New recommendations for the periodic well-woman visit: impact on counseling.

Since 2000, the recommendations for women's health care have undergone considerable changes that have prompted a modification in terminology from the "annual examination" to the "periodic well-woman visit." A pelvic examination is not required before prescribing hormonal contraception, selected women 30 years or older may receive less frequent cytological testing and teaching breast self-examination is no longer recommended unless the patient requests it. Counseling will be needed to reassure women that these changes are based on sound scientific evidence. The periodic well-woman visit provides an opportunity for ongoing contraceptive counseling. The expanding array of contraceptive choices necessitates counseling that focuses on methods that are most appropriate for the individual. In addition to the changes in screening recommendations, increased utilization of ancillary staff, self-administered questionnaires and other time-saving strategies to gather information before the patient sees the health care provider can increase the time available for counseling within the time constraints of an office visit.