Why Some Women Distrust Doctors

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 ViewDiscussion Forum,  and Psychological Harms of Pelvic Exams.

41 comments

      • Thanks for the new post, Sue!

        We’ve been kind of feeding off of ourselves since the last post…..didn’t realize it was that long ago. This site – our site – is so invaluable. In a sea of websites – from hospitals to medical facilities and independent medical “officials” and offices that still keep up the lies about pelvics and paps and withholding the truth about the rarity of cervical cancer, our site is indeed a very welcome necessity to keep us grounded; keep us hoping; keep us fighting. I’m so glad you have the courage to keep it up. Our site has become known amongst our opponents. I’ve seen it mentioned in a derogatory way on one of those sites that promote pelvics; my apologies – I surf so much that I forgot the site. I wonder, though, if our opposers contact you – criticizing you – threatening you – trying to shut you down. I notice now that when I post comments, I get a message stating that my comments are being moderated – is this a result of outsiders trying to take legal steps against you? If you are being antagonized by those against our site, please let us know; please don’t let them discourage you as there’s so much misinformation misleading women. They must know the truth and unfortunately it’s taking time. Those who find our site sound like women who have found land after being lost at sea – dragging onto the beach and falling on the sand grateful to be safe and finding help. Please do keep our site, Sue; keep on giving us new posts; new information; new points to ponder.

        Be Blessed!

      • Thanks Penelope! I agree this is an important site for all the good reasons you mention, well worth keeping up. The comments (almost 11,000 now!) keep it up and running, so valuable. I’m glad to provide a new forum with more space!
        Sue 🙂

  1. http://www.bbc.co.uk/news/uk-england-birmingham-39753498

    Just splashed all over the news here in the UK is this surgeon, who is expected to end up in prison, for carrying out unnecessary surgery on patients. Those who got the “treatment” privately are not expected to get any compensation, due to the private health care businesses getting themselves off the hook. I wonder how many of these women, ended up there through screening?

    • Hi Adawells:

      I just wanted to say Thanks. You gave me a nice compliment to one of my recent posts and I didn’t acknowledge it. Now, I can’t seem to find it. For what it’s worth to you – I’m sorry about that.

      Thanks again – be blessed.

  2. What might help some patients trust their doctors more is easier access to medical records for the patient and more control over what shared between others in the healthcare chain. While it might be and an advantage to have important information about medications or conditions such as diabetes or allergies available readily to emergency staff, I do not want my cancer screening history or lack of available to every single primary care provider I see. I want more control and more privacy. While it is possible to black out sime information sharing, the system is not easy to navigate. I just want more choices.

    • Absolutely agree! It is time to end the practice when medical information is a one-way road: patients are expected to disclose every private detail with the doctors, while doctors are free to warp the facts and choose what to tell their patients and what to hide.

      For example, in Australia any medical record is legally the property of the doctor, even though every the patient is paying for its existence at their appointments. To add insult to an injury, the doctors have the right not to show the record to the patients. It’s outrageous!

  3. I had a doctor blame all of my problems on depression, but neglected to tell me that. He had me coming in every month acting like he was trying to figure out what was wrong. If he’d just told me that, I could’ve said it can’t be depression and if he still was being a jerk, found someone else. If I’m upset I don’t eat (my chief complaint was a ravenous appetite, not ONCE was this mentioned in my records). He also hounded me about getting a pap smear. Sorry, I refuse to support ob/gyns. I can’t support someone who thinks it’s acceptable to tell an 18 year old girl with debilitating cramps “that’s what’s so wonderful about menopause, you don’t have to worry about those things anymore”. I complained of a few symptoms to that thing, 2 of which are well known symptoms of hypothyroidism, and she just blew me off. If I didn’t have hypothyroidism I’d never go back to a doctor.

  4. I don’t trust doctors because they have proven to me their job is to sell me drugs and not protect my health. Even after I told my gyn that hormonal birthcontrol makes me suicidal and too emotional to function she still tries to push it on me. She even takes it a step further by manipulateing data and insisting condoms have an 18 percent failure rate. Which is bs. The pill has a higher failure rate actually because it’s effectivenes is contingent upon remembering to take it at the exact same time daily. And let’s face it, how many of us can do that. Unfortunately for her I’m not stupid so she sold zero drugs that day. My sanity comes before her beach house.

  5. https://www.theguardian.com/society/2017/aug/26/rogue-doctors-use-superhero-status-abuse-patients-ian-paterson-myles-bradbury?utm_source=esp&utm_medium=Email&utm_campaign=GU+Today+main+NEW+H+categories&utm_term=241183&subid=12717179&CMP=EMCNEWEML6619I2

    Some revealing observations raised here about how these doctors operate and some good tips for patients to be aware of. When I was getting treatment for cancer you are on a conveyor belt of appointments with no detail in the letter about what would take place at that appointment. As patients we should start asking questions about the necessity of every appointment and what will happen there.

    • Same happened to me after I was diagnosed with a blood clot in my lungs and I put in a complaint to the hospital about how I was treated at my outpatient appointment with them and how it had upset me that there was no information with my appointment letter about what would happen there when I went.

