medical Association (AMA) Master File, attendance at two NYS primary care conferences, and staff meetings at two NYS federally qualified health center (FQHC) networks. We describe the recruitment, data collection, and study instrument details, as well as report other findings elsewhere.3, 4 Our sample was more likely to be female, younger, and specialize in family medicine than the AMA sampling frame. We conducted chi-squared and one-way ANOVA tests to assess significant differences by specialty in providing any RH or contraceptive services in the last year, and the mean number of perceived benefits and disadvantages (including barriers) to providing RH services, respectively.
RESULTS
Half of the physicians in our sample were female. The largest proportion of respondents was aged 42–59 (38%), followed by 36% aged 24–41. The majority of respondents provided at least one RH service in the last year (88%), with HIV/STI testing and counseling (74%) being the most common, Received March 18, 2020 Accepted August 14, 2020
followed by contraceptive counseling (67%) and cervical cancer screening (63%; Table 1). The least reported service provided was induced abortion (9%). The majority of respondents provided at least one contraceptive method/service (74%), most notably the pill (71%). Eighty-eight percent of family medicine physicians reported providing the pill, compared with 58% internal medicine providers. However, less than 40% of PCPs provided any of the other contraceptive services. A significantly larger proportion of family medicine physicians reported providing any RH (97% vs. 82%) and contraceptive service (91% vs. 61%) in the last year, compared with internal medicine respondents (p < 0.0001). Respondents endorsed an average of 8.4 benefits, from a list of 14 (standard deviation (SD) 4.3, range 0–14; Table 2) associated with providing RH services in primary care settings, with increased access to RH services (82%) and patient convenience (82%) cited as the most common benefits. On average, respondents endorsed 1.5 disadvantages, from a list of 10 (SD 1.5, range 0–9). The most frequently held perceived disadvantage was not being sufficiently trained (51%), cited more often by internal medicine pr
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