Background: The author felt that issues related specifically to women's health were being overlooked by housestaff as they performed admitting histories and physical examinations.
Method: A retrospective review of 120 patients' charts at a city and county teaching hospital was conducted during two periods (September 1988 through January 1989 and March 1992 through June 1992) to determine the frequency with which 46 housestaff considered women's health issues while performing admitting histories and physical examinations. The charts selected were those of women, 17 years old or older, who were admitted to the inpatient medical service, were interviewed and examined by an intern and a resident, and were able to give their own histories. To better gauge the results (i.e., the numbers of charts on which women's health issues were recorded compared with the numbers on which such issues should have been recorded), two non-gender-specific control issues (history of tobacco use and the performance of a rectal examination) were used.
Results: Histories of tobacco use and rectal examinations were noted on 97% and 72% of the charts for the first study period, and on 95% and 70% of the charts for the second period. In contrast, the histories of Pap smears for the patients with intact uteri were noted on 5% and 0% of the charts; mammograms for the patients age 50 and older, on 4% and 0%; self breast examinations for all age groups, on 4% and 0%; and breast examinations performed by housestaff, on 33% and 25%.
Conclusion: Issues related to women's health promotion and disease prevention were rarely a part of the housestaff's admitting histories and physical examinations.