      I also complained about poor communication and how nothing was explained to me about what they would be doing and why and how it had upset me and I did receive an apology off them.

  6. how can women trust Drs ? they don’t respect a women’s right to refuse screening. celebrities
    opening talking about female organs being removed as prevention. Breast cancer survivor Christina Applegate reveals she recently had ovaries removed
    FOX News · 8 hours ago
    After undergoing a double mastectomy in 2008, breast cancer survivor Christina Applegate has preventively had her ovaries and fallopian tubes removed. “Two weeks ago, I had my ovaries and [fallopian] tubes removed,

    They its. like taking out a mechanical part and saying the device will still work.
    I feel don’t care about the long lasting mental effects on women.

    I have had enough of Drs abusing women, as preventive medicine.

    diane

  7. Speaking of main stream media. This morning on the MSNBC news, two woman were interviewed about health care costs. The burden of rising costs. One woman said ” woman don’t have a choice about buying health insurance. We have to go to the doctor every year. On about how woman are burdand with paying up to 800 dollars a month already and what was 50 dollars more. Meanwhile I’m sitting hear 33 years old I do not have health insurance right now but I have managed with out going to a doctor in . And I have never seen a gynecologist before. I’m thinking have these healthy woman been helped by all this ” health care they receive. My question is why are most woman so brainless when it comes to this. Idk it just irks me. If I dare tell anyone I don’t go they act like I’m a freak.

  8. I have been abused recently by a horrible obgyn. I think I am having ptsd about it. It keeps waking me up out of my sleep. If I would of just listened to my body and not everyone else around me, I wouldn’t be in this horrible situation. I am trying to meditate and use the law of attraction. I just want to get this horrible thing out of my mind.

      • I started focusing more on the goals that I want to accomplish. It still comes back every now and then but I try not to dwell on it. It was the worst experience I’ve ever had in my life.

    • It’s quite simple, these men need to take note: we now have a choice, finally, we have a choice. Where was the concern when the profession was almost exclusively male? When I was 19 years old, there were 3 female gynaecologists in the State.
      Do they think women were served well back in those days? I certainly don’t…
      Also, where’s the concern about male dominated fields in medicine, basically most other areas…urology, the various branches of surgery, etc.

      I read a thread on obgyn.net a few years ago that’s stayed with me, three male gynaecologists complaining women were choosing female doctors, they weren’t getting the daughters of their current patients etc.
      One doctor said he could always work in emergency medicine or the military, where women had no choice. I couldn’t believe what I was reading, why would a doctor, who claims he cares about women, want to FORCE his services on women? It sounds like power and control to me and it shows little respect for or concern about women, it’s all about what he wants…

      When women have no choice, that’s when abuse often follows…just look at the past.
      I well remember the days when a rape victim had to have an incredible invasive examination by the male police surgeon IF she wanted to take the matter further, I know some women walked away, they simply couldn’t face what felt like to them, a second rape.
      Now barriers have been broken down, the world have changed and we have a choice, if some don’t like it, too bad.

  9. Sometimes choosing a doctor by sex is not an option. I think of the surgery I had to after sustaining an injury to my testes. The only surgeon available was a (highly regarded) woman. I didn’t think much of it at the time other than that the pain (along with my testicles) was being removed. After that the only thing I noticed was that female medical personnel were more likely to refer to the operation as castration while males referred to it by a more benignly medical name: bilateral orchiectomy. Pure professionalism all round, though.

  10. I was on the receiving end of shoddy treatment from my last gp surgery after I had a blood clot in my lungs last December.

    Firstly I had called on them to get a sick note to have some time to recover away from work and I was told I was having a blood test with no explanation of what was going to happen or anything. I had been absolutely terrified as well but thankfully it was fine but that’s not the point.

    Then I went to see them to ask about a return to work and I was shouted at by one of the doctors there which was most rude and unprofessional when you are poorly!

    One afternoon I had returned home from work and had received a rude phone call off them as the nurse had wanted to see me for an anticoagulant review and I had asked what was going to happen and got told you will have to ask her that and this had upset me.

    Then the last straw was in April when I had gone to the pharmacy to pick up my repeat prescription only to be told they had refused to issue it until I had a blood test and it had been sprung on me again with no information or explanations of why and what it was for and at this point I had had enough and had said no I wasn’t going to their stupid blood test and made it clear I didn’t want it to the pharmacist and why I felt like that so he rang them and said how I felt about it and why and that they were to issue my prescription and they did back down and said one more but after that I would have to go in and see them.

    What it was that upset me wasn’t the blood test in itself but how I was treated by them.

    The following day I collected my prescription from the surgery and got it dispensed by the pharmacist over the road who said I was right to have stood my ground and how that wasn’t very nice treating me like that!

    Then I received a slip saying about the blood test on the prescription and it said no more prescriptions until seen and I thought to myself they can fuck off with their blood test and under no more prescriptions until seen I had written fuck off and I wasn’t going back there and was going to see about changing surgeries once I had calmed down!

    I did change surgeries after once I had calmed down and the new surgery is fine and the doctor was nice and I am happy to see her for a review in a few weeks time just before my current medication runs out.

