Yes, most primary care doctors can do Pap smears. Primary care providers, including family medicine physicians, physician assistants, and nurse practitioners, receive specialized training in women’s health screenings, including Pap smears and breast exams. “All medical students, including those who become primary care providers, receive training to perform Pap smears and pelvic exams in medical school during their OB/GYN clerkship rotation,” according to medical experts.
According to the National Cancer Institute, cervical cancer is the fourth most common cancer worldwide, with approximately 13,820 new cases expected in the United States in 2024. However, with proper screening, this highly preventable disease can be caught early or prevented entirely.
What Primary Care Doctors Can Do Pap Smears
Family Medicine Doctors
Family medicine doctors are some of the best-trained primary care providers for Pap smears. Any primary care curriculum devotes a great deal of time to women’s health. Why? Women represent more than half of the patients in doctor’s offices today. These doctors receive extensive training in women’s health during their three-year residency.
For female patients, not only can your family medicine physician perform your annual physical and order your labs, they can also perform your pap smear and order your mammogram as part of your physical when indicated. Many family medicine doctors also handle routine women’s health concerns like irregular periods and birth control.
Internal Medicine Doctors
Internal medicine doctors focus on adult patients 18 and older. A board-certified primary care physician has received obstetrics and gynecology training, though not as much as an OB/GYN, and they are more concerned with overall health. Still, many primary care physicians do pelvic exams, screenings for sexually transmitted infections, Pap smears and breast exams as part of an annual well-woman exams.
Some internal medicine doctors perform Pap smears as part of their practice, while others prefer to refer patients to gynecologists for these screenings.
Nurse Practitioners and Physician Assistants
Advanced practice providers like nurse practitioners and physician assistants can also perform Pap smears. A woman’s primary care physician, internal medicine specialist, an obstetrician/gynecologist (OB/GYN) or another trained health professional, such as a physician assistant, nurse midwife or nurse practitioner, can perform the exam.
These providers receive specific training in women’s health procedures during their education programs.
Training Primary Care Doctors Receive for Women’s Health
Medical School Education
All doctors who become primary care providers learn about women’s health during medical school. Medical students must also gain adequate experience in psychiatry, dermatology, ophthalmology, office gynecology, otorhinolaryngology, non-operative orthopedics, palliative medicine, sleep medicine, geriatrics, and rehabilitation medicine to comprehensively care for adults.
The training includes hands-on experience with pelvic exams and Pap smear procedures during their OB/GYN rotation.
Residency Training
During their three-year residency, primary care doctors get more training in women’s health:
- Family medicine residents learn to care for patients of all ages, including pregnant women
- Internal medicine residents focus on adult health conditions that affect women
- Both types of residents practice performing Pap smears under supervision
Ongoing Education
Primary care doctors must stay up-to-date with the latest guidelines for cervical cancer screening. “Both primary care providers and OB/GYN providers follow the American Society for Colposcopy and Cervical Pathology (ASCCP) guidelines,” which provide clear instructions for when and how to perform Pap smears.
When to Choose Your Primary Care Doctor for Pap Smears
Convenience and Comfort
Many women prefer getting their Pap smear from their primary care doctor because:
- You already have a relationship with your doctor
- You can combine it with your annual physical
- You don’t need to schedule a separate appointment
- “Patients typically have a strong provider-patient relationship with their primary care provider, which allows them to feel at ease during sensitive exams, such as those involving the pelvic region.”
Comprehensive Care
Your primary care doctor knows your complete health history. They can:
- Look at how other health conditions might affect your reproductive health
- Coordinate all your preventive care in one visit
- Track your screening schedule along with other important tests
Cost and Insurance
Most insurance plans cover annual visits with your primary care doctor. Getting your Pap smear during this visit can be more cost-effective than seeing a specialist.
When You Should See a Gynecologist Instead
Complex Women’s Health Issues
“If a patient has a history of an abnormal pap smear, cervical biopsy, or has previously been treated for cervical cancer, they should be seen by an OB/GYN provider.” Gynecologists have specialized training to handle:
- Abnormal Pap smear results
- History of cervical cancer
- High-risk HPV infections
- Complex reproductive health issues
Pregnancy Planning
If you’re planning to get pregnant or are already pregnant, an OB/GYN is usually the better choice. They specialize in:
- Preconception counseling
- Prenatal care
- High-risk pregnancies
- Delivery and postpartum care
Specialized Procedures
Gynecologists can perform procedures that most primary care doctors cannot:
- Colposcopy (detailed examination of the cervix)
- LEEP procedures (treatment for abnormal cervical cells)
- IUD insertions (though some family doctors do this too)
- Treatment for complex menstrual disorders
Understanding Pap Smear Guidelines
Current Screening Recommendations
According to the American Cancer Society, cervical cancer testing (screening) should begin at age 25. Those aged 25 to 65 should have a primary HPV test every 5 years. If primary HPV testing is not available, screening may be done with either a co-test that combines an HPV test with a Papanicolaou (Pap) test every 5 years or a Pap test alone every 3 years.
