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How Often are Routine Doctor Visits Recommended: OB/GYN, Dentist, Optometrist/Opthamologist, Dermatologist, and others?

By June 29, 2008 - 12:39pm
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I know that I am suppsed to visit my OB/GYN once/year for a Pap Smear and to get a refill on my birth control pills. I also know that I am supposed to go to my dentist/dental hygienist every 6 months for a dental cleaning and checkup.

I am wondering if there is a list of recommended preventative screenings or "check ups" that we are supposed to get, for certain ages (from an unbiased source)? (For instance, is my dentist wanting to make money from seeing me twice a year, or is this medically necessary)?

I am not sure if I should see an eye doctor (optometrist or ophthalmologist) if I am not having eye problems: is there a recommendation for checking vision on a regular basis? What about seeing a dermatologist: should we have our skin checked "just because", even if we are not showing any signs or symptoms?

Lastly, any other recommendations for doctors/speaclists that we should check into BEFORE we have problems? What is good prevention, anyways?


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EmpowHER Guest

Recommendations for how often you should have an eye examination vary. For children I recommend the first exam anywhere between 6 to 12 mos (check out http://www.infantsee.org) then at age 2 and every year until college. Then every 2 years (at least...more if you wear contact lenses or if you are at risk for problems) until age 40....then once a year.
Dominick M. Maino, OD, MEd, FAAO, FCOVD-A

February 3, 2010 - 6:16pm
EmpowHER Guest

Thank you for your share anonymous. I had the opportunity to live in Germany for two years and medical care in each country is certainly different and I will agree with anonymous on the fact that I think American Doctors tend to over indulge in unnecessary testing. Most women from Germany that I spoke to were amazed also by the amount of exams we (as Americans) were subjected to annually. This is not common practice worldwide. The motivation is another topic all together.

I am not sure that a list will be an easy way to answer the above question for the simple reason that genetics and family history will play a role in what you should be routinely checked for. See, in my family, breast cancer is very high. I started getting mammograms at age 25. This is only because of my family history.

As for the other things, I have great teeth and always have and do not regularly visit the dentist. I go when there is something wrong. Call me crazy. As for regular testing, I get my annual exam with the gyno and started getting tested for cholesterol just recently since I guess you are supposed to have this test taken after you turn 30.

Other than these things, the physicians don't see me unless I need them. Be certain to talk to your physician about your family history and add that to your list. I think that would be very important.

November 8, 2009 - 10:35am
EmpowHER Guest

As a Finnish woman, that list horrifies me....
You are all having far too many exams and smears and that can be very bad for your health.
Our doctors do not recommend routine pelvic exams in asymptomatic women at all, EVER.
They are of low to poor clinical value and can lead to more invasive and possibly, harmful testing.
You should be told they are optional and have the risks and limitations explained to you before agreeing to the exam.

You are all terribly over-screened for cervical cancer.
The risk of this cancer is low and near zero for a low risk women. Over-screening greatly increases the risks of over-treatment. American women have more pap smears and colposcopies and biopsies than any other women in the world. Biopsies carry risks to your mental and physical well-being.
Less is more with pap smears.
We have the lowest rates of cervical cancer in the world and just as importantly, send the smallest number of women for biopsies.
Sexually active women are offered screening from age 30...
Women under 30 are very likely to have abnormal pap smears and have unnecessary treatment. The cervix is changing over these years and this is perfectly normal, but may be labelled abnormal by a pathologist....the very rare case of cancer that occurs in a young woman is often an adenocarcinoma and pap smears are very bad at picking up these rare cancers. It means young women have lots of false positives and unnecessary treatment and can produce false negatives in the very rare case of cancer.
In fact, the pap smear is an unreliable test, full stop.
But in young women it does more harm, than good. The UK doesn't screen before 25 as they believe the risk/harm to benefit ratio would make it unethical to screen. The Netherlands is also, age 30.
From age 30, Finnish women are offered 5 yearly testing stopping at 50, 55 or 60...(depending on risk profile and past results)