  11. I just wanted to leave a few links. The late Dr. Schwartz

    Spent her life trying to warn patients of unnecessary tests and overdiagnosed. She put together

    https://knowyourchances.cancer.gov/

    It is shocking to know how small your life time risk of being diagnosed vs dying of cancer.

    I recommend any books by H. Gilbert Welch:
    Should I be Tested for Cancer? Maybe Not and Here’s Why (University of California Press, 2004)
    Overdiagnosed: Making People Sick in the Pursuit of Health (Beacon Press, 2011)
    Less Medicine, More Health: 7 Assumptions That Drive Too Much Medical Care (Beacon Press, 2015)

    All Americans should read pages 20-27 of “How We Do Harm” by Otis Brawley MD it is an honest and scathing critic of “health care” in America. My favorite line is, “Patients need to learn that more care is not better care, that doctors are not necessarily right, and that some doctors are not even truthful.” Watch all of his lectures and talks on YouTube. They are on screening and how the medical community has harmed people with post menopausal hormone replacement, vioxx, prostate cancer screening, etc.

  12. I stopped trusting doctors from a very early age because of blatant, repeated lies. I consider myself a tough, high-pain-tolerance person, but I was sick of being a victim of medical lies and deception. I have been avoiding doctors for 4 decades now, and hopefully can do this for another 4 decades.

    Medical lies and the partial truths

    It is appalling and angering to see how many patients are put through extremely painful or harmful procedures without being accurately informed of what to expect. Most doctors tell their patients that “they’ll feel a little bit of pain” or “some mild discomfort”, and the so-called information brochures given to patients do exactly same: they downplay the pain and harm and make procedures appear safer and simpler. Most of the time, the lies are told to women about women’s health-related procedures, which not only leaves the women in deep shock and depression after the procedure, but also does not allow them to ease the agony by preparing and taking painkillers before the procedure.

    Have you ever been left shocked, embarrassed or feeling guilty for being such a sob because a procedure that the medical brochure or the doctor described as “painless” turned out to be a sheer agony? Don’t blame yourself. It is a common practice. The medical profession routinely uses euphemisms and downplays the pain, calling painful procedures “painless”, and extreme pain — “mild discomfort”. They know that it is impossible for the patient to quantify the pain and later prove what it felt like, so they say whatever keeps the medical conveyor belt going smoothly, quickly and profitably. When confronted, they usually say it is to reduce the patient’s anxiety, dismissing the fact that the patient is left feeling violated, betrayed, loses trust in doctors and often cannot agree to receive further “health care” no matter how necessary.

    Patients are often promised that once they feel any pain, the doctor or nurse will immediately stop whatever they are doing. In reality, the action continues despite the patient begging to stop. “Almost done”, “C’mon, it’s not that bad”, “Just a bit more”… Sounds familiar? Nobody had any intention to stop, the promise was a deceiving lie. Once bitten, the patient will be more anxious next time, will refuse even less painful procedures, and will not believe anything the medical profession says. For that, the patient will be ridiculed, told to be reasonable or offered counseling. First time, it was the patient’s fault for being a wuss; the subsequent times, it is their fault again for being unreasonable. That’s how the medical establishment sees it.

    If a patient lodges an official complaint, most of the time they get a blanket reply that they “received the service according to all standards and proper pain management was administered”. There is no openness, honesty or justice, because despite holding the health and lives of public in their hands, the medical profession is only accountable to their peers. Imagine if every occupation had to answer only to their colleagues! Wouldn’t that result in malpractice, negligence and cover-ups?

    Patients are often given incorrect doses of anesthetics, or an anesthetic drug that is inefficient in their case despite the existence of a better alternative. Sometimes it is done to cut costs, sometimes — because the medical establishments doesn’t have the patience to wait until the anesthesia starts working and they begin the procedure too early, or they want to get rid of the patient as quickly as possible (especially at the end of the day) and a gentler procedure or a stronger anesthetics would mean the patient will need to spend more time in their care. The staff wants to go home, so they rush.

    Same goes for risks and complications. It is easy for a doctor to send a patient to a painful, invasive procedure, saying that’s the “gold standard”. Very often, there are better alternatives, but they are either inconvenient for the doctors, or the National health care system sees them as unnecessary expensive. The system processes millions of people, so it always opts for something easier and cheaper, yet it always wants more tax funding. People’s suffering is free. Saving a dollar on each procedure means millions. That’s where the “gold” of the standard comes from. Even when the patient is willing to pay extra for more safety and less pain, the establishment cannot be bothered altering their routine. It is more effective to spit this patient out and wheel the next one in than fiddle around being gentle and considerate.

    Verbally, a procedure is often described as “routine, safe and well-tolerated”, but when it comes to signing the consent form, the patient is suddenly given a long fine-printed document listing all sorts of risks and nasty side effects. Often the paperwork is done just before the procedure and the patient is too stressed to read anything properly. If they do read and question the complications, they either face a rude, bullying and dismissive attitude of the medical staff, or, again verbally, told that all these horrors are “extremely rare”. How rare? Ask for a precise number and ask to have all the promises in writing. After all, you have to sign, why don’t they too? The medical profession can be very casual, promising and reassuring in words, but not so much on paper. Remember, your procedure is an everyday money-making activity for them, but for your it can be an experience affecting all your future life. And you want to make sure it is a good experience rather than a nightmare that would haunt you forever.

