John P. McHugh, MD, District IX newsletter editor and Section 7 chair
I had the opportunity to speak with Debra R. Gierut, MD, who serves as Section 7 vice chair, a physician at Kaiser Permanente Orange County Women’s Health Services, and a representative on the District IX Task Force to Increase Chlamydia Screening and Treatment.
Dr. Gierut, what purpose does the District IX Task Force to Increase Chlamydia Screening and Treatment serve?
The task force’s primary goal is to increase the chlamydia screening rate in California. We know that undiagnosed chlamydia harms women’s entire reproductive lives. Women with ectopic pregnancies, infertility, and chronic pelvic pain may have had untreated and undiagnosed chlamydia for years despite multiple visits to their ob-gyns.
Where does the work start with such a tremendous public health problem?
First and foremost, we need to understand what’s happening in physicians’ practices today. We know there are barriers to screening, but what are they? Screening for chlamydia is a simple test from the doctor’s point of view—all we need is a urine sample. Still, even in the best health care systems, patients who need the test may only be getting it half the time.
The task force recently conducted a survey of California physicians. Can you tell me more about it?
The survey covered a good cross section of California physicians. Forty percent of physicians surveyed recognized that they were not doing the best screening they could do. Many expressed a concern that the billing statements naming chlamydia testing go to the patient’s home and may be read by partners or family members. They don’t want to put their patients at risk. Some physicians also noted that the chlamydia rate is low in the patient population they serve. For this reason, routine screening is not being done.
What is next for the task force?
Task force members represent a variety of different organizations. We plan to meet soon and look for ways to address barriers to screening as we sift through data. Patients, providers, and payers all recognize that lack of screening is a substantial public health problem. A targeted response to each barrier is needed. Stay tuned for more information and resources to help your patients.