It’s difficult for some women to trust their doctors these days. There are many reasons for the lack of trust, including the following:
Mainstream Media – Media is keeping the public updated on all sorts of unsavory events involving doctors. For example, many media headlines are exposing doctors who sexually abuse female patients. Media also keeps us updated about the tendency of so-called regulatory committees to allow these doctors to continue practicing. A national investigation revealed that doctors sexually abuse their patients more often than commonly thought, and that “a broken system forgives sexually abusive doctors in every state” (source). In addition, “Dollars and Doctors”, a Propublica series containing over 70 articles, highlights problems related to the association between the pharmaceutical industry and physicians (source). Other media headlines highlight stories related to doctors abusing drugs, making careless errors during surgery, inaccurate diagnoses, and deadly mistakes stemming from greed and/or incompetence (source).
Social Media – It’s a bit shocking when a doctor writes a blog post warning patients to not trust doctors, but in a post written by Dr. Peter Rost he plainly states “I’m a doctor, so I can say this with a straight face: Don’t trust your doctor. There’s no question in my mind that today most doctors are businessmen first and doctors second” (source). This doctor’s post is difficult to ignore. Social media also allows women to share negative health care experiences, and these shared experiences can help other women to avoid the same situations. For example, women discuss negative encounters with doctors when they have conditions unrelated to their reproductive organs that need treatment, but their doctors ignore their conditions, instead attempting to coerce them into unwanted pap tests and other screening (source)
Evidence-Practice Gap – It can be difficult to trust a doctor who ignores or is unaware of the most recent available scientific evidence in relation to screening and exams such as pap tests, pelvic exams, and breast screening. In some cases female patients are more up to date regarding current evidence than their doctors are. It’s difficult to trust doctors who attempt to coerce women into screening and exams by misrepresenting the evidence, when research reviews raise serious questions about the benefits of pap tests (source), pelvic exams (source), and breast exams (source). The evidence also highlights the harms associated with these types of screening, such as over diagnosis and follow up interventions that are unnecessary and can be harmful. Some women are up to date regarding this recent scientific evidence, and these women may be left questioning their doctor’s competence and/or motives when his/her practices contradict the evidence.
Paternalism – It’s often easy to forget that doctors are working for their female patients given some doctor’s way of relating to them. For example, when it comes to pap tests there is usually no discussion or shared decision involved. Women often don’t get offered a choice about whether or not they want to have a pap test; and regardless of the reason for their visit they are simply expected to comply. In fact, the withholding of informed consent has been standard practice for such a long time, and has been done so cleverly, that some women are not even aware that they have a right to choose. Paternalism in medicine has deep roots, extending beyond doctors’ behavior and their tendency to withhold informed consent. Women have had to endure what is commonly referred to as bikini medicine for a long time. Bikini medicine refers to the tendency of scientists and doctors to focus only on a woman’s breasts and genitals, rather than on the whole body (source). The tendency to focus on bikini areas to the exclusion of other body parts is concerning for a few reasons, including the fact that heart disease is a main cause of mortality in both men and women (source). When researchers and practitioners focus on bikini areas there is less focus on the other areas, thus placing women at risk.
Personal Experience – Some women experience physical and psychological harm as a result of physicians’ practices. This blog is full of women’s shared experiences that reveal many more reasons why some women distrust doctors. On this blog there are more than 10,000 comments, many of which reveal women’s experiences with doctors’ practices. Many of these comments can be found under the following posts: The Other Side of the Speculum: A Male Doctor’s Point of View; Discussion Forum, and Psychological Harms of Pelvic Exams.