All women can benefit from an annual visit that includes a general medical history and examination, infection screening, breast examination, and a pap smear. For most insurance plans, a well woman visit is covered with no deductible or co-pay.


Preventative care measures change through the lifespan. Women over 40 years of age need an annual mammogram and women over 50 need rectal examination including a test for occult blood in the colon. They also should be tested periodically for thyroid problems, diabetes, high cholesterol and Vitamin deficiencies. Consideration of the contraceptive method or hormone status is included, as well as general health issues including smoking status, alcohol use, and domestic violence or abuse. All of these services are included in the well woman visit.


There has been controversy concerning the annual pap smear at different stages of life. It is generally agreed that women under the age of 21 do not benefit from a pap smear, since their risk of undetected cancer is virtually zero. Young women do however need an annual screening for sexually transmitted diseases that could threaten their lives or their future fertility. These tests can be performed on a urine sample if the young woman does not wish to have an internal examination. The Gardasil vaccine for HPV is recommended to decrease the risk of cervical cancer by 90 percent.


Women who have had the Gardasil vaccine against cancer causing Human Papilloma Virus and have had several normal pap smears can safely space pap smears to every other or every third year. An individual’s need for a pap smear will be reviewed and recommendations based on patient history. Medicare pays for women over 65 to have a screening pap every 2 years, and the indication for a pap smear will be discussed with each patient.


Additional screenings may be indicated depending on your personal health history and family history. Colonoscopy, chest x-ray, EKG, urinalysis, and additional blood work may be indicated for those at risk for problems in those areas. Dr. Holley and Teresaell will work with you to determine the appropriate testing and interval that is best for you. However, if a problem is discussed, particularly if it is a new problem, a significant problem, one that requires additional testing or a prescription, that visit is no longer a well woman visit, but a diagnostic visit, which is subject to co-pays and deductibles. We are required by law to code and document your visit honestly and appropriately.