Laws were established in an attempt to improve women's health by allowing women direct access to obstetricians or gynecologists. Managed-care plans were forced to allow women to make these appointments without having a referral from their primary care physicians. This gave women easier access to get screened for breast and cervical cancer. It was thought that this approach would increase the likelihood of the women getting the preventative tests.

A study was conducted to compare health care utilization among privately insured women before and after passage of direct-access legislation in various states. The study, published in the current issue of Health Services Research, found that there is no evidence for a strong consistent relationship between direct-access legislation and screening rates for breast or cervical cancer.

So it's not working according to lead author Laurence Baker, Ph.D., of the Center for Health Policy at Stanford University. "Good health care requires much more than having these laws in place. Maybe direct access legislation isn't the right way to go about this at all. Consumer and provider education may be better ways of improving population health. Covering preventive care for uninsured individuals is also key." said Baker.