    In 1930-40s, Nazi used a special language. For example, death process in camps was called “special treatment”. Such euphemisms not only shielded reality from their victims, but also softened the truth of the Nazi involvement in mass murder. These days, hardly anyone would agree that it was a good practice. But if so, why is it still acceptable in medical settings?

    For example, cervical biopsies are described by doctors as “a bit of cramping”, while many women, even those who birthed children, report that it was the worst pain they ever felt in their lives. In addition to the excruciating pain, some doctors make the experience worse by dismissing the patient feelings as they are just a pathetic wuss and making them feel guilty for screaming, crying or fainting. Cases of male ob/gyn doctors telling the agonising women “c’mon, it’s not that bad” during cervical biopsies are beyond comprehension! Then, when the same women call the doctors next day to complain about extreme pain or heavy bleeding, they are told by the staff that it’s normal. Normal?! A day ago it was described as “slight discomfort with very rare complications”.

    Perhaps, the medical profession believes that patient ignorance is a bliss and that it is better not to scare the patients in advance; which means that they also believe that it is better to let the patients to learn the truth through pain shocks, emotional traumas and feelings of violation.

    If you are not the person who prefers to learn this way, first of all question whether the procedure is really necessary. Too often they are performed by the doctors to tick the boxes and cover themselves against lawsuits. Then make sure to obtain the true information about any procedure before you agree to it. Insist on the whole truth. Insist on the proper pain management. The modern range of anesthetics allows not only to eliminate the pain during the procedure or surgery, but also to greatly reduce the pain caused by the injections of the anesthetics themselves; it is just that the medical personnel is often either lacking the necessary skills, or do not wish to give extra time to each patient, or simply cannot be bothered. Proper pain management may also be considered too costly and thus not offered under national health schemes, because the aims of these schemes are to prevent the development of the diseases that are expensive to cure and to stop people from dying too early; the pain is not seen as a problem of the individual until it hinders the individual from work, self-support and socially acceptable behaviour.

    Doctors are afraid that if the patients learn the truth and find out that the procedure is very painful or risky, they may refuse to undergo it, demand guarantees, ask for inconvenient alternatives or hold the doctors responsible for the complications and side effects afterwards. In addition, many tests and screenings are done primarily to put the doctors on the safe side with little or no direct benefits for the patients. The doctor will tick the box, but it’s the patient who is left in pain. In addition to the comprehensive information about safety, risks, reliability, side effects, complications and degree of pain, it is very important to ask questions about the actual necessity of any procedure. Make sure that the offered procedures are really necessary. Ask how exactly you will benefit from the procedure.

    It is also useful to know that medical practitioners often receive “service incentive payments for reaching screening targets”, or, in other words are paid extra for persuading their patients to undergo certain tests, screening or procedures. In most cases, the patients are not informed about the doctors’ financial interests in such persuasion, pressure and coercion. This incentive payment money can be another reason behind the misleading information about the procedures given to patients: the pain and risks are diminished, while the necessity and reliability are overstated.

    Another sad fact about mass screening programs is that they often lead to overdiagnosis by picking up abnormalities that otherwise wouldn’t do the patient any harm during their lifetime. Most people have some sort of abnormal growths or tumours, and those would have never revealed themselves if the person did not submit to the screening. But once the abnormality is discovered, comes a miserable time of overtreatment and unnecessary worries, and what is the most unfair, the patients are mislead to believe that the screening saved their life. The more unnecessary the treatments was, the more people believe their lives have been saved by the screening. Alarming people about a disease they were never going to die of, stressing them with a scary diagnosis, torment them with unneeded treatments, and then declaring them “cured” — makes it seem like the screening was successful.

    As they say: there are no healthy people — they are just underscreened.

    • This fits in well with a book that I just read, _Less Medicine More Health: 7 Assumptions that Drive too Much Medical Care_ by Dr. H. Gilbert Welch. He echos your statement that there are no healthy people – just underscreened. Everyone has abnormalities in their bodies, and as our screening tests get more and more sensitive, more of these are found – leading to a cascade of intervention, a medicalized life, while distracting from actual, bothersome symptoms. Occasionally, a screening test can incidentally reveal something potentially serious in time to do something, such as Ruth Bader-Ginsberg’s discovery of early pancreatic cancer during her virtual colonscopy. More often, when they do reveal an abnormality, there are cascades of further tests, interventions, further diagnoses, even futher tests – all for naught.

      What is “health”? Certainly, health is not a several-weeks longer life at the expense of living a number of years as a cancer patient – on radiation and chemo, living a medicalized life going from clinic to clinic, out of necessity foregoing travel to see friends, relatives, or “the world”, with the time the person has left. This will likely end or severely limit that person’s career – which provides a great deal of psychological satisfaction. It is also extremely expensive to live this way.

