Obstetrician-gynecologist as primary care provider.

Obstetrics and gynecology is a unique field that combines preventive and primary care with female pelvic surgery and obstetrics. With the evolution of managed care, it has been a challenge to fit this field into the standard primary care paradigm. This article describes a 3-tiered, patient-oriented definition of primary care that encompasses the essential aspects of all primary care specialties, followed by a critical examination of how primary care specialties, including obstetrics and gynecology, fit into this definition. This approach suggests that to better meet the primary care needs of both patients and society, obstetrician-gynecologists must continue to improve their skills in preventive care, diagnosis and treatment of self-limited conditions, and diagnosis of serious nongynecologic conditions.