Preventive Health Examinations and Preventive Gynecological Examinations in the United States

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Abstract
The value of many preventive health services is well established, but the role of preventive health examinations (PHEs) (also called periodic health evaluations) for health promotion and screening of disease risk factors and subclinical illness remains controversial.1,2 Surveys have found that two-thirds of patients and physicians believe it is important for adults to receive a PHE each year,3,4 and routine PHEs are believed to strengthen physician-patient relationships.5,6 Approximately 80% of commercial insurance plans pay for annual PHEs.7 In 2005, Medicare introduced the “Welcome to Medicare” examination, a PHE for beneficiaries during their first year of enrollment.8 However, annual PHEs or preventive gynecological examinations (PGEs) (also called annual pelvic or gynecological examinations) are not recommended by major North American clinical organizations.9,10 These organizations have instead recommended a more individualized package of preventive services for patients.10,11 Some observers have raised concerns that preventive visits are an inefficient use of physicians' time, potentially interfering with timely access for sick patients.12,13 Others have emphasized the value of providing preventive care during nonpreventive visits.14

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