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Re: women's experiences at the doctor'sFrom: anonymous@obgyn.netFri, 07 Aug 1998 11:27:12 -0500
I have read the responses to your post and thought I might add a few insights from the *other* side of the exam table. Most patients who have spent a lot of time in Europe do seem more comfortable with both nudity and gynecologic exams. I have not studies this objectively, but subjectively these patients seem less nervous, and often start getting undressed (or dressed) while you are still in the room. This is not the norm for most patients from the US. A 34 year-old married Latin lady I know recently told me that when she goes to the gynecologist she always trims her bikini line that morning, and uses the doctor's office bathroom to check for and remove leftover bits of toilet paper. She also washes her feet in the office sink right before the exam so they don't smell bad! Most patients prefer "small talk" during the exam (I have asked). Of course, it depends on what one is discussing, and it depends on the patient. A doctor should never replace a good medical history with small talk, however. A minority of my patients really do prefer the "get it over with" approach, but not many. I hear about job advancements, engagements and marriages, vacations, kid's stories, and other news. Unfortunately, I have a fondness for food, so a nubmer of my patients bring me cookies, cake, and other interesing food (including a great West Indian roti I had recently). I think the interaction between doctors and their patients is part of the patient/doctor relationship, and I would not be happy practicing medicine without it. I disagree with the person who suggested that doctors are not paying attention when they talk during exams. This is what we do for a living, and after performing literally multiple thousands of exams, I can certainly have a conversation while doing an exam! (We can also pay attention to surgery while listening to music). Patients will tell you anything and everything if they 1)trust you, 2)believe that you care about them and their health, and 3) believe that you are nonjudgemental. I'm always saddened to read or hear that many women cannot bring themselves to ask "embarassing" questions to their doctors. This is what we do every day, and it is highly doubtful we will find it shocking or distasteful. I have just heard about everything possible from patients. In many cases it gives me the opportunity to discuss important health issues, while in other cases it allows the patient to get something "off of her chest" or to verify that she is not weird. Patients do not have to worry about their doctor thinking of them in sexual terms during a history or exam. I have met and interacted with well over a thousand doctors in my career, and only 2 have ever made what I consider inappropriate sexual comments about a patient. One was a gynecology intern who wanted to perform an exam because the patient had unusual genital tatoos and a heart-shaped bikini line. However, I doubt he was "turned on" by this lady. Another was a non-gynecologist who liked a patient's last name because it had sexual connotations (he did not, however, like the patient because she was not very nice). 2 out of a thousand is not a high percentage, although it's 2 too many. I'm sure there are a few other points I'm forgetting. Your project is interesting. Perhaps you could keep us updated. Thanks,
-- Ashley Hill David Ashley Hill, M.D. Associate Director Department of Obstetrics and Gynecology Florida Hospital Family Practice Residency Orlando, Florida
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