      Health is not spending your time worrying about your health. It’s not spending your time and energy stressing about dealing with sales pitches for the latest screening test, the same unacceptable ones over and over. There is living life, having fun, having enjoyment. We may miss out on those if we live with a medicalized life. Do you really want “safety”? How safe do you want to be? Are you serious? Do you drive 55 mph and travel only on limited access highways? Always wear your seat belt? Do you hike? Ski? Bungee jump? Most of the things we do have risk.

      Dr. Welch goes into this is a value judgement, that no one can answer for anyone else.

      One thing that gets lost in all of the noise involved with the screening sales pitches, and the “cancer risk” talk is just how much smoking contributes to cancer. It doesn’t just effect lung cancer just a little bit – or even double. It raises the cancer risk for numerous cancers 18 times! Plus, it greatly increases the risk for earlier cardiac problems – which is the cause of death for most people. Quitting smoking (or never starting) reduces the cancer death by itself more than if someone were getting all of the cancer screenings we have, annually.

      Furthermore, what are you going to do with the test results? Are the follow-on tests, procedures, and treatments acceptable to you if it’s positive? Are you going to consent to it? If not, you’ve just got data. You do not have information. You do not have useful information. You’ve wasted money, time, and introduced more worry into your life, and provided a distraction from things which might be important. For instance, if taking a statin is unacceptable to you, modifying your diet is not acceptable or impossible for you, knowing your cholesterol level is about as good as taking the hyperbolic cosine of your checking account balance – while it’s a number, it’s not actionable in any way. We have a LOT of data! It’s cheap and easy to store, and someone else mostly pays for gathering it. Does it help in any way?

      Look at the research, and look at the actual number that benefit – not just the percentages. If it’s a fatal condition that effects 2 people in 10,000, and a screening test takes that down to 1:10,000 – we can say the test reduces it by 50%. The reality though is that this won’t help 9,999 people out of 10,000: 1 in 10,000 dies anyway, (flip the fraction over) The other 9,998 cannot benefit from the test. They can be harmed. They can experience stress. They can experience worry. Their lives can be disrupted. They can have pain and side effects. Is it worth it?

      There are any number of screening tests that can be done. Some of them are pushed and “oversold” more than others. The “awareness campaigns” are often little more than what’s referred to in politics as “astroturfing” — something looks like a grassroots campaign from concerned citizens, when actually, the whole thing has been funded and is run by those who have something to gain. For instance, much of the “awareness raising” done involving prostate cancer, urging men to get their PSAs and DREs is paid for by the makers of Depends (TM). Prostate interventions frequently lead to incontinence. That’s right: They’re working to protect the right of men to wear diapers, as well as to be impotent – for their bottom line.

      What other diseases and tests have their “awareness raising” paid for by those who have a lot to gain by having more people treated.

      Treatment, for most, is not health. Living a medicalized life is not health.

      • “Health is not spending your time worrying about your health. It’s not spending your time and energy stressing about dealing with sales pitches for the latest screening test, the same unacceptable ones over and over. There is living life, having fun, having enjoyment. We may miss out on those if we live with a medicalized life. Do you really want “safety”? How safe do you want to be? Are you serious? Do you drive 55 mph and travel only on limited access highways? Always wear your seat belt? Do you hike? Ski? Bungee jump? Most of the things we do have risk.

        Dr. Welch goes into this is a value judgement, that no one can answer for anyone else.”

        This so much!

        It’s like that bs about embarrassment. So what if I AM embarrassed?–if it can be honestly out so simply, that is. If I prefer to prioritize quality of life over quantity, and living without constant medical humiliation is part of my “standard of care” for quality of life, and I consider the supposed risk of dying a bit earlier (supposing the rhetoric is true for argument sake) as worth it to live a life of dignity and self-respect, that is a value judgment only I can make for myself.

        Go screw them with their abusive enforcing of their own value judgment on other people. Embarrassment/humiliation and the desire to avoid it are entirely valid reasons to refuse any medical screening.or treatment!

        “For instance, if taking a statin is unacceptable to you, modifying your diet is not acceptable or impossible for you, knowing your cholesterol level is about as good as taking the hyperbolic cosine of your checking account balance – while it’s a number, it’s not actionable in any way.”

        Also this! Okay, so the screening Nazis want to go full India and force non-screeners legs open against their will. So then,what if I am going to refuse follow-up and treatment? What if I staunchly refuse to submit to biopsies, chemo, radiation, etc? Will they also force everyone to submit to any and all treatments the doctor chooses for them against their will? And I don’t want to Godwin too much,but at the point of forcing medical treatments on unwilling victims, how close have you gotten to Nazi scientist Dr. Mengele fascist medical horror? Because if I can be mandated to submit to whatever the doctor demands either by physical.or economic force, and not allowed to choose, refuse, or even question anything His Holy Majesty Dr Whathisname and the High Court of Established Medicine want to do to my body, the flesh I alone wear and feel and suffer in, what is to prevent full-on human experimentation by either government or corporate powers–or more likely, both working together as they always have? Among other abuses that are possible. It’s a very real and well-documented slippery slope we’ve seen play out millions of times in history–when anyone or any group is given absolute and unquestioned power over the lives and bodies of others, nightmarish abuses are inevitable. Were already seeing some of it in the medical in industry, with its being allowed to handle abuse charges internally among their cronies, not unlike the Catholic Church did with rapist priests, and that isn’t even at the level.of absolute power the pro-screeners want for them.

