Women's Health: New Models of Care and a New Academic Discipline

Abstract

Shortcomings in the delivery of health care to women have become evident. One proposed solution is the creation of a separate specialty of women's health within medicine. This article views the debate as having two components, the first being that of clinical services for women, the second that of women's health as a body of knowledge. With regard to women's health programs, a model is proposed using allied health professionals and nursing advanced practitioners. In that context, the question of medical specialty in women's health is less relevant because the physician is not the primary care provider. With regard to women's health as a body of knowledge, the need for education and research in women's health is recognized. A framework is proposed for the development of an applied discipline in women's health with education and teaching at the master's level. Further recommended changes are (1) creation of Wellness models of care for women, (2) restructuring of medical specialties, with internal medicine and family medicine to include routine gynecologic care so that healthy women do not need two physicians, (3) reassessment of medical liability in conjunction with use of allied health problems and nursing advanced practitioners, (4) use of technology to expand women's access to health education and services, (5) creation of partnerships across disciplines, including public health, medicine, nursing, women's studies, medical sociology, psychology, and (6) reexamination of the hierarchy of power within medicine and the assumption that medical care is health care.