Chlamydia screening is a team effort
There are many reasons to screen for chlamydia. It’s the most common bacterial sexually transmitted disease in the United States. Repeat infection is common and increases a woman’s risk of serious reproductive complications, including pelvic inflammatory disease, infertility and ectopic pregnancy. However, screening rates are often low.
Shannon Kusiak, M.D., who practices in the Ypsilanti area with IHA Family Medicine—Arbor Park, says the key to chlamydia screening is a team approach. She and the other five doctors at the practice use medical assistants to help track screenings and all follow the same protocol with patients.
“I first identify who needs to be screened and do it in a nonthreatening way,” says Dr. Kusiak. "I let patients and parents know it’s part of the physical exam.” Dr. Kusiak says it’s important not to seem as though you’re singling out patients by assuming they’re sexually active. That’s why it’s part of the annual physical for her patients between 15 and 25.
Dr. Kusiak says screening rates could increase if physicians have an open discussion with patients and make screening a part of their physical. “It’s also important to let patients know about sexually transmitted diseases and some of the effects, such as infertility and PID,” she says.
"It’s easier to talk to younger patients if you let them know the discussion is protected,” says Dr. Kusiak. “I can act as an ambassador between the patient and parent, but I also keep the conversation private if that’s what the patient prefers.”
One of the challenges to chlamydia screening is the patient’s belief that she has to have a pelvic examination. "It’s easy to allay a patient’s fears because chlamydia screening only requires a urine specimen," says Dr. Kusiak.
How does the office make sure they screen all eligible patients? "Most adolescents don’t come in for many visits so we do it mostly on the annual visit. But we also capture them if they only come in for an asthma check,” says Dr. Kusiak.
The office also receives registries from insurance companies that list patients who have not been screened. “I have patients who are assigned to me as their primary care physician who never come in for a visit and we have called them,” she adds.
Dr. Kusiak said it’s important to test annually, but also to check back with patients. “If they’ve had a new sexual partner we do the screening then as well. We definitely recommend testing again,” she says.