        So is have to ask them.how far theyre willing to go.

      • Yes, embrace life!
        It’s sad that so many women (and some men) don’t just accept they’re fine when they feel well and are asymptomatic, they need medical reassurance that all is well.
        Of course, with false positives, false negatives and non-evidence based exams and tests, it’s usually false reassurance. Also, incidentalomas are a huge issue, especially as we age, an ultrasound might pick up “something” on your kidney or an asymptomatic kidney stone or gallstone or is that something on your thyroid? Are these cells abnormal? Are your blood tests within the normal range. Of course, the ranges have been moved lower over the year catching more people.
        Once “something” has been sighted, then what? A biopsy, surgery…have the kidney or ovary out? Have the kidney stone “treated” and possibly end up with a damaged kidney or ureter or an infection?
        We have to stand guard of our healthy, asymptomatic body…the consequences of these “simple” exams and tests can be severe. Peace of mind is so important, I certainly don’t want to spend my life on a medical fishing expedition.
        I trust my body, I’ll listen to it…far more reliable than the medical official discourse.

      • Elizabeth,

        The various (reasonable) definitions of health in that book, combined with the “embrace life!” message makes it one of the best books I’ve read lately.

        The reason that I became active on this site, once again, is that the whole thing got brought back with my January appointment where I was pushed – HARD – to have a pelvic/pap – tests I’ve 100% decided to NEVER have (pelvic, maybe, if symptomatic and I cannot handle it myself), and with a male physician who I’ve never met before. I’m just not in the habit of spreading my legs for strange men – one thing that lowers my risk for HPV.

        The book was not especially written for women. Men get pushed into tests too – I’ve observed it when accompanying DH to his appointments. Men push for tests. All of these tests have a possibility of revealing something “abnormal” as well as false positives – all of which lead to overdiagnosis and overtreatment – greatly increasing the cost of medical care because of overuse. It all leads to anxiety and worry and stress – which are problems in themselves. At the same time, due to false negatives, it delays obtaining care – diagnosis and treatment if symptoms do arise. They won’t go to something that’s just been screened for until they eliminate all other problems – and it being “all in (the patient’s) head” is one thing they have to get around or through.

        Taking a well person, convincing them that they are sick and need treatment makes a lot of money – for the pharmaceutical industry, the labs, and for the healthcare providers.

        You know, if you or I or anyone went in, nearly hysterical about some rare cancer (say of the kidney, heart, spleen – all of which are more common than cervical cancer), demanded to be tested for that rare cancer – which we have no symptoms of nor any family or personal history of – they would refer us to mental health care for our hypochondria. Yet, when they are hysterical about us being tested for cervical cancer, they are “following recommendations”, and claim we are being (fill-in-the-blank) for not wanting to let them finger us. Gee, could something else be going on here? Misogyny combined with money flow. Women doctors aren’t immune from that either – they were taught in that system and are rewarded for meeting “targets” in that system.

        The “virtual colonscopy” appears to eliminate many of my objections to standard colonscopies – risk of injury or infection from unclean instruments. It does reveal many “incidentalomas” on surrounding organs in the abdomen – leading to lots of overdiagnosis and overtreatment of things which would probably never have bothered the person.

        Yet, these overdiagnosed, overtreated people make the best cheerleaders for all of this extreme overtesting – they are convinced, to a person, that the test “saved their life”. It’s possible. It’s more likely they were treated for something that never would have amounted to anything during their lifetime. Many of these things are slow-growing or they are simply not growing. Or, the test revealed a risk factor for (a disease). Or a pre-disease (pre-cancer, pre-diabetes, etc). If you have “pre-cancerous” cells, YOU DO NOT HAVE CANCER! What does that even mean? It would be just as correct to diagnose anyone as “pre-dead”. Of course, they treat every female who has not yet reached menopause nor had a hysterectomy as “pre-pregnant”. That’s true whether there are any plans, desires, or inclinations to become pregnant ever (again).

        One thing that is certain is that we are all going to die. Sooner or later, of a disease or an accident. Some treatments for cholesterol show in randomized controlled trials to not increase lifespan, or even decrease it – because the treatment does reduce cardio symptoms while increasing the incidence of some cancers – mechanism not currently known, but far beyond what chance would indicate. Other random controlled trials show that those screened from colon cancer are less likely to die of colon cancer – but death from all causes increases because of a higher incidence of heart attacks – again, mechanism is unknown, but far beyond chance.

        Personal experience has a lot to do with it. I’ve been hospitalized several times over the past 20 years. EACH TIME I developed an infection I acquired in the hospital! 3 of them have been quite serious – one nearly killed me, one lead to another surgery, another gave me osteomyelitis (painful bone infection lasting several years). Plus, injured with a catheter which I had explicitly NOT consented to.

