Despite the common perception that medicine is becoming specialty driven, there are many reasons for primary care providers to offer womens health procedures in an office setting. Women feel more comfortable having procedures done by prov- ers whom they already know and trust. Continuity of care is still valued by patients, who trust their primary care providers to work with them as collaborators in the decision-making process. Women have found that their options for care have become limited, not by their own decision, but by the lack of training of their p- vider. In rural areas, the barriers of time, expense, and travel often prevent many women from obtaining necessary care; yet many of the procedures that these women are requesting are relatively easy to learn. Positive experiences are shared by women who then refer friends and family by word of mouth. This book has been designed to assist not only the clinician performing the pro- dures covered, but also the office staff with setting up the equipment tray prior to p- forming the procedure and with preparing office documents and coding information needed to complete the procedure. Most procedures covered can be done with a mi- mum investment in equipment and require minimal training.

Introduction: The Case for Procedures in Primary Care.- Coding, Billing, and Reimbursement for Procedures.- Legal Aspects of Office-Based Womens Health Procedures.- Empathic Pelvic Examination.- Difficult Exams: Cystocele, Rectocele, Stenotic Cervix/Cervical Dilatation, Nonsexually Active Women, Elderly Women.- Sexual Assault Victim Examination.- Pap Smear.- Vaginal Discharge.- Cervical Polyp Removal.- Diaphragm and Cervical Cap.- Copper Intrauterine Device.- Levonorgestrel Intrauterine System Insertion.- Intrauterine Device Removal.- Natural Family Planning.- Implanon®: Insertion and Removal.- Pessary.- Bartholin Gland Cysts and Abscesses.- Endometrial Biopsy.- Breast Cyst Aspiration.- Vulvar Skin Biopsy.- Treatment of Genital Warts.- Colposcopy.- Cervical Cryotherapy.- LEEP: Loop Electrosurgical Excision Procedure.- Hysterosalpingography/Hysterosalpingogram (HSG).- Medication Abortion Using Mifepristone and Misoprostol.- Manual Vacuum Aspiration (MVA) Abortion.- Botulinum Toxin A Injections for Reduction of Facial Rhytids.- The Use of Cosmetic Lasers in Clinical Practice.- Glycolic Peels.