The current issue of the Journal of the American Medical Association contains an article whose headline is:…
"A sinister cabal of superior writers."
The current issue of the Journal of the American Medical Association contains an article whose headline is:…
Article comments
— go to most recent comments8976 - kleigh us
from what i understand . if you dont make over a certain amount of money you can get medicade. im sure thats me . it scares the crap out of me all i have heard from woman on medicade is that they are treated like walking stds when they see a doctor for any thing also i hear they are pushed to take birth control at every vist to the doctor. i dont know if things will change with this new health care. but i hate to think i am going to have to put up with being harased to have std and pap test and have to fight with doctors about not wanting to take birth control. im scared.
8977 - Elizabeth (Aust)
I cannot imagine an insurance company demanding you have screening tests to maintain your cover, here as long as they get your money, they're happy.
I'd be sending them the information on the risks and ACTUAL benefits with these tests and exams and advising them that any harm, physical or emotional, incurred as a result of screening would be their responsibility and my lawyers have been advised...I'm being forced to have these tests to maintain my cover, when legally and ethically it should be my choice. The end result - they'd probably simply refuse to cover me, I'd be too much trouble, but I wonder about the legality of their actions...it would be interesting to see what a Court thought of this conduct, it sounds like another try-on to me, but then I know the "standard of care" argument means doctors (and probably insurance companies) get away with outrageous conduct in the States.
If my insurance company made these demands, they'd be told loud and clear I value my health far too much to allow screening tests that have not passed my risk v benefit assessment, with lots of information to back that up, I doubt I'd hear from them again. I know they mention these things in their magazine, but are fairly moderate in their statements about screening.
(In that example...it's clearly a try-on on my behalf, even if the insurance company accepted my terms, I would not have the tests and exams, I'd probably be looking for a new job and home far away from medical coercion)
Kleigh, I can understand your concern. Public/free hospitals and medical care can mean less control over your body...no choice of doctor and you may be more likely to be pressured into testing and routine exams or pushed out the door without a proper examination. Private hospitals want good word of mouth and repeat customers and your preferred/chosen doctor is less likely to be intimidating and rude (but that might mean shopping around to find that doctor) You hear lots of horror stories, but most seem to come from the public sector, free, bulk billing clinics and the like...do others agree with that assessment?
8978 - Alice (Australia)
Elizabeth, I think we are (still) luckier here in Oz, because we only forced (by additional 1% Medicare levy surcharge) to buy additional hospital health insurance if we earn more than $80K or so (and that's only hospital cover, so they have no interest in pap smears; actually, they would rather see the cancer - that's where the money is for them).
And If we don't earn 80K, we just have to pay 1.5% to Medicare, without any surcharge, and Medicare, being compulsory and government-run, can't say (so far) "go do a pap smear, or we won't cover you". Every Australian citizen and permanent resident is entitled to Medicare, and they can't really kick us out of the country for not papping.
All they can do is to copy the bad practice from USA (they can be good at that) and invent a fine for women who refuse pap screening. But in this case, it will be gender-based discrimination sanctioned by the govt. They can't punish women only for non screening for a cancer that is much rarer than males' prostate cancer for which there is no pressure to screen.
Americans are in a bad situation because they are forced by their govt to take insurance in private companies, who can impose any nonsense they fancy. Whatever brings them money. And, as we know, forcing women into screening and over-treatment makes way more money than losing an odd stubborn customer who knows that pap smears are harmful and refuses to submit to them even if that means losing the cover.
8979 - Mary (aus)
Although I got a weird phone call out of the blue from my health insurance once and they were asking me to join some sort of program, I can't remember the details but it was supposed to be some kind of thing where they have a nurse sort of take a closer look at your records and llok after to you or some BS. And they asked me for my hospital records.I said "you want my hospital records?!" She quickly backed down then and said "no" you don't have to give it to us. I smelt a rat. And I considered quitting my cover with them. Never heard from them again about this program.
8980 - Elizabeth (Aust)
Alice, we're definitely luckier than many other countries, we don't get the well-woman propaganda urging women to climb into the stirrups most of their life and now ACOG are calling for girls aged 12-13 to start seeing a gynaecologist every year...it "might" not include a pelvic exam, but it sounds like they do a breast check and visual inspection of the genitals (to check you're maturing properly)...it's just sickening and must be terribly traumatic. It's an easy way to destroy the health and happiness of your daughter, that's for sure.
