Leveraging primary care ultrasound in obstetrics and gynecology and women's health outcomes

The use of primary care ultrasound is expanding across multiple areas of specialization¹ as patients demand more personalized and seamless care through every stage of the treatment process. One of the specialty areas in which this demand has become particularly apparent is ultrasound in obstetrics and gynecology. 

Research indicates that women are getting scans from their primary care physicians at a markedly higher rate. Ovarian pathology, uterine assessment, and abnormal vaginal bleeding are some of the common indications for ultrasound in women's health.² When facing complex, serious, and potentially time-sensitive health issues, women expect and deserve timely diagnosis and comprehensive plans of care that, whenever possible, are administered and coordinated by the doctors they know and trust. 

Primary care physicians are uniquely empowered to step in and fill this need by integrating primary care ultrasound into their practices. By offering ultrasound in their offices, they can make the diagnosis and treatment processes more straightforward and less fragmented while also helping to build trust and confidence with their patients. Comprehensive and uninterrupted care helps patients feel safe and listened to as they continue to navigate their health challenges. 

What women's health issues can primary care ultrasound help treat? 

Primary care ultrasound has a key role to play in maternal-child health. Even in resource-limited areas, it has the power to improve health outcomes, more proactively identify problems, and ensure both mother and child are safe and healthy.³ 

In a time when complications related to pregnancy and childbirth are the leading cause of maternal mortality across the globe, and most of these deaths occur in lower- to middle-income nations,³ expecting mothers need and deserve every opportunity for early detection. It's critical to assess weight, heart rate, gestational age-related size disparities, polyhydramnios, oligohydramnios, cervical insufficiency, gastroschisis, placenta previa, limb-size anomalies, and more. Having these diagnoses early is essential for successful treatment. 

Unfortunately, the lack of ultrasound resources at the time of care in many of these countries, and the fragmented process of diagnostic referrals causes many of these issues to go unnoticed until it's too late. Putting the power of ultrasound in the hands of primary care physicians helps ensure prompt identification of these issues. 

In addition to helping ensure safe and healthy pregnancies, ultrasound can help to simplify and augment routine OB/GYN exams,⁴ including but not limited to identifying and understanding the source of pelvic pain, assessing fertility, locating intrauterine devices (IUDs), evaluating the progress and efficacy of in vitro fertilization (IVF) and other fertility treatments, monitoring and addressing abnormal menstrual bleeding or irregular cycles, identifying pelvic masses, and a variety of other diagnostic functions. 

Outside of the routine OB/GYN visit, primary care ultrasound can be instrumental in detecting, identifying, and treating a wide swath of urgent conditions that may require immediate intervention, such as masses or cysts in the ovaries, adnexal region and uterus, as well as early detection of possible cancer. 

For example, an established and growing body of research points to the efficacy of moving transvaginal ultrasound into the primary care environment for early detection of ovarian cancer.⁵ Primary care physicians can also use ultrasound to detect uterine fibroids as well as tissue and cyst growth that can indicate endometriosis. 

Helping to reduce breast cancer mortality 

Another valuable use of primary care ultrasound in women's health, and perhaps one of the most common, is its application for early detection of breast cancer. This is especially important in lower-resourced regions where even traditionally treatable breast cancer often goes undetected and contributes to mortality. Mammography continues to be the gold standard, but ultrasound is also viable for women who cannot undergo mammography; however, it should not be seen as a replacement. ⁶ 

With breast cancer being either the first or second leading cause of female cancer mortality in most countries,⁷ it's imperative that women have prompt and immediate diagnoses for early detection and proactive intervention. 

Although certain clinical and administrative barriers persist, there is a growing call, including from the American Cancer Society and the American College of Obstetricians and Gynecologists, to incorporate breast cancer screening in primary care physicians' offices as a means to empower patients and achieve shared decision-making during diagnosis.⁸  

Beyond ultrasound in obstetrics and gynecology: Other applications in women's health 

Primary care ultrasound can also help aid in and expedite the treatment of a wide array of conditions even outside of the reproductive health and breast areas of specialization, including musculoskeletal injury, abdominal pain, thyroid disorders, cardiovascular disease, and more. These conditions, among many others, are common in both women and men,^9.10.11.12 which makes it especially important to access effective and prompt diagnostic resources in their primary care physicians' offices whenever possible. 

In many parts of the world, including the United States, it can take weeks or months to get a referral for an ultrasound, depending on the type of scan needed, insurance resources, geography, and other factors. In other parts of the world, these diagnostic services are inaccessible to patients altogether. Many of these cases are urgent conditions requiring immediate care. Bringing ultrasound into primary care environments reduces, and in some cases eliminates, the need for these wait times for time-sensitive conditions, facilitating greater health outcomes. 

Using primary care ultrasound to improve patient experience 

Women face a variety of unique and distinct issues related to trust and sensitivity when interacting with their care providers.⁸ Many feel as though they aren't being heard or listened to when they report their symptoms.¹³ One of the added patient-experience benefits of women's health ultrasound for primary care physicians is that it signals to their patients that they're committed to providing the most thorough and comprehensive care possible through increased diagnostic confidence. 

This extra layer of treatment provides assurance, peace of mind, and empowerment to patients. In a community that faces a wide array of unique health risks while also experiencing higher rates of provider mistrust and adverse experiences with their doctors, the importance of these benefits can not be understated. 

Growing your relationships and revenue 

In addition to strengthening relationships with their patients, offering ultrasound can also help primary care physicians grow their practices and explore an additional revenue stream. Each condition that can be diagnosed through ultrasound represents another chance to provide better treatment. 

Women are more likely to avail themselves of ultrasound scans than men, often by virtue of the OB/GYN treatment journey alone. Primary care physicians can help leverage this reality to provide more immediate diagnoses, improve patient satisfaction, explore a new revenue stream, and experience operational growth. In short, offering ultrasound in their offices can be an effortless way for primary care physicians to facilitate improved interactions. 

The right system makes all the difference 

There is more opportunity than ever for primary care physicians to leverage ultrasound to improve health outcomes for women. Today's systems offer specialized probes that allow you to scan multiple areas of the body using one unit, including transvaginal. They also offer productivity tools for the breast, OB/GYN, thyroid, abdomen, and many other areas of the body that uniquely affect women's health. In practices with more limited space, the right primary care ultrasound system offers portability and easy maneuvering. 

These systems also provide comprehensive system education and training, and service agreements so first-time users can start using the system immediately. Image optimization tools, hands-free voice commands, automated measuring tools, and scan-assistant tools make it easier than ever to perform scans with limited personnel. These systems are also designed to suit practices' specific sizing and scalability needs, offering the ability to upgrade with minimal to no disruption to practice operations. 

The more services primary care physicians are able to provide on their own, the stronger their relationship with their patients can become. In women's health, the integration of primary care ultrasound can help to improve early detection, better symptoms management, and improved overall health outcomes. 

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