Abstract:
OBJECTIVE:To survey the interest of obstetrician-gynecologists in serving as primary care physicians and their perceived preparedness for that role from the view points of managed care plans and obstetrician-gynecologists. METHODS:A sample of obstetrician-gynecologists was asked to describe their preferred physician roles in managed care plans. Managed care medical directors were asked to define the obstetrician-gynecologist's role in their health plans. The mailed survey questions focused on 1) obstetrician-gynecologists' interest in serving as primary care physicians and/or gatekeepers, 2) direct access to obstetrician-gynecologists, and 3) additional training needed to serve as primary care physicians. RESULTS:Thirty-seven percent of obstetrician-gynecologists expressed little or no interest in serving as primary care physicians, and 37% had some or high interest. Fifty-six percent were not interested in serving as gatekeepers, and 45% believed that physicians in the specialty should not do so. Almost all believed women should be allowed direct access to obstetrician-gynecologists. Over half of the managed care plans allowed women to refer themselves to obstetrician-gynecologists, and one-third allowed these physicians to serve as primary care gatekeepers. Most plans believed that extensive additional training is needed for obstetrician-gynecologists to serve as gatekeepers, whereas 70% of specialists believed that little or no additional training is needed. CONCLUSION:Obstetrician-gynecologists do not all agree on their appropriate and preferred role as physicians in the managed care environment; 37% see themselves as primary care physicians, whereas 37% would rather act as consultative specialists. Nearly all, however, support direct access to obstetrician-gynecologists. Most (69.7%) believe that they are capable of serving as primary care gatekeepers with little or no additional training, but managed care plans believe otherwise.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Scroggs JA,Griffin LP,Bayerl M,Schulkin Jdoi
10.1016/S0029-7844(97)00224-Xsubject
Has Abstractpub_date
1997-08-01 00:00:00pages
291-5issue
2eissn
0029-7844issn
1873-233Xpii
S0029-7844(97)00224-Xjournal_volume
90pub_type
杂志文章abstract::Placental sonolucency has been reported to be a normal sonographic finding after 36 weeks' gestation. To further characterize this acoustic phenomenon, 15 placentas from previously scanned high-risk obstetric patients were studied in vitro. Placentas were obtained at delivery, and were washed, weighed, sonographically...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1980-01-01 00:00:00
abstract:OBJECTIVE:To study the plasma levels of homocysteine in preeclampsia and relate them to insulin sensitivity. METHODS:In association with a 3-hour intravenous glucose-tolerance test (glucose 0.3 g/kg at 0 and 0.03 IU insulin 20 minutes later), we measured plasma levels of homocysteine, vitamin B12, and folic acid in 22...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(98)00527-4
更新日期:1999-04-01 00:00:00
abstract:OBJECTIVE:To estimate unintended pregnancies averted and the cost effectiveness of pharmacist prescription of hormonal contraception. METHODS:A decision-analytic model was developed to determine the cost effectiveness of expanding the scope of pharmacists to prescribe hormonal contraception compared with the standard ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000003265
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVES:To define the profile of 24-hour uterine activity in normal pregnancy and to correlate contraction frequency with physical activity and emotional stress diaries. METHODS:One hundred nine low-risk pregnant women who delivered at term recorded uterine contractions for 24 hours twice weekly from 20-40 weeks' g...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-199404000-00006
更新日期:1994-04-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that fetal growth restriction (FGR) associated with a maternal hypertensive disorder results in worse perinatal outcome than FGR in pregnancies without maternal hypertension. METHODS:All consecutive, singleton, nondiabetic, small for gestational age (SGA) deliveries (birth weight at or...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(96)02169-2
更新日期:1996-08-01 00:00:00
abstract:OBJECTIVE:To explore the relationship between race and depression symptoms among participants in an early pregnancy loss clinical trial. METHODS:We performed a planned secondary analysis of a randomized trial by comparing treatments for medical management of early pregnancy loss. We hypothesized that Black participant...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000004212