It's grooming IMO, getting girls "used" to this unnecessary and harmful intimate invasion...to "get over" their embarrassment for the sake of their health. (read, future profits)
I read on one US girls health site (directed at mothers) that the earlier girls start, the easier these exams become, they become a "normal" part of your healthcare, like brushing your teeth and seeing a dentist. Sounds like grooming to me...and it's preaching to the converted with many of the mothers getting into the stirrups every year of their life (if not more often) A woman my age might be up to pelvic exam, pap test and breast exam...(assuming I started at 18) number 36 (probably more with re-testing, over-investigation after false positives) and you can bet there would also be excess cervical/breast biopsies, hysterectomies and other nasty things caused by these exams. (1 in 3 American women will have a hysterectomy by age 60, one of the highest rates in the world...so much for the life-saving, health promoting well-woman exam!)
Then we have the medical coercion that still appears to be the norm in the States, Canada and elsewhere...you want the Pill, jump through this hoop or rather, jump into the stirrups.
The UK also have a call and recall system which gives the program greater control over women, so they can capture and screen as many as possible. As I understand it, women must register with a GP and that doctor is responsible for your screening, unless you opt out, but you then get the red ink letters again 4-5 years later urging you to have a pap test. You can't permanently remove yourself from the register. (taken from electoral rolls or Medicare records, I assume) That sort of system has been suggested for Australia.
If it happens they'll be taking me off and I mean OFF the register...any further contact and I'll take action, why should I be expected to opt-out every 5 years, especially when I've never been part of the program, I didn't opt-in in the first place. The cheek of these people...
If it happens...it will place more pressure on women and those who say they had the test elsewhere (but actually have decided not to screen) will be challenged...others will give in and screen, tired of the pressure/letters.
I see issues bringing that system into this country with bulk billing places and we're free to see any doctor we choose, go to any Clinic...but I'm sure they'll look at it and see if they can find a way...more plotting.
8981 - Mary (aus)
Elizabeth don't forget though, that the head of Obestetrics and Gynecology, Rupert actually had to check to say that pap smears are a "requirement" for the pill. Doctors here, I am certain, will still use the opportunity to bring up pap smears when you ask for the pill. Rupert's still living in the last century. And they do ask when your last pap was at your first antenatal visits. Just asking makes you think that it's a requirement. They don't ask if you've had any other kind of test of course,nothing else matters.
8982 - Alice (Australia)
Elizabeth, unfortunately Australian medical system seems to lean that way: with the electronic heath records and greater control and monitoring of the population, it will use every opportunity to collect more private information about us and heard us where it wants to.
That is why, unless you see it necessary, it is very important to give the least possible minimum info to the system, read the fine print, cross out every condition you don't agree with, opt out of everything you don't want, and keep a copy of every form you fill or sign (it's easy with a digital camera). This way you will remember exactly what you agreed to, and will find easier who leaked the information.
For example, doctors always want to know your date of birth. Do you know why? Technically, unless you are an infant, it should be enough to know your year of birth to estimate your age for medical purposes. Date of birth, together with your name is used to search for you in the comprehensive database provided to every doctor by Medicare, to assign you with an unique health identifier and track you from there. All people who disclose their Medicare card number are tracked also. Then, your address. No doctor will ever take you back home after your appointment. So, what do they need the residential address for? Again, for identification and tracking.
Once, when I was visiting a dentist, I saw "driver's license number" field in their new patient form. I was really pissed off! I never even give my full date of birth (I write just the year) and my home address to dentists, because the dental is not covered by Medicare anyway. And I hate those reminders the dental clinics always bombard you with: "regular check-ups are very important blah blah, come again, pay another lot". I am a mature person, and I can decide when I should see a dentist without the reminders, especially since I never asked to be pestered. Then, I don't want the private medical junkmail coming to the address after I move out, or call to every blasted company I dealt with and tell them I changed my address. So of course, I left the address and the drivers license number blank. And when the assistant asked me for my ID, I said, I either leave blank everything I see fit, or I simply leave. They accepted that.
8983 - Mary (aus)
I moved and I am sure the pap screen reigstry has been sending reminders to my old address.I'll be interested if they ever track me down. The Family Planning clinic sent me a 'friendly' email to remind me to come in for a check up. They didn't specifically say pap smear but I wonder if they emailed me because they got no response from the letters I presumed went out.
