The annual well-woman visit needs an upgrade

Levy is a board-certified obstetrician/gynecologist and certified menopause provider. She has more than 40 years of experience in direct care, research, and physician training in women’s health care. Levy is currently chief medical officer of Visana Health and chief medical officer of Uroshape, LLC. In addition, she is vice-chair of the American Medical Association’s Current Procedural Terminology Editorial Panel, past chair of the American Medical Association Resource-Based Relative Value Scale Update Committee, and past vice president of health policy at the American College of Obstetricians and Gynecologists for more than 7 years. She has published more than 100 studies and peer-reviewed articles.

The health care industry has told women for decades that prioritizing their annual well-woman visit is an essential part of maintaining their health. There is no shortage of literature about its importance. Health systems send appointment reminders, public health campaigns reinforce the importance of scheduling an annual exam, and insurers promote preventive visits covered at no cost.

Messaging about the importance of the annual well-woman visit has helped increase yearly visits and screening rates over the past decade. Data show that nearly 3 out of 4 women have had a preventive visit in the past 12 months.¹ However, we’ve also inadvertently created the impression that women’s health care happens once a year, during a 17- to 20-minute appointment.

The annual well-woman visit is and will remain an essential component of preventive medicine, but it is long overdue for an overhaul. Too often, women leave their appointments with unanswered questions and a set of standard laboratory results that offer little insight into their overall health. The problem isn’t a lack of commitment from clinicians. It’s that the current structure of the visit leaves little room for the complexity of women’s lives.

How we got here

The annual well-woman visit was designed with good intent: a single comprehensive visit that prompted screening for issues most likely to cause problems down the road, offered early and regularly, and made available without out-of-pocket cost to encourage women to actually show up. But over time, visits grew shorter, and health systems began drawing a hard line between a "well visit" and a "sick visit"—2 categories most women don't even know exist. A woman doesn't know that the question that she’s been saving for this very appointment can push her annual visit out of "well" territory and trigger a sick-visit bill. She doesn't know the visit has rules at all. She’s simply doing what she’s been told she should do.

Consider one example in which a woman arrived for her annual preventive visit with her obstetrician-gynecologist with questions about perimenopause, hormone replacement therapy, and joint pain. She was told those concerns belonged in a “sick visit” and that she would need to come back. It took nearly 5 months to get a follow-up appointment, and what began as one preventive visit ultimately resulted in 3 referrals, multiple appointments, and additional co-pays.

This has become known as the diagnostic catch. A woman can arrive for her annual preventive visit expecting to discuss her health, only to learn that raising a new symptom or concern could turn part of that encounter into diagnostic care, resulting in another appointment, an unexpected bill—or both.

Consider the experience of another woman in her mid-30s who began experiencing night sweats, brain fog, and other symptoms she suspected could be perimenopause. She discussed her symptoms during her annual well-woman visit and worked with her clinician on a plan that included lab testing. But when the results came back, they were reviewed by a different clinician, who simply reported that everything was “in a normal range,” without context for why the tests had been ordered. Like many women, she was left to seek answers elsewhere before eventually finding ways to manage her symptoms.

The current rigid interpretation of a well visit often misses the conditions that most affect women's health over time. Reproductive health is only one part of the picture. Cardiovascular disease remains the leading cause of death among women, and metabolic and hormonal conditions can shape a woman's health across her entire life span, including her reproductive health.

Related: What women’s health providers need to know about testosterone therapy and menopause

Yet these concerns rarely get the same attention during the annual well-woman visit. One study of preventive care visits among nonpregnant women aged 18 to 44 years found that Pap tests were provided at 44.5% of ob-gyn visits, compared with lipid testing at 2.8%.² Despite a broad definition on paper, what counts as preventive care has narrowed sharply in practice.

A new approach to the annual well-woman visit

The annual well-woman visit remains an important touchpoint. The opportunity is to make it work better for the people it's intended to serve. Here are a few things that forward-thinking health care organizations will want to consider when redesigning the annual preventive appointment:

• More time with the clinician: When time runs short during an appointment, difficult conversations are often postponed. Symptoms may be minimized, follow-up delayed, or referrals left unexplored. Expanding the visit allows clinicians to conduct a more comprehensive evaluation of hormonal, metabolic, reproductive, and lifestyle health. It also creates space for discussion of the patient’s health goals and what has or hasn’t worked in the past, and for developing personalized care plans, ensuring that patients leave with a clear understanding of their current health and next steps.

• A whole-person approach plus continuity of care: Standard preventive screenings for cervical and breast cancer remain critically important, but a woman’s long-term health is shaped by much more, including cardiovascular and metabolic health, hormones, sleep, mental well-being, nutrition, family history, and personal risk factors. When one clinician oversees the full picture—and follows a patient over time—they are better positioned to connect symptoms, interpret results in context, and develop a care plan that considers the whole person rather than each concern in isolation.

• Personalized labs and screenings: Women’s health care is not a one-size-fits-all approach. Health care professionals can and should recommend clinically appropriate labs and screenings based on each woman’s age, symptoms, health goals, medical and family history, and individual risk factors. Case in point: Many women don’t know that pelvic exams need to be performed only when indicated by their medical history or symptoms rather than as part of every annual visit, yet routine annual pelvic exams remain deeply ingrained as part of the annual visit. A woman experiencing persistent fatigue, weight changes, night sweats, or mood changes may be recommended comprehensive thyroid testing to determine whether her thyroid function could be contributing to her symptoms. By personalizing screenings and diagnostics to a patient’s individual needs, the annual well-woman visit can work harder for the women it's intended to serve while delivering a better experience that supports and meets each woman’s unique health goals. This does not mean more tests; it means ordering the right tests for the right patient.

For years, the health care industry has measured preventive care by whether a woman showed up for her annual exam. It’s time to raise the bar. We should also be asking whether her health concerns were addressed, whether her symptoms were appropriately evaluated, and whether she left with a clear understanding of what comes next.

We have spent decades encouraging women to prioritize their annual well-woman visit. The next step is making sure the visit evolves to better meet their needs.

REFERENCES

1. Well-woman visit in United States. America’s Health Rankings. Accessed September 30, 2026. https://www.americashealthrankings.org/explore/measures/well_women_visit_women

2. Attanasio L, Ranchoff B, Jeung C, Goff S, Geissler K. Preventive care visits with ob/gyns and generalist physicians among reproductive-age women with chronic conditions. Health Serv Res. 2023;58(1):207-215. doi:10.1111/1475-6773.14100