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Retained viable intrauterine pregnancy is an infrequent complication of vacuum aspiration. We report a case of a retained single intrauterine pregnancy after an elective vacuum aspiration of a dichorionic-diamniotic twin gestation. CASE:A patient presented to the emergency department reporting vaginal spott...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3181dd1fac
更新日期:2010-08-01 00:00:00
abstract::The efficacy and safety of bromocriptine mesylate (5 to 7.5 mg per day for up to 24 weeks) were studied in 22 clinical trials involving 226 patients who had amenorrhea/galactorrhea associated with hyperprolactinemia and no demonstrable pituitary tumor. Of the 187 patients evaluated for efficacy, 80% experienced reinit...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1097/00006250-198003000-00002
更新日期:1980-03-01 00:00:00
abstract::Response of luteinizing hormone-releasing factor (LRF) and gonadotropin levels to orally administered L-dopa and clomiphene citrate were measured in 13 healthy female volunteers. Testing was carried out during the early follicular phase of the menstrual cycle. The results indicated a suggestive but statistically nonsi...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1976-07-01 00:00:00
abstract::A series of 117 patients with stage I squamous cell carcinoma of the vulva was followed for 3 to 21 years. Twenty recurrences (17.1%) were found, 12 in the vulva or vagina, 7 in the groin, and 1 in a patient who developed distant metastases. Invasion of tumor cells in lymph or blood vessels was found in operative spec...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1981-01-01 00:00:00
abstract:OBJECTIVE:To assess the relationship between preeclampsia or eclampsia and stroke, myocardial infarction (MI), subsequent cardiovascular outcomes, and long-term survival. METHODS:Using the Myocardial Infarction Data Acquisition System in New Jersey (1994-2009), we analyzed cardiovascular outcomes in women with and wit...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e31826ae78a
更新日期:2012-10-01 00:00:00
abstract::A total of 410 colposcopic examinations were performed on 188 female cebus monkeys that were under study to determine the oncogenic potential of herpes simplex virus type 2 in this genus. A split-cone vaginal speculum was developed that permitted good observation of the vaginal cervix in the cebus monkey. The cervical...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1978-11-01 00:00:00
abstract:BACKGROUND:Because of donor oocyte programs, women who previously were considered too old to successfully achieve conception and delivery can now bear children. To our knowledge, there have been no previous reports of pregnancy outcome in women over age 50 who conceived using donor oocytes. This study presents the preg...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract:OBJECTIVE:To estimate the occurrence and to assess clinical predictors of emergent cesarean delivery in the second twin after vaginal delivery of the first twin. METHODS:We conducted a population-based cohort study, using the 1995-1997 linked mother/infant twin data from the United States. The adjusted risk ratios and...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000110248.32558.fb
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:A rare malignant germ cell tumor of the ovary during pregnancy was detected by screening of maternal serum alpha-fetoprotein (MSAFP). Treatment of this uncommon tumor during pregnancy incorporated combination chemotherapy including etoposide. CASE:An 18-year-old primiparous woman undergoing antenatal geneti...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1994-10-01 00:00:00
abstract::The ovarian remnant syndrome is one of the least recognized and least discussed complications of oophorectomy. The most common presentation is pelvic pain with a pelvic mass. To prevent the condition, the ureters should be mobilized and laterally displaced during oophorectomy, and the pelvic side wall and cul-de-sac p...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-08-01 00:00:00
abstract:OBJECTIVE:To establish nomograms of fetal ear measurements. Newborns with trisomies have smaller ears than the normal population. This observation led us to believe that ear measurements might be useful in the antenatal prediction of fetuses with abnormal karyotypes. METHODS:Fetal ear length and width were obtained ul...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the counterregulatory responses to insulin-induced hypoglycemia in healthy women and in women with insulin-dependent diabetes during pregnancy and in the nonpregnant state. METHODS:Hypoglycemia was induced using the hypoglycemic clamp technique in 17 women with insulin-dependent diabetes and in t...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(95)00495-5
