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Re: Gyn: ASC-US From: Rafael Haciski (haciski@earthlink.net) Fri Aug 31 21:20:52 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Robert Modugno MD: "An article from the BMJ (http://bmj.com)" Previous message: Robin Kurtzman: "Invite from Robin Kurtzman (robinmk02@aol.com)" In reply to: Garry E. Siegel, M.D.: "Gyn: ASC-US" Next in thread: Efrain Ramirez: "Re: Gyn: ASC-US" Reply: Efrain Ramirez: "Re: Gyn: ASC-US" Although I agree with your approach, I have heard others suggest a less intensive approach: serial PAPs to observe. In the younger and healthy female most of these will resolve on their own. But I like to CYA. I am intrigued by your office policy > I explained that due to insurance issues and office policy, we need to > have two separate appointments for her issues--one for the pap issue, > and another for the dyspareunia. They said, "No problem, we'll > reschedule a colposcopy." So you do not handle multiple problems? I routinely will evaluate several issues at one visit -- maybe that is why I have trouble making money :( -- Rafael Haciski MD FACOG Anchor Health Centers GYN 800 Goodlette Rd #360 239-643-8780 office 239-571-0292 cell Naples, FL. On Aug 31, 2007, at 9:40 PM, Garry E. Siegel, M.D. wrote: > 16 YO P0000 seen by CNM for annual in April, and the pap is ASC-US, > reflexed to HR HPV positive. > > Cancelled appointments, multiple calls--doesn't come in for follow-up. > > I sent a certified letter, and today she came in with her fiancee. > For > those of us who are parents, let's say that these two had more tattoos > and piercings than I think we would generally like to see in our own > children. > > So, after taking a history and explaining what was up with her pap, > etc., she said, "We want to bring up another issue. It hurts when we > have sex." The fiancee said, "Yeah, we only can have sex like once a > week." > > I explained that due to insurance issues and office policy, we need to > have two separate appointments for her issues--one for the pap issue, > and another for the dyspareunia. They said, "No problem, we'll > reschedule a colposcopy." > > So, I had to convince her that after 4 months of attempting to contact > her for an evaluation, that my opinion was that we needed to do > today's > colposcopy today, and she reluctantly agreed. > > It was pretty hard not get very "parental" on her, but I didn't. > > Garry > > -- > Garry E. Siegel, M.D. > Private Practice > Roswell, GA Next message: Robert Modugno MD: "An article from the BMJ (http://bmj.com)" Previous message: Robin Kurtzman: "Invite from Robin Kurtzman (robinmk02@aol.com)" In reply to: Garry E. Siegel, M.D.: "Gyn: ASC-US" Next in thread: Efrain Ramirez: "Re: Gyn: ASC-US" Reply: Efrain Ramirez: "Re: Gyn: ASC-US"

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