And it conicided exactly on the four anniversary mark- the time when the govt pays providers the bonus service incentive payment on women who have gone four years without a pap.
8984 - Diane (US)
There is definitely a lot of information collection going on at hospitals/doctors' offices that shouldn't be happening. At my clinic and the imaging center where I recently got x-rays, the forms were asking for my employment information -- including employer's address and phone number -- my parents' names, my marital status, et al. I simply wrote that I would not supply any of that information. When they asked for my mother's maiden name, I said that I could not disclose anyone else's information.
In the States you can get a credit freeze that stops anyone from snooping through certain files with your Social Security Number, but it doesn't stop you from being connected to all of those databases, sadly.
8985 - Elizabeth (Aust)
Even the beauticians try-it-on, they want to know your occupation...one of the reasons for that is targeting the pressure to buy products and more services. I used to visit a day spa in Sydney whenever I was there working or visiting family, but I stopped going after a facial full of hard sell and then having to fend off the purchase of products at the counter. Do they really think someone who spends $120 on a facial is then going to turn around and spend $200 on products at every visit?
Then you get the anti-aging propaganda...the $230 cream that slows the aging process. A relaxing bath, glass of red or leisurely read of the weekend papers with a pot of tea works just as well.
IMO, you don't need to spend a fortune to care for your skin.
Mary, quite right, if you're not informed you're likely to be pushed into testing or misled, many of our doctors assume consent, "you'll be needing a pap test"...and I know some pick their targets and imply the test is required for the Pill.
Women also never hear that it's reasonable to refuse a pap test, it's only an option and can never be "required"...so feel stressed, fearful, reckless, guilty or embarrassed refusing the test.
I also don't know any women who've had a doctor explain the pros and cons of testing with them, you might get a lecture on the risks when you don't screen or you're "overdue", but not a word about the risks with testing. (far more likely)
They also don't disclose they get target payments for pap testing. Also, their "overdue" amounts to serious over-screening...even a woman who wants to test is risking her health for no additional benefit having 2 yearly pap tests from teens to age 70...6-7 tests would do the same job and also, bring down risk.
No, there is a lot wrong with our cancer screening programs.
As an informed woman, I find the doctors at the Clinic I use are very careful, I suspect my file has been clearly marked, "Be careful with this woman!". I get on well with my doctors, but I suspect they behave differently with other women. I think the pendulum of risk swings the other way with an informed patient...it's dangerous then for the doctor to ignore your concerns. An ignorant patient is bliss for these screening programs and essential with our programs.
If you don't bring up over-screening, risk/over-treatment/over-diagnosis, uncertainty of benefit, the rareness of the cancer or HPV primary testing, it's almost a given your doctor won't mention it either.
8986 - Sue
I'm sorry to ask but I would really appreciate help from the troops here. A dr has just commented on my most recent post "What Doctors Don't Want You to Know About Pap Tests and Pelvic Exams" and he has spouted off some inaccurate information. I am so PO'd I can't do justice to a good response. He has stated "While most of your information is accurate . . ." WTF? ALL of my information is accurate, but his is not. He hasn't even provided any references to support his claims. I would really appreciate any help from the troops here in this matter. Click on my name to take you to the site if interested in setting him straight.
8987 - Diane (US)
Hmmmm, the Cervista site doesn't mention their urine test anymore; only the one that is used in conjuction with ThinPrep paps. I wonder why.
This is promising: Trovagene is working to roll out a non-invasive HPV test for Southeast Asia.
8988 - Elizabeth (Aust)
Diane, I fear countries that have people making a fortune from population pap testing and over-treatment are unlikely to offer women self-testing, unless like the UK they tell women that regardless of your HPV status, you still need pap tests. (Tampap is the self test option there)
They have most women in screening programs, it suits them, so giving women options will be resisted, especially self-testing. Piling up tests (if someone will pay for them) is even better, as we see in the States with women having both pap and HPV tests every three years.
Excess means more money, so making the risk of a rare cancer a concern for all women creates a huge amount of money...when the reality is about 95% of women are not even at risk. Haven't they kept that quiet?
They also use the patronizing and convenient, "women may get it wrong" to keep women firmly under their control. More informed women who want to check for HPV will find a way to source the urine test, Tampap or the Delphi Screener. Australian women can use the Delphi Screener in Singapore....it's available from lots of clinics. It's easy though for vested interests to neutralize these threats, they simply question their reliability.