The American Cancer Society updated their guidelines in 2020 to recommend starting screening at 25 instead of 21.
Why Guidelines Changed
According to the American College of Obstetricians and Gynecologists, cervical cancer is extremely rare in this age group. Fewer than 1 in 1,000 cases of cervical cancer occur in young women 15 to 19. Most HPV infections in young women clear up on their own without causing problems.
When to Stop Screening
Those over age 65 who have had regular screening in the past 10 years with normal results and no history of CIN2 or more serious diagnosis within the past 25 years should stop cervical cancer screening.
What to Expect During Your Pap Smear
The Procedure
Whether performed by your primary care doctor or gynecologist, the Pap smear process is the same:
- You’ll undress from the waist down and put on a gown
- You’ll lie on an exam table with your feet in stirrups
- Your health care provider will use a speculum to widen the vagina and collect cell samples from the cervix and the area around it.
- The cells are sent to a lab for testing
- The process takes just a few minutes.
Getting Your Results
“Primary care providers should notify their patients immediately when Pap smear results are available—regardless of whether the results are normal or abnormal.” Most results are available within a week.
Follow-Up Care
If your results are normal, you’ll follow the standard screening schedule. If abnormal, “Typically, PCPs refer patients with abnormal Pap smear results to their OB/GYN colleagues.”
Benefits of Having Both a Primary Care Doctor and Gynecologist
Comprehensive Women’s Health
“OB/GYNs and primary care physicians are specially trained in their fields, and their expertise is different. That’s why seeing both an OB/GYN and a primary care provider is the best way for a woman to be healthy and stay healthy.”
Different Areas of Focus
Your primary care doctor focuses on:
- Overall health and wellness
- Chronic conditions like diabetes and high blood pressure
- Preventive care for your whole body
- Mental health screening
Your gynecologist focuses on:
- Reproductive health
- Hormone-related issues
- Specialized women’s health procedures
- Pregnancy and childbirth
Better Coordination of Care
When both doctors work together, you get:
- More thorough health monitoring
- Referrals when you need specialized care
- Better management of conditions that affect multiple body systems
Choosing the Right Doctor for Your Needs
Consider Your Health History
Choose your primary care doctor for Pap smears if you:
- Have normal screening results
- Don’t have complex reproductive health issues
- Want to combine it with your annual physical
- Feel comfortable with your current doctor
Choose a gynecologist if you:
- Have a history of abnormal Pap smears
- Are planning to get pregnant
- Have complex women’s health concerns
- Need specialized procedures
Think About Your Preferences
Some women prefer the convenience of getting everything done with their primary care doctor. Others like having a specialist who focuses only on women’s health. Both choices are valid.
Insurance and Access
Check with your insurance to see:
- Which doctors are covered in your network
- Whether you need referrals to see specialists
- What your copays are for different types of visits
Making Your Decision
The most important thing is getting your Pap smear done regularly, whether it’s with your primary care doctor or a gynecologist. The U.S. Preventive Services Task Force reports that over the past 30 years in the United States, the number of cases of cervical cancer and deaths has decreased by one half. This is mainly the result of women getting regular cervical cancer screening.
If you’re not sure which doctor to choose, start with your primary care provider. They can perform your Pap smear and refer you to a gynecologist if needed. Many women find this approach works well for their routine screening needs.
At Yorktown Health in Vernon Hills, our primary care team is trained to provide comprehensive women’s health services, including preventative gynecological care and well-woman exams. We work closely with local gynecologists to make sure you get the right care when you need it.
Final Thoughts
Most primary care doctors can safely and effectively perform Pap smears as part of your routine health care. They receive proper training during medical school and residency, follow the same guidelines as gynecologists, and can provide this important screening along with your other preventive care.
The choice between your primary care doctor and a gynecologist often comes down to your personal health needs, comfort level, and preferences. The most important thing is making sure you get regular cervical cancer screening according to current guidelines.
If you need a primary care provider who can handle your women’s health needs, contact us to schedule an appointment. Our experienced team is here to provide comprehensive, compassionate care for women at every stage of life.