      • I left out that I’m active here again to get support for my feelings from that January appointment, which feels to me like verbally fighting off a rape by coercion. That’s what I did, but this won’t be the end of it. It was more satisfying when I was faced with a more conventional attack from a man and I decked him (left cross that knocked him to the floor) then ran out of the area.

        Being “stuck” dwelling on this is not health. The situation did result in “harm” – stress, and an obsession that takes time from what else I want to spend my life doing. Thank you all for being here, sadly, I expect, much for the same reasons. This is not health either.

        I’ve had a lot of “therapy”. The last therapist discussed “informed consent” with me, and ways I could enforce that it’s adhered to – just what I’m doing.

  13. I don’t think we face anything like the sort of pressure we face to have cervical screening about anything else, I can’t think of a thing. Also, doctors often assume a headmaster type tone when they raise the subject, like they’re ready to meet any resistance or they talk over the top of you, fobbing off your excuses or intimidating you with their greater knowledge. (I’ve actually found many GPs have a poor knowledge of the evidence, IMO, they’re trying to hit targets and collect the prize)
    Or, they become rude, impatient and dismissive…
    It’s not just about following recommendations, because we don’t see the same attitudes about any other test or exam. It’s a demonstration of the patriarchal and perverse attitudes behind women’s “healthcare” – the “we know best, do as your told”…

    It will take a long time to change attitudes, for the “tone” to change, and it starts with women pushing back…

    It’s also clear GPs will try and tack on a Pap or HPV test at every opportunity, a friend is having issues with repeat UTIs, the locum GP wanted to do a quick exam, “I might do a cervical screening while I’m in the area”…she firmly declined saying she didn’t want a speculum exam and didn’t want a screening test, she’s HPV-
    The GP then said that she might have become HPV+ since her last test (she used the Delphi Screener about 3 years ago when it was possible to get it here, she stopped having Pap tests over 10 years ago due to the painful process) – she said that wasn’t the case, and decided to end the consult and wait for her GP to return from holidays.
    There’s also an attitude, if you don’t screen and there’s a need for a pelvic exam or an exam involving that area, they try to do a cervical screening, tack it on…a screening test is inappropriate for a symptomatic person – yet any opportunity will be seized to tick off a never-screened cervix or under-screened cervix.

  14. Forgot to add, that some older women end up with UTIs after a speculum exam, so hardly in our best interests to tack on a screening test using a speculum when the patient is already having issues with UTIs!

    • It’s not just older women who end up with UTIs after a speculum exam. Plenty of young women get them too… as well as a host of other things. It keeps ’em coming back. If she asks how she got some other foobar infection which she knows she was not exposed to, the “latency theory” will be introduced.

      GPs either don’t know the actual data, or they are deliberately lying to us. They sound like they’re reading off a pro-pap propaganda leaflet, rather than any scientific research. So, are they just plain stupid or are they just playin’ stupid, in order to tick off an unscreened or underscreened cervix?

      When you’ve got a symptomatic woman in stirrups, opportunistic screening is almost guaranteed to yield an abnormal pap! It also keeps ’em coming back – for a “confirmation screening”, then the cascade of other interventions, up to and including hysterectomy – after one or more painful biopsies – but they’ll lie that it doesn’t hurt, and there are no nerves there. Try telling a man that his genitals don’t have nerve endings when you propose a urethral swab!

      There are plenty of screenings they can do, which also yield a lot of false positives, overdiagnosis, overtreatment, and get a lot of people coming back. Yet, those are not pushed with the same vehemency that paps are. Colonscopies used to be pushed with nearly the same vigor, but with more data out there that screened populations have a higher death rate from all causes, it’s losing some of its appeal. Paps aren’t nearly as dangerous with the test, but all of the follow on procedures being so unappealing and dangerous, the question is why do it if you’re not going to follow through with treatment?

      • As paps are pushed with a far more aggressive, paternalistic attitude than all of the other screenings, which can be just as lucrative, one has to ask what’s special about this screening test beyond all of the others. Oh, I know!

      • Smear tests have been pushed so aggressively at women here in the UK that we must back at the British Cervical Screening Programme as an operation of incentivised, organised, mass rape.

        Any women coming into the doctors consult room could be ‘opportunistically’ attacked to have a smear test. Women coming in for a pill check, migraine medication, ingrowing toe nail could be brow beaten until they submitted. There was no way of getting out of smear tests for British women it was just something that was done to them. This injustice was carried out during the 80’s and 90’s until more women began questioning attitudes.

        I will never trust a doctor again because of what happened to me. If a doctor was to be rude or aggressive to me over smear tests I would become very aggressive back to them. I would let them have a piece of my mind until they backed off and apologised to me.

        Don’t be afraid to be rude to doctors to protect yourself if you don’t want a pap or pelvic.

  15. I was reading a book earlier, and this quote seems very appropo.
    “A Cynic is a spy who aims to discover what things are friendly or hostile to man; after making accurate observations, he then comes back and reports the truth. — Epictetus (135 CE)”
    Flynn, John. The Cynic’s Handbook . Cró Cló. Kindle Edition.

