How To Choose Your Gynecologist
How Do I Choose a Gynecologist? Take Dr. Donnica's Decisionnaire™.
All women do not have the same needs from their Ob-gyn, nor do most women have
the same needs from their Ob-gyn throughout their lives. Answer all of the
following questions for yourself to create a check-list of your individual
needs. This will help you choose the most appropriate gyn for you, now. Remember
that your needs may change over time and you may have to review this process.
Do you have any limitations or guidelines for Ob-gyn selection or referral
from your insurance carrier?
How important is "bedside manner" or personality to you? If this is very important,
you may want to consider asking a potential Ob-gyn to meet you for an informational
interview or "get-to-know-you" visit. Feeling comfortable with this person
__ Is the doctor's gender important to you? Race, age, religion, and other
commonalities may also be (or seem) important to you. Some women feel
more comfortable with doctors who are more like them; other women feel differently.
Remember, however, that while sharing values is nice, feeling like you and
your values are valued is much more important.
__ How important are logistical concerns? Consider how far you're willing
to travel, whether you want your gynecologist to be closer to your home or
office, whether you will need to get there by public transportation, whether
you need someone with evening or weekend hours, etc.
__ How important are the gyn's affiliations to you? Some women prefer having
a gyn who is based at an academic health science center or a hospital; some
prefer gyn's with private practices; some women are limited to the Ob-gyn's
listed in their managed care plan manuals. Generalizations about the quality
of care or qualifications of gyn's solely on these credentials is inappropriate,
however, and often irrelevant.
__ Are you planning to get pregnant? If so, you may want someone who
practices obstetrics (provides prenatal care and delivers babies). If this
goal is far in the future, this may not be relevant now, but be aware that
you would have to switch to an OB once you became pregnant.
__ If you are pregnant: do you need an OB trained in high-risk pregnancies?
Common reasons to consult a specialist in maternal fetal medicine include
having multiples (e.g. twins, triplets), having had a serious medical problem
(from diabetes to high blood pressure to certain surgeries), having had previous
miscarriages, or if your mother was given DES (diethylstilbesterol) in her
pregnancy. Choosing an OB requires all of the same questions as choosing
a gyn when you're not pregnant, but some additional criteria may take precedence
__ Where do you want to deliver? Many OB's deliver at more than one hospital;
it's important to identify an OB who delivers at the hospital of your choice.
How far the hospital is from your home (in time more than in miles!) may
take precedence over any other factors!
__ Do you have specific concerns about your needs for the hospital? Things
to consider are whether you have limitations from your insurance carrier,
whether you want/need an Intensive Care Nursery, whether you want/need 24
hour in-hospital anesthesia coverage, whether you want/need 24 hour in-hospital
neonatology experts, whether you want a birthing room, whether you want
a midwife to deliver your baby and an OB to supervise, the hospital's policies
on visitors, the hospital's policies on the baby staying with the mom (or
not), whether you want a circumcision performed on your son in the hospital,
or whether you want a sterilization procedure after delivery.
__ Do you like all the members of the OB's group? Will you have the opportunity
to meet all the OB's in the practice? Remember that you may not deliver
when "your" OB is on duty. Even solo practitioners generally have cross
__ If you have had difficulty getting pregnant, you may want to consult a sub-specialist
in infertility called a "reproductive endocrinologist". These are gyn's
who have extra training, experience, and further board certification. There
is a difference between a gyn who has done a fellowship in Reproductive
Endocrinology and Infertility versus a generally trained gyn who has a special
interest in infertility. If you are being evaluated by your regular OB/Gyn
for infertility, you should ask at what point they would refer you to an
infertility sub-specialist. Generally this should happen within 6--12 months
of treatment with your OB/Gyn depending upon the particulars of your history,
diagnosis, insurance coverage, and age. Particular concerns in choosing
an infertility specialist include many of the same factors as choosing any
gyn, as already discussed. Some unique considerations for infertility specialists
__ Questions about in vitro fertilization (IVF) treatment: ask the doctor's
specific success rate for patients who have had similar circumstances
__ Questions about cost: don't be embarrassed to discuss this frankly. Many
costs related to infertility treatments are not covered by insurance,
and this can be very expensive. Many specialists who perform IVF
have financial counselors on staff to assist couples proactively in this
regard. Make sure that the prices you are quoted include all the
details; find out what your insurance will cover before initiating
treatment. Remember that prices for IVF are often quoted per treatment
cycle; most couples require more than one treatment cycle to achieve
__ Questions about convenience: As with obstetrics, there are often many tests
involved; convenience may be a concern. You should ask whether blood
tests and ultrasounds, for example, can be performed at the office or
if you will have to travel to another location for them. Many treatments
depend upon happening on a particular day of your cycle; ask if the doctor's
practice has staff and technicians seven days a weekand during holidays.
__ If you (or your mother or your sister) have had a gynecologic cancer (e.g.
ovarian, cervical, or endometrial cancer), you may want a sub-specialist called
a gynecologic oncologist ("Gyn Onc") to provide your routine gyn care. Alternately,
you may want to choose a gyn who has had additional training in your particular
kind of cancer, or one who has a good working relationship with a gyn onc
with whom you're comfortable.
__ If you are sure (or at least pretty sure) that you do not want to become
pregnant again, you may want to choose a gynecologist who no longer practices
obstetrics. In some cases, these gynecologists are able to have more predictable
office hours schedules and may be able to focus more on non-obstetric gynecologic
or general women's health issues.