更新日期:1996-04-01 00:00:00
abstract::Recent reports have suggested that focal hyperechoic abdominal masses detected during the second trimester may represent a normal variation in fetal intestinal development that is transient in nature and not associated with pathologic conditions. The patient described here had second-trimester ultrasonic findings of f...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-11-01 00:00:00
abstract:BACKGROUND:Anaphylactoid syndrome of pregnancy is a rare and poorly understood complication of pregnancy. Intrauterine pressure catheter placement is a procedure routinely performed in labor and delivery that is traditionally associated with few complications. CASE:A pregnant woman at term experienced anaphylactoid sy...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3181b5c8cc
更新日期:2010-02-01 00:00:00
abstract::Two patients with severe postpartum hemorrhage refused blood product transfusion for religious reasons. The patients' hemoglobin level had dropped to 3.0% or less after operative intervention, and the cardiac indexes on transfer to the tertiary care center were 8.0 and 7.3 L/minute per m2, respectively. Each received ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract:OBJECTIVE:Adverse fetal heart rate (FHR) changes occur frequently during the first 30 minutes after epidural analgesia. The aim of this study was to estimate whether intravenous administration of ephedrine during induction of epidural analgesia can reduce the frequency of adverse FHR changes. METHODS:We prospectively ...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.AOG.0000146281.05275.73
更新日期:2004-12-01 00:00:00
abstract::Unilateral jaw and ovarian Burkitt's lymphoma occuring in an adult American female is reported. The patient was treated with a combination of surgery, radiation, and chemotherapy. The diagnosis, treatment, prognosis, and relapse patterns are briefly reviewed as they relate to the specialty of gynecology. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1976-07-01 00:00:00
abstract::Although it is generally believed that patients with previous cervical cerclage have abnormal labor patterns, there is little evidence to support this belief. We analyzed the pattern of cervical dilatation during labor in 114 women with cervical cerclage by the McDonald procedure who delivered vaginally at term and co...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1990-08-01 00:00:00
abstract::A new method to replace fetal membranes that have prolapsed through an incompetent cervix, which includes overfilling of the urinary bladder, was successful in four consecutive patients who presented with this clinical entity. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1989-09-01 00:00:00
abstract::A study of the records of patients seen in a two-year period in a private gynecologic practice and a one-year period in the emergency department of a general hospital was prompted by the incidence of chest wall pain diagnosed as costochondral pain. The study revealed 76 women in the former practice and 156 men and wom...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1983-11-01 00:00:00
abstract::The nonstress test is a commonly used tool for fetal well-being assessment. The antenatal death rate using the nonstress test as a primary modality is significantly higher than that with the use of the contraction stress test. The nonstress test is commonly performed on a once-a-week basis. The rate of stillbirths wit...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1986-04-01 00:00:00
abstract:BACKGROUND:Recent reports have advocated conservative management rather than hysterectomy for placenta increta and its related conditions, placenta accreta and percreta. We report an unusual case of placenta increta in which initial conservative therapy for a presumed placenta accreta failed and hysterectomy was perfor...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(96)00121-4
更新日期:1996-10-01 00:00:00
abstract::We examined the release in vitro of tumor necrosis factor-alpha (TNF-alpha) by peritoneal macrophages and peripheral blood monocytes following incubation with toxic shock syndrome toxin-1 (TSST-1). We obtained peritoneal macrophages from 22 women at laparoscopy and peripheral blood monocytes from four healthy women du...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-08-01 00:00:00
abstract::Laparoscopy was used to evaluate 100 women who consistently reported pelvic pain in the same location for a minimum of six months. These findings were compared with those of 50 asymptomatic women who underwent laparoscopy for tubal ligation. Overall, 83% of the group with pelvic pain had abnormal pelvic organs as comp...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1984-11-01 00:00:00