Variable and conflicting organizational guidelines for women's preventive healthcare: A threat to the embracement of evidence-based medicine

In 2015, 1,268 primary care providers responded to a questionnaire regarding their opinions on evidence-based recommendations for women’s preventive healthcare by the American College of Obstetrics and Gynecology (ACOG), the American Cancer Society (ACS), and the United States Preventive Services Task Force (USPSTF). These primary providers represented Gynecologists (34%), Family Practitioners (25.1%), Internal Medicine Physicians (23.3%), Nurse Practitioners (25.4%) and Physician Assistants (28.0%). All were actively engaged in the delivery of preventive healthcare to women and were randomly chosen from a 163,696 square mile region in the United States. These providers were statistically similar to all providers region wide. The results show that there are great differences of opinion regarding these evidence -based recommendations. Disagreement among providers was great, and there was no statistically significant preference between one of these organization’s current guidelines – this although the recommendations often differed. Our study showed that the net result is a tendency towards dismissal of evidence-based medicine. At a time when increasing focus is placed upon adherence to best practice recommendations of care, providers find it confusing and disconcerting when these guidelines are not uniform or are in conflict. Our study speaks to the need for greater uniformity in making recommendations regarding what truly represents the optimal preventive healthcare for women. This may require some compromise between the differing organizations, but the benefits of uniformity will far outweigh the current state of affairs in which providers are confused, distrustful, and prone to ignore current valuable evidence-based guidelines