My Doctor Online The Permanente Medical Group
Are you having back pain with any of the following?
- Severe pain, weakness or tingling in your leg(s).
- Difficulty stopping urination or loss of control of bladder or bowels.
- Unexplained fever, nausea or vomiting.
- A history of cancer or unexplained weight loss.
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
Scott Puza, MD
Obstetrics and Gynecology
As your physician, I value my relationship with you. And I know that maintaining a good relationship means being able to communicate with each other. My colleagues and I have developed My Doctor Online so that we can stay in touch more easily. Because the better connected we are, the healthier you are.
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General References
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Frequently Asked Questions (FAQs)
Common Questions about Women's Health
Here are answers to some common questions you may have about the obstetrics and gynecology (Ob/Gyn) department.
Ob/Gyn stands for "Obstetrics and Gynecology." Physicians that specialize in this area of medicine are often called "Ob/Gyns." They are physician-surgeons who have a detailed understanding of the female reproductive system. They specialize in the health of the female reproductive system and in preventing, diagnosing, and treating its diseases.
Ob/Gyns also care for women throughout their pregnancies and childbirth. Some Ob/Gyns focus on obstetrics (pregnancy and childbirth) while others may focus more on gynecology (overall reproductive health).
Ob/Gyns can also do specialized training in:
- Perinatology or maternal fetal medicine (the care of high-risk pregnancies)
- Gynecologic oncology (the care of female cancers)
- Urogynecology (the care of women with urinary problems)
- Reproductive endocrinology and infertility (the care of hormonal and fertility problems).
What is an Ob/Gyn Nurse Practioner?
Nurse Practitioners (NP), are advanced practiced registered nurses (RNs) who have completed a Master’s Degree in Nursing and additional specialized clinical training in patient diagnosis, treatment, and management. In the Ob/Gyn Department, NPs diagnose and treat a wide range of complex and routine obstetrical and gynecological patients. Additionally, some NPs practice in specialized areas such as Perinatology, Breast Care, Infertility, Young Mother’s (Teen) Clinic , and Adolescent Care. NPs can serve as your primary Ob/Gyn clinician or partner with physicians and other members of your health care team. NPs provide complete, high quality care through health promotion, disease prevention, and patient education.
NPs practice within the scope of their state’s nurse practice act, and are nationally board certified in their area of specialization. NPs are an important part of Kaiser Permanente’s efforts to provide you with quality care.
How much training does an Ob/Gyn physician have?
In addition to graduating from medical school, our Ob/Gyn physicians have completed a 4-year residency training program in obstetrics and gynecology. If they decide to pursue further specialty training, then they complete an additional 2 to 4 year fellowship.
After training is completed, an Ob/Gyn takes both a written and oral exam in order to become "board certified." This distinguishes the physician as a true specialist in his or her field. Continued certification is achieved through periodic exams and specialized classes throughout the physician’s career.
All of our Ob/Gyns are board certified or are in the process of achieving this designation as a women’s health specialist.
How do I choose an Ob/Gyn provider?
You can browse through the professional and personal profiles of Ob/Gyn physicians on this Web site. Our Choose your Doctor page will allow you to find physicians or specialists in your area. Talk to your friends or to another physician you see at Kaiser Permanente; they might recommend an Ob/Gyn physician in your area. Also, our Member Services Department can assist in matching you with an Ob/Gyn who might best suit your needs.
How often should I come in for a visit?
Discuss this with your personal Ob/Gyn physician. Generally, we encourage women to come in for a well-woman check-up every 1 to 2 years, but this can vary:
- If you're under 25 and sexually active, you should be tested for sexually transmitted diseases every year. This can be done during a check-up with your Ob/Gyn doctor or with a general medicine doctor.
- Pap tests for cervical cancer screening should begin at age 21. If your Pap results are normal, you can wait as long as 3 years between tests.
- If you are 40 or over, and you have no personal or family history of breast cancer, you should come in for a clinical breast exam and a mammogram every 1 to 2 years.
- If you have risk factors for breast cancer, you should talk to your Ob/Gyn physician about when to begin regular screening.
A perinatologist is an Ob/Gyn physician who specializes in the treatment of women with high-risk pregnancies, like insulin-controlled diabetes, pre-eclampsia, or preterm labor. The perintologist supports our Obstetrical team and can provide additional expertise and experience in difficult cases.
When do I start getting mammograms?
If you have no history of breast cancer in your family, you should begin getting mammograms every 1 to 2 years at age 40. Starting at age 50, you should get one every year, until you are 74 years old. Talk to us if you have a history of breast cancer; we can decide when to begin your screening based on your family history.
When should I have a bone mineral density (BMD) test?
You should have your first bone mineral density (BMD) test starting at age 65, or earlier if you're older than 45 and you've had a significant bone fracture or a spine fracture of any kind. You may also need a BMD test if you:
- Have a first degree relative with hip fracture
- Smoke
- Weigh less than 127 pounds
- Use steroids
- Have significant hyperthyroidism or hyperparathyroidism
How often should I get a Pap test?
A Pap test is the most common type of screening test for cervical cancer. Pap tests should begin by age 21. We can discuss the screening interval that is best for you, but most women can safely wait three years between Pap tests because the incidence of cervical cancer is very rare in women. Also, cervical cancer develops very slowly, usually over the course of 10 years or more. So, a Pap and HPV test every 3 years can detect changes in cells early on and allow treatment and management.
You can stop having Pap and HPV tests if you are over 65 and have had either three or more normal Pap tests in the past 10 years and/or you are HPV negative. You can also stop having Pap tests if you have had a total hysterectomy (where your cervix was also removed) and you have no history of cancer of the cervix, vulva, or vagina.
Will I always see the same doctor?
Usually, yes! However, you may not see your own doctor if you want a certain day and/or time for your appointment and your provider is not in the office at that time. You may also see a different doctor if you need an urgent or same-day appointment.
Can I review my lab results online?
Yes. Many of your lab test results will be available for viewing online. But due to privacy concerns and regulations, some may not be. These may include Paps, tests for cancer, HIV/AIDS and others.
How do I pick a pediatrician for my child?
During your pregnancy, it’s a good idea to investigate which pediatricians or pediatric nurse practitioners would be a good fit for your family. If you have older children who have a particular pediatrician, your new baby should be able to see the same one. Browse through the home pages of our different pediatric providers using this Web site. Also, ask your friends or other Kaiser Permanente employees who they would recommend.
After the birth of your baby, you will be assigned a medical record number for the baby and can choose your pediatric provider. If you do not have a specific preference for a particular provider, someone in the pediatric department can help you choose one.
Yes. You can send secure, confidential e-mail to your doctor at any time during the day, night, or on weekends. We are usually able to respond to your messages within 48 hours (excluding weekends & holidays). Since we’re not in the office every day, it’s best to contact our appointment and advice call center with any urgent concerns.