Hang on to your knickers and read what a Doctor has to say on the subject of pap smears and pelvic exams. What follows is a comment from Blogcritics.org written by a Doctor that uncovers an honest and all-male point of view (Warning: may be disturbing to some readers):Apr 07, 2010 at 4:08 am
I’ve read several of the posts here, and just wanted to get a few things off my chest . . .
I am a doctor myself, in a smallish town in the midwest. I’m in a specialty where we do not do pelvic exams, but of course I was trained in how to do them while in medical school. It has always bothered me, for a couple of reasons, but the male/female thing has been the main thing originally. I always got a small, secret thrill out of doing a pelvic exam (or a breast exam, for that matter) on an attractive woman. Because we were told that “it’s not sexual,” “it’s just a medical procedure, nothing sexual about it, no reason to have sexual thoughts,” I though I was weird. I didn’t worry that much because I knew I wasn’t going into an area where I would do exams, but…
Then, during residency, I worked with a lot of doctors in the community, and discovered that, for most of them, it WAS at least partly sexual: they would sit around in the lounges and such and sometimes discuss the anatomy of beautiful women who’d been in, and on two occasions discussed, in front me and everyone else, the sexual anatomy attributes of women who worked in the hospital, nurses and such that were mutual acquaintances. I was horrified! I have to say, too, that many doctors, when I asked (because it bothered me), talked about it like, “Oh, it’s just another test to have to do, kind of boring, really.”
Still, the inescapable fact is that a guy likes to look at a naked woman. Period. Doctors are no different. They like to look at naked women, too. So, if they get PAID to look–I mean, really LOOK–at a woman’s sexual organs, and even better, they get to touch them, well… So much the better! I’m not saying that doctors do exams just to get a sexual thrill, because the circumstances really don’t allow a full-out sexual experience, but given a choice between doing a lung exam on an 80-year-old guy or a pelvic exam on an attractive 30-year-old woman, I’d say most docs would MUCH rather do the latter. They’re only human. They would flatly deny having any such thoughts (in most cases), but deep down, they ARE men, after all.
So, I think sometimes part of what prompts docs to urge women to have more testing is, that secretly they kind of like doing it. The money doesn’t hurt (i.e., they get paid to do it). In terms of pap smears being unnecessary for post-hysterectomy women, they also probably often just don’t know–there are several things in my specialty which GPs do wrong, all the time, even though they should know better. The ACOG recommends that even without doing pap smears, women have pelvic exams regularly, to screen for various cancers that are of very little risk. I’m sure part of that is just the “hyperscreening” that we’ve gotten sucked into, part of it is the money, and part is the male domination of women (gives you a great chance to stand there, fully clothed, with a woman who is naked and in a vulnerable position), and the chance to look at and touch naked women.
My wife (my second wife) and I got married last year, just past age 50 (for both of us). She had a hysterectomy (for benign disease) nearly 20 years ago. Before we married, she got kind of funny one day, then when I asked about what was wrong she admitted that she had had to make an appointment to “get my pap smear,” which she felt guilty for missing for the previous few years. I informed her she didn’t need one any more, and she told me I was wrong, that her gyn had told her she DID need them YEARLY, even though she’d had a hysterectomy. I showed her the research and persuaded her not to go back, ever, to that gyn.
Later, in looking at her records myself, I find that she had a small cyst removed from her back a few years ago. The surgeon did a complete pelvic exam as part of the physical before surgery. A VERY complete pelvic exam. There was no need for that (he did NOT record anything other than lungs, heart, breasts, and pelvic exam on his H&P report). A couple of years later she had a small cyst removed from her shoulder. THAT surgeon (a different one) did a complete breast exam as part of her H&P. My wife works in the hospital, with all these doctors (she’s in administration). She had her first colonoscopy last year, and the GI doc did a complete pelvic exam as part of her exam. Again, no medical reason to do that. She is not unattractive (not a magazine-model stunner, but attractive–I think she’s the most attractive woman in the world, but realistically she’s average attractiveness).
In my office, I am now doing a small study. I’ve asked women who come in (either as patients or as family members of patients) who are aged 30-60, who have had hysterectomies, whether they have continued to have pap smears/pelvic exams and whether their doc has recommended they still have them. I rank them as “attractive,” “not unattractive,” or “unattractive,” being aware this is a judgement call and not really PC (but the ones I’ve judged “unattractive,” I think everyone would agree, are really not attractive at all). So far, I’ve had 14 women agree to answer my questions, and the results have stunned me: of the 4 unattractive ones, all were told they no longer need to have pap smears/pelvic exams, because of their hysterectomies (even though for one, the hyst’y was for cancer, meaning she DOES need to continue exams). Of the 4 “not unattractive,” 3 have continued to have paps/pelvics irregularly (not yearly but every few years, at least), and 2 told me their doc told them they needed them, in one case “yearly” (and her doc was the same one who told 2 of the unattractive ones not to bother with exams any more, including the 1 who had had cancer)–the other 2 never asked and were never told anything by their doc. Of the “attractive” ones (all of whom had hyst’y for benign disease), only 2 have continued paps/pelvics, but all told me their doctors have continually told them they need to come in for regular exams, including pap smears and pelvic exams (interestingly, all but 1 had the same doctor who’d told 2 unattractive ladies not to come back). My wife’s (previous) gyn had told one of the unattractive ladies not to have further paps/pelvics, and 1 of the attractive ones she really, really needs them regularly (and she has, until our discussion).
Make your own judgement there, but that’s one more reason to be skeptical of attempts to get women to have regular exams. If I were a woman, I would not go to a male doc for such an exam, ever. http://blogcritics.org/culture/article/unnecessary-pap-smears/comments-page-8/#comments
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