I'm 51 years old and have never had a routine pelvic exam. I have a breast exam every 2 years (started at 45) and have declined mammograms. (concerned about the risks)
Low risk women may choose not to have cervical screening or have it infrequently.
No healthy woman has more than 5-7 tests in her lifetime. US woman can have 50-60 tests in her lifetime...that's shocking and explains your very high rates of over-treatment.
Your doctors have ignored the call for fewer smears and most still push annual screening KNOWING this causes unnecessary biopsies.
They recommend annual screening for women under 30 - this makes no sense at all, as these women have the lowest risk of cancer and the highest risk of over-treatment.
Screening for women not yet sexually active, is not recommended in any other country in the world.
Germany is the only other country that recommends yearly pelvic exams and annual smears. (as far as I could find)

You have to ask yourselves, why your doctors are disregarding very clear medical and scientific facts and research?

My American friends were very surprised to hear that other women don't live with this level of medical involvement in their lives.
Our doctors tell us the truth and don't try to scare us. We can then make the right decisions for our health and not act on fear and misinformation.
As an exchange student many years ago, I refused the US annual exams, following my Finnish doctor's advice. I saw the distress these exams caused my American friends and found it upsetting. I felt sorry that so many women were already afraid to even question the need for these invasive procedures. The use of stirrups also shocked me...like women are not entitled to any dignity. Stirrups are never used in a consult situation in my country and in fact, I could only find them in general use in the States. They are used in surgery and possibly during day procedure clinics in other countries.

There is some great discussion about these issues at a site hosted by an American doctor, Dr Joel Sherman...there are lots of great references and facts.
Protect your health and make informed decisions...good luck everyone!
Love your country and the people, but have MAJOR concerns about your doctors.
It seems to me this conduct is motivated by money, power, politics and defensive medicine and has nothing to do with your health.
Google, Dr Joel Sherman's Patient Privacy - see the women's heath issues thread.

November 7, 2009 - 8:49pm

You are right on in thinking you probably need to have preventative screenings, but what and how often may actually depend on your age. The University of Tennessee Medical Center has a great write-up about the type of exams women should receive and when. Here's what they had to say.

"The American College of Obstetricians and Gynecologists (ACOG, 2004) recommends that young women have a complete physical exam that includes a pelvic exam with a pap smear, by age 21 unless they are sexually active. For sexually active women, this exam is recommended approximately three years after the first sexual encounter no matter what age that occurred. Women, younger than 21 who are not sexually active, but are having gynecological problems, should seek care if symptoms are severe or do not improve.

Until age 30, ACOG recommends that all women have yearly pap tests. After age 30, if a woman has a negative history of abnormal pap smears for three years and no evidence of a virus called HPV, cervical screening can be extended to every three years unless they are at high risk for cervical cancer. [Human papillomavirus (HPV) is a sexually transmitted virus that is responsible for genital warts, cervical cell abnormalities and, in some cases, cervical cancer. There are treatments available if HPV is detected, and often it clears up on its own.]

Women who have had hysterectomies (removal of the uterus and often the ovaries) should know that ACOG suggests that if a hysterectomy was done for health reasons that did not include abnormal cells and cancer, they do not need pap smears. After age 70, the American Cancer Society suggests that pap smears are no longer necessary. It is important to know that ACOG advises all women to continue yearly pelvic exams even though they may not need a pap smear. "

They also recommend a clincal breast exam as an annual exam after age 40 in addition to your monthly breast exam in addition to the following screenings:
A screening colonoscopy, usually performed with general anesthesia in the hospital outpatient area for detection of colon cancer, is recommended for all women at age 50;
Women more than 65 years old or those younger with risk factors, should be tested for the bone disease called osteoporosis with a DEXA scan;
A heart healthy screening is also a good idea especially if you lead a lifestyle that may be less than kind to your heart;

With regard to vision, you may want to check out this chart courtesy of the U.S. government as it changes with age ...

When it comes to skin and dental health, age-associated guidlines are key.

And prevention involves making smart decisions about your health prior to the onset of conditions rather than reacting to medical conditions upon their onset.
Does that info help?

June 29, 2008 - 2:04pm
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