Every time I go to a walk in clinic the doctor asks me “When was your last pap test?”. I went to a clinic for a sprained ankle and the doctor glanced briefly at my ankle, and then continued to pressure me into a pap test. The same thing happened when I went to a clinic about a suspicious looking mole on my back.
The scenario always goes something like this:
Me: I’m worried about a mole on my back.
Dr.: Uh huh, when was your last pap test?
Me: I can’t remember, not too long ago.
Dr.: Well, we will have to do one then. Get undressed and hop up on the examining table.
Then the Dr. leaves before I have a chance to say anything. I worry if I don’t comply and be a good girl that he won’t help me with my health concerns. I would like to be given information and a choice!
Link to a good article about informed consent for pap smears: http://www.kevinmd.com/blog/2009/11/informed-consent-missing-pap-smears-cervical-cancer-screening.html
Link to summarized article about unnecessary pap tests/pelvic exams: http://forwomenseyesonly.wordpress.com/2012/09/30/battle-brewing-over-pointless-pelvic-exams/
Pap and mammogram happy hours. Nice link. Maybe the informed part of consent will be more regular.
Pap and mammogram happy hours
– it is always about boobs and vaginas at the dr’s office. We do have other parts! It is hard to say “no” to a stern dr’s gaze asking about paps, but I have started wriggling out of it. Now I always say “I had my last pap 3 months ago, but thanks for asking”! I find it easier to lie than to explain I have chosen to not be screened for cervical cancer since it is very rare in developed countries. In Canada the incident rate is .000007%. It is about the same incident rate found with mouth cancer but you don’t see dr’s bugging us to open our mouths for them. Thanks for the comments Katie.
Here, in the US the situation with Dr’s is similar. Though they do not demand a pap test each time I go in, I have been in for a sore back, or throat and they ALWAYS ask. If my vagina hurt I would tell you! I am here
for my ankle. Ugh.
Exactly! I would like to say to drs if there was a problem with my vagina I would let you know but otherwise could you please focus on the reason I’m here! I think I’ll get a t-shirt that says “VAGINA” printed on it to wear if something comes up, because that is all the drs here in Canada seem to care about. I think in the US the drs might be further ahead than they are here in terms of following the recommended guidelines to screen once every 3 years. Here they want to play with their speculums every chance they get. They have been causing harm to women both mentally and physically.
Doctors in the US are very very focused on “bikini medicine” – looking at a woman only in terms of her breasts, vagina, and rectum, and ignoring any other health concern that brings her in to see the doctor. They’re probably more interested in performing pelvic exams and other such “follow-on” exams because it’s extremely lucrative.
More than half the time spent in an “ordinary’ doctor visit is spent arguing with them about refusing a pelvic exam, regardless of the complaint that brought me in. After they’ve spent 5-10 minutes pressuring me to show them my vagina, I’ve started asking, “Do you think my (shoulder pain, mole, breathing difficulty, etc) is in my vagina? Could I have that in writing?” By then, the appointment time is exceeded, and I never did get medical care for why I went in.
I’ve stopped going for fairly-minor problems. I don’t get health care anyway – just pressure to look up my skirt and grope my breasts. In high school, I at least got dinner and a movie for such pressure.
Beth, you have done a great job of summing up the problem here. Women don’t get health care, period. All they get is traumatized, coerced, humiliated, exploited, dehumanized, and sometimes molested . . . or worse. On its own a pap test feels worse than being molested, and sometimes there is the added bonus of a dr taking it up a notch. Sometimes women are further terrorized when a smear comes back positive (fairly common), and then they get re traumatized, humiliated and dehumanized when they get even more pressure to go for follow up tests and “treatments”, which are even creepier. I loved the part about how in high school you at least got dinner and a movie – exactly, going to the dr is just like a bad date, a very very bad nightmarish date.
I also like the term “bikini medicine”, I hadn’t heard that before but it does describe all focus points of interest very nicely. Interesting how they have very carefully de-sexualized the term for such an exam by calling it a “pelvic” exam, when in fact what is involved is far more intimate than most women would allow a close lover or spouse do to them.
I am very thankful to have stumbled on this article. I had a PAP smear come back “positive” for abnormal cells in November and got the call on my way to the store. I was terrified until I was able to get to a computer and do research, and even after that I was still afraid. This makes me feel much better about my choice to wait until my next (required to get BCPs) PAP before doing anything.
Kate, pap tests are not required for birth control, the only clinical requirement is a blood pressure test and your medical history.
Here is a summary put together by Dr Robert Hatcher.
http://www.managingcontraception.com/newsevents/dr-bob/pelvic-exam-necessary-for-contraception-rx/
The more often you test, the more likely you’ll get a false positive for no additional benefit over 5 yearly testing from 30 to 60, annual and 2 yearly pap testing carries high risk – 77% is the lifetime risk of referral for colposcopy/biopsy with 2 yearly testing, almost all amounts to over-detection. Annual pap testing would be even higher. So over-screening risks your health for no additional benefit.
We now know only HPV+ women aged 30-60 can benefit from pap testing. No country in the world has shown a benefit pap testing those under 30, but young women produce the most false positives. (1 in 3 for those under 25)
Not sure of your age or whether you’re having annual or two yearly testing, but I think you’re wise to be cautious…the cervix is there for a reason. Unnecessary “treatments” can cause damage and lead to some serious health and obstetric issues.
http://www.motherjones.com/politics/2012/04/doctors-holding-birth-control-hostage
(an interesting article written by a journalist on the subject of medical coercion ie. holding birth control hostage until you agree to unnecessary exams and ELECTIVE cancer screening)