    This pap crap seems to be quite hostile to women, women’s healthcare, and women’s health. We seem to be among the few who are talking about it, and not falling in line that it’s all for saving our lives from our cervixes which are sure to come out and attack at any time. It’s more like a pathological attack on women’s sexual pleasures, abilities, and capability for procreation.

    Cynicism is the only sensible mindset to look at this through.

  16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4819835/

    I’ve been reading up on hormonal changes after menopause, the rising pH of the vagina and vulva and the links with all sorts of issues – infections, dryness, itching, soreness, pain (including when you urinate) and atrophy.
    A lot of the articles focus on vaginal dryness and intercourse and one study looked at a possible link between these issues and CIN, (typical) no link found. Instead they found (as have other studies) that vaginal pH is strongly related to age and to menopausal status and thus could be a marker of age related hormonal changes.
    I’ve become aware that a lot of women suffer in silence, and some really suffer, and most don’t mention the problems they’re having or see a doctor. The latter often means the first thing mentioned is a Pap test, which is ridiculous – the woman is symptomatic, so a screening test is inappropriate and the test would almost certainly produce a false positive anyway.
    (and the speculum could cause more damage)
    Others use vaginal oestrogen or HRT; there are possible health risks associated with both options, and it means going back to the GP or gynaecologist every 6 months – I’ve noticed these women end up having a lot more exams and tests.
    (and I suspect they’re unnecessary in most cases)

    I have a friend who’s been struggling with issues for a few years, but I had no idea how bad it was and how it’s negatively affected her life – cancelling a trip to Africa, giving away exercise, no swimming, no trousers or shorts, only skirts and cotton underwear etc.

    Raising this subject recently with a group of friends, all in their 50s or early 60s, I was surprised to hear that 6 out of 9 women were having issues, some were itchy, mainly at night so broken sleep, others sore, others just aware of that area when they sat on a hard chair, some felt stinging when they went swimming or urinated…2 had sisters on vaginal oestrogen or HRT.
    (they’re no longer shocked at the subjects I decide to explore!)

    I suspect the answer for something that affects about 50%-60% of older women is simple, restore the pH level in your vagina and vulva, and over the counter preparations might be the answer, there’s a chart in the article that looks at most of the options.

    Isn’t it disgraceful that they go on endlessly about a rare cancer, push screening tests that end up harming most of us (Pap tests) or have a huge cloud hanging over them (mammograms) but not much is said about something so common that seems to be easily sorted out for most women. I wonder how many women are on HRT or using vaginal oestrogen when an off the shelf option might be enough?

    So take note – if you’re approaching menopause or it’s already happened, if you get what you think is thrush or a bacterial infection, if you’re itchy, uncomfortable or sore, try one of these products, it’s more than likely the infection or other issue is the product of a high pH in your vagina and vulva. (caused by a change in your hormones)
    Treating the BI or dryness without treating the pH, may mean you go around in circles for years.

    Anyway, hearing good things from my friends who’ve started using one of the off the shelf products, no itching, more sleep, less soreness and it’s early days, they’ve only been using the product for a week.
    PS Beth, Yes, I know many younger women also find the speculum exam painful – any woman who wants to test should be offered self-testing. It says a lot about medical thinking when they prefer unnecessary speculum exams…they don’t give a damn about our health, dignity or comfort.

  17. Elizabeth thank you for the link and post about a sensitive subject that has or will affect most of us, and perhaps our quality of life, because our bodies do change as we age. Knowing that there are over the counter products, or perhaps even natural remedies to help with vaginal dryness and atrophy is especially helpful because women’s bodies are so medicalized at every stage of the life cycle and presenting at a gyn office with this complaint may well subject one to a whole slew of interventions. Hormonal changes themselves may cause an abnormal pap smear result, and I have read that older cells sometimes appear abnormal under a microscope. In addition, as you know our hysterectomy rate in the US is appallingly high. I believe a major reason, besides padding the coffers of doctors and hospitals in our for-profit system, is that every gyn resident-in-training is required to perform dozens of hysterectomies in order to become certified in the field. They therefore are looking for cases, and as soon as an older woman walks through the door, especially if she has good insurance, she’s fair game.

    • Thanks, Judy. I knew there was something else. Yes, hysterectomies are lucrative (follow the money), yes, there’s a lot of misogyny that goes with gyn (even women gyns buy into it), but that STILL didn’t explain the huge numbers of hysterectomies in the US.

      Getting well-insured older women to act as guinea pigs for gyn residents who have to participate in a number of hysterectomies, as well as nurses and surgical techs (even if surgery techs have very little training) who need to participate in a number of these would very well be a reason.

  18. Absolutely women are being used as guinea pigs. Many gyns are now using something called a Da Vinci robot to perform hysterectomies and other operations. Besides needing to generate enough revenue to pay for them (at about $1 million per unit) they want to practice their technique. Several years ago there was a case in New York where a young woman died when one of these devices was used during her gynecological surgery. My brother was working at the hospital at the time and he told me the sales rep for the device was present in the operating room and the doctor basically let him perform the surgery!

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