|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Re: OB-GYN-L digest 1704 Rectal examFrom: John T. Gregg, M.D. (jgreggmd@mwec.com)Tue Jun 23 08:48:59 1998
In regards to rectal exams at GYN visits: 1. In the medicare population, it should be standard of care to do the rectal exam and stool cards - not all rectal pathology bleeds. 2. Purely anecdotal evidence - 9 years private practice, rural setting, Texas and Oklahoma - 8 referrals for ultimately malignant anorectal lesions noted on GYN rectal exam by OBGYN referral doctors - ages 33 to 55; includes one anal squamous cell lesion requiring biopsy and chemoradiation protocol. 3. As an aside, when the GU people are pushing for greater recognition of the role of testicular self exam and not forgetting to check same on routine exams of males, why would the AGA consider such a bizarre statement with potentially serious impact? Should I delete breast exams for patients either referred to me, or more importantly self-referred, for treatment of biliary disease, because of potential embarrassment issues??? If the OBGYN specialist is acting as the women's primary care physician - do the rectal...just IMHO. John T. Gregg, MD Gen Gurgeon > ---------------------------------------------------------------------- > > ---------------------------------------------------------------------- > Date: Sun, 21 Jun 1998 21:39:37 -0500 (CDT) > ---------------------------------------------------------------------- > From: garrys@mindspring.com (Garry E. Siegel, M.D.) > To: OB-GYN-L@OBGYN.net > Subject: Re: ctal with pelvic exam > Message-ID: <199806220239.VAA04559@talk.obgyn.net> > > In the past, I have tried the home hemoccult cards, but the response > rate has been poor. Thus, the rectal exams! You also corrrectly pointed > out something that I also do--rectals for retroverted uterii. > > I can't remember the last time I found pathology; I can remember > receiving a mailed hemoccult card without a name, however. > > >Garry, > > > >Last January the American Gastroenterology Association (or whatever the > >GI organization is) put out a statement to the effect that annual rectal > >exams were "not worth the time or embarrassment." They suggested instead > >that the patient be given 3 hemoccult cards to "fill out" on 6 different > >days. (The article about this is at the office, will find and post.) I > >have been trying this with my more motivated patients over 50, having > >them use their toilet paper to put a dab on the hemoccult card. Problem: > >only about a third of the patients (or less) actually return the cards. > >I still do a rectal exam with hemoccult for the less motivated patients > >over 50, probably should do it for 40-50yo's too. > > > >Rectovaginal exams are a different, also controversial matter. I was > >taught that a good pelvic exam demands a rectovaginal exam. However, my > >patients certainly don't like it. I insist when it is F/U exam after > >gyn cancer, or when the vagina is too stenotic to admit 2 fingers, or > >when the uterus is retroverted. > > > >Has anyone found significant pathology doing a routine rectal exam? How > >about routine rectovaginal exam? > > > >Jane > > > >-- > >Jane Helwig, MD > >Private practice > >Nassawadox, VA > > > > -- > Garry E. Siegel, M.D., FACOG > Private Practice > Roswell, Ga. >
|
|
Return to
|
Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Tue Mar 2 05:27:57 2010 |
The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.