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Huge Opportunities in the OB-GYN Office - The New Reality in Women's Health
By Wayne Care

The New OB/Gyn Brings New Opportunities
Used to be that the OB/GYN's office was the place only for pregnant women and those with "female troubles," but no longer. Today, many women name their OB/GYN as their primary care physician, who is now charged with overseeing the total health of their patients.

Office visits are just as likely to address cholesterol levels and the patient's chances for osteoporosis as they are fertility and menopause. This specialty, which for years was among those that provided the least amount "in-office" testing, now presents huge opportunities. Let's explore some of them.

Glucose Testing
Since gestational diabetes during pregnancy is not uncommon (approximately 135,000 cases of gestational diabetes occur annually in the U.S.), the OB/GYN has always been concerned about glucose levels-but generally only in expectant mothers.

Most OB/GYNs already do glucose screening with one of the many glucose meters available. For those patients at risk, OB/GYNs either perform Glucose Tolerance Tests (GTT) in-house, or send them out. For a GTT, the patient drinks a substance containing a set amount of glucose (usually 50mg), then she is tested three times over a three hour period to see how well the glucose has broken down. During the pregnancy, the patient is monitored (using glucose, Hemoglobin A1c or fructosamine) and may be prescribed medication as well as dietary changes.

The opportunity with glucose testing extends beyond gestational diabetes. In the overall U.S. population, diabetes has become epidemic, affecting more than 15.7 million Americans. Unchecked diabetes leads to a number of other disease states, such as congestive heart failure, kidney (renal) failure, and neuropathy.

Osteoporosis Screening
Earlier generations believed that developing a hunchback or "widow's hump" was a foregone conclusion for an older woman. But with recent advances in the detection and treatment of osteoporosis, this condition could become a thing of the past.

According to the National Institutes of Health, there are approximately 10 million patients diagnosed with osteoporosis, while an additional estimated 18 million have low bone mass and are not yet diagnosed or in treatment. One and a half million fractures a year are caused by osteoporosis at a cost of about $14 billion annually.

The opportunity for selling bone densitometers to physician offices is phenomenal. When osteoporosis is discovered early enough, there is a wide array of treatments available. Instrumentation is available as smaller screening devices or large table models.

Cholesterol Screening
According to statistics from the American Heart Association (1998), coronary heart disease (CHD) accounted for 226,467 deaths among women-almost 49.2% of all deaths, more than from any other disease.

CHD is frequently a result of atheroschlerosis, arteriosclerosis, or the narrowing of at least two arteries. Death can be sudden-five to seven minutes-but the survival rate improves dramatically in areas where defibrillation is used immediately. If the physician prescribes medication such as any of the "statins," they also need to perform tests for liver function.

Cholesterol testing is a must for primary care physicians. CLIA waived instrumentation is available that performs lipid profiles and liver function testing.

Other Screening Opportunities
Some of the other screening tests recommended for females are:

  • Urinalysis strips: Every age, every visit
  • Occult blood: Annually for women over 40
  • RH factor: Every pregnant woman
  • Hemoglobin: Annually for women over 19
  • Mammography: Annually for women over 40
  • Flexible sigmoidoscopy or colonoscopy: Every ten years over 40
  • Chlamydia testing: Sexually active women

How To Sell To OB/GYNs In Your Territory
You need to find out what tests the OB/Gyns in your territory are performing, as well as where they purchase their equipment and test materials.

Ask specific questions when you meet with them. Instead of asking, "Do you do any testing?" ask "Do you have any patients with gestational diabetes?" Target questions so that you get actual answers, and involve them in the process. Always listen! Let them talk. If you are committed to making a presentation and talking you will never hear their concerns.

Some other questions:

  • How do you treat osteoporosis?
  • How do you identify patients with osteoporosis?
  • How do you treat your patients with high cholesterol?
  • How do you monitor your patients with gestational diabetes?
  • Do you see patients for STDs?

You are not a medical educator, but you can remind them about medical facts and alternatives. Have those facts at hand. Don't push, but encourage. Let them talk and they will lead you to the next question and the next answer to their needs.



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