There is a reason self-test options end up in India, Malaysia, Indonesia and not Australia or the States...IMO, vested interests basically control women's cancer screening in the latter countries for their benefit, they exert their influence and block change and other options, like self-testing....they of course, call their self-interest, concern about women.
In countries with no screening programs they may make these tests available for purchase or the Govt may pay for one test...they have higher priorities and can't afford population cancer screening when many are without decent food, shelter, basic healthcare etc...
Singapore...like the Netherlands seem to have contained vested interests and focus on the problem....rare cancer and how to deal with it in a cost effective way without harming the masses....these countries are focused on the issue, not using women to maximize profits.
8989 - Elizabeth (Aust)
I should add control of women and offering no other option but population screening is about the continued denial of informed consent. If women have the facts and options, they can make an informed decision about testing - not in THEIR best interests.
I notice the "The Conversation" has quite a few articles on screening and a new one by Assoc. Professor Robin Burton, co-authored by others, including Professor Michael Baum - it's on breast screening, informed consent and the recent UK review.
8990 - Sue
Well now, I'm certainly glad I know you girls. Talk about brilliance! Unbelievable. I had been in the depths of despair and about ready to blow a gasket when I posted yesterday, but the world looks much rosier today. Thank you.
8991 - Elizabeth (Aust)
Sue, many doctors don't have a clue about screening, apart from spouting the recommendations...and some, I'm sure, deliberately mislead women. The only safe approach with screening is to do your own research, no one in this country will give you the information you need to make an informed decision about testing. (apart from Assoc Prof Bell with breast screening) It is amazing to me that after decades there is still no whistle blower with cervical screening, when our program so blatantly operates with no informed consent, it seriously over-screens and that means high rates of over-treatment. Our program is obviously harmful and yet we're still being urged to take part...and scolded if we don't....we get more and more dirty tricks aimed at us to force more of us into harms way. So the argument we should just follow the advice of those who've trained in medicine and know best falls a bit flat, don't you think? Ignoring their advice and checking the facts for myself was the best decision I ever made...and has kept me and my cervix out of day procedure.
8992 - Sue
Yes,well put Elizabeth. I could not agree more. My cervix is intact, whole and healthy as well. But it is sad how difficult it is to protect it from harm. First, you have to recognize that something isn't adding up with drs forcing paps on you, then you have to be healthy enough to be able to avoid drs/say no to the pill (which is usually forced upon you as well), then you have to do your research to confirm suspicions, and then you have to have the courage to stick to your guns, ignore the misinformation and continue to defend yourself from zealot pushing pro pappers. It does take a lot indeed to protect oneself from cervical damage. No wonder we are in the minority. All the fear mongering and smoke screens to cover up the simple facts that cervical cancer is rare and the pap is a highly unreliable testing method. Rare cancer plus unreliable test equals no thanks don't think so.
8993 - Chrissy (UK)
Sue, I agree it is sometimes depressing that we have to put up so much of a fight to just to exercise our right of informed consent, but I am continually encouraged by the amazing women on this forum. In addition, your excellent website is another source of encouragement for women who are searching for information.
And I sincerely hope that the doctor who recently commented on your blog is open minded enough to take on board many of the points that were made in response.
8994 - Sue
Chrissy thank you and I agree there are many amazing women on this forum. I didn't know I was joining a Mensa type of group when I started posting here! I have been loving the comments BTW, very fun:)
8995 - Alice (Australia)
Diane (comment# 8985), well done! I too cross out the parts of medical forms that I don't want to answer. Or, if the place is interrogating and insisting too much, I write NOAFB as the answer to the irrelevant questions. And when they ask what that is, I tell them it stands for None Of Anyone's F****g Business.
Medical places want us to share way too much private information, most of which is either irrelevant, collected "just in case" or, worse, collected to coerce us into something nasty in the future. That information is called personal and private for a reason. And a medical degree doesn't give anyone any privilege over what is private and personal.
Elizabeth (8986), I think my files are also marked "Be careful with this woman!". Pity we don't have access to our own files. The medical establishment is so good at squeezing information out of us, but they put thousand obstacles when we want so honest info back, or want to access the medical records about our own health. This practice has always been pissing me off.
I am also amazed by that James Pate MD who wrote the nonsense in Sue's blog. I wonder if in his case MD stands for "Mediocre D***head".
Besides writing a bunch of standard outright lies about cervical cancer and pap-screening, to the following sensible comment written by a well-known knowledgeable person:
"We now know only roughly 5% of women aged 30 or older can benefit from a 5 yearly pap test, those HPV positive. Most women are HPV negative, not at risk and cannot benefit from pap testing. It's risk for NO benefit."
his reply was:
"This is a very bold, unsubstantiated statement. The reason why we continue to do Paps in HPV negative women after age 30 is because humans are terrible at lifelong monogamy. Approximately 1/4 of relationships are impacted by sexual escapades and over 50% of marriages end in divorce. Just because you are HPV negative at one point in time does not mean that you are immune to (re)infection."
So, ladies, an MD admits that the medical system has been torturing our genitals because they decided that we are "terrible at monogamy". To add insult to an injury, this has been fed to us as "care about our heath".
Disgusting!
8996 - Sue
If you google "is it slanderous to call someone a liar online" you will see it is a bit of a gray area. I put ellipses in place of the words "lie" to whoever wrote the last comment on my blog, just in case. I'm a chicken about getting shut down and apologize for doing that! It is a great comment though so I hope it's okay to leave it up as is with the ellipses. Let me know if its not and also if anyone knows if its okay to call someone a liar please let me know.
8997 - Sue
I will check back in the early morning (it is late here in Canada). I am such a chicken, worry about being head hunted, or I should say cervix hunted. They would love to shut us down I'm sure.
8998 - JeanArt
Alice:
That doctor's comment about people being terible at monogamy really hit me wrong, also. Why do doctors want to assume things about their patients? Maybe it is because THEY are terrible at monogamy and so presume everyone else is, too. It still boils down to informing women and letting them make the choice. It's as if women have no idea if they are being monogamous, abstaining completely, etc. and the doctors just have to test them "in case". It's ridiculous and insulting at the same time. It still comes down to infomed consent which they just don't seem to get. The commenting doctor says he absolutely believes in informed consent but then he goes on to make statements like that which seems to cancel out the agreement on informed consent. Do any doctors tell women that they are at low risk for HPV if they have been in a long term momogamous relationship? Rarely if ever I would guess. Just make blanket assumptions about everyone and test away. Not for me, thank you.
8999 - Alice (Australia)
Sue, it looks like the author of the comment didn't mind your editing, judging by his/her reply (though I can't see you editorial comment about ellipses substitution anymore). I understand your caution - in our age of ubiquitous political correctness and fear of silly lawsuits one never knows what's right and what's wrong. Everything is a grey area.
Personally, I do agree with that person and I think that "liar" was an appropriate word. In my vocabulary, liar is a person who knowingly supplies untrue information. And that definition is correct for Pate MD.
But you are the head of that blog, so you should keep it the way you see fit.
9000 - Mary (uas)
"Do any doctors tell women that they are at low risk for HPV if they have been in a long term momogamous relationship?"
Jean Art my friend's mother was widowed in her early forties (and was in a monogamous relationship)and never slept with a man again yet her doctor still forced her into two yearly paps till she turned 70.
The blanket assumptions are ridiculous. It's like whne they say lesbians need one, because sometimes lesbians sleep with men.WTF! And the US just herds all women into testing from 21 virgin or not because it's just easier for them.
Yet of course, with prostate cancer men are encouraged to talk it over with their doctor and go over their personal risk factors.They're treated like individuals we're treated like sheep through the sheep dip as Germaine Greer put it.
9001 - Chrissy (UK)
JeanArt,
It was also rather irritating and predictable that the good dr rolled out the usual ‘persuasions’ that we are so used to:
Scare tactics: I have seen women in their 20s die from cc. Start your paps at 21 regardless of sexual activity or you may die a horrific and painful death.
Scolding: Don’t encourage others to neglect their exams.
Misleading information: cc is 2nd leading cause of death in women worldwide.
Pulling rank: I am an MD, you are not.
He must think we have the collective intelligence of a gnat.
I don’t need a medical degree to understand risk verses benefit. I could almost feel him patting me on the head.
9002 - Elizabeth (Aust)
The truth is a defence to defamation, but when you have the authorities misleading and lying to women, well, I just state the facts and supply references and let others judge the doctor's or anyone else's comments.
My mother was also pap tested two yearly until she turned 70...