Milan Family Medicine makes chlamydia testing an office routine

Maria Heck, D.O.

Approximately 2.8 million chlamydia infections occur annually in the United States, according to the Centers for Disease Control and Prevention. Maria Heck, D.O., maintains that chlamydia testing is an important routine at Milan Family Medicine because chlamydia is the most common sexually transmitted infection and because, in 70 percent of infected patients, there are no symptoms.

The ability to test for chlamydia using a urine sample has made it easier to increase testing, says Dr. Heck. She notes that waiting until 21 to do Pap smears leaves a lot of gaps. The Healthcare Effectiveness Data and Information Set® measures recommend that testing begin in females as young as 15.

“The urine sample also takes the stigma out of testing because it is a standard check for sexually transmitted diseases and other infections,” she said.

Dr. Heck speaks with a patient during an exam.

“The urine sample also takes the stigma out of testing because it is a standard check for sexually transmitted diseases and other infections,” she said.

“One of the important things is to educate young patients that chlamydia is very common and can lead to pelvic inflammatory disease and infertility,” says Dr. Heck. “I tell patients that the best way not to get chlamydia is to be abstinent. I also tell them if they are sexually active, they need to use barrier contraception,” she adds. Adolescents make up about 10 to 15 percent of the practice.

Dr. Heck also lets parents know that the chlamydia test is standard procedure and that the office tests for a variety of infections. “I tell parents I am not making judgments,” she says. “If we tell parents what to expect on the front end, they don't get as upset.”

Dr. Heck's office uses electronic medical records to check when patients need certain preventive tests. “My medical assistant can then get a urine test going before I come in to examine the patient.”

Milan Family Medicine is implementing an upgrade to its electronic medical records that will give the office the ability to send out reminder letters to patients. In the meantime, the office runs reports on patients who haven't been in the office for more than a year.

“I like having my patients come in for their annual physicals,” says Dr. Heck. ”It gives me a chance to have a longer visit and discuss other issues.”

Dr. Heck says one of the reasons that chlamydia testing isn't more widely done is because doctors are being asked to do more preventive screenings and immunizations. “It's a matter of getting it into the routine,” she says. Also, Dr. Heck notes, “Some doctors may just assume their patients don't have chlamydia.”

“The more we can keep the urine testing part of the physical, the better off we'll be,” she said. ”Sometime it's a matter of educating physicians as well as patients.”

HEDIS measure for chlamydia

This HEDIS indicator measures the proportion of sexually active females between the ages of 15 and 25 who were screened for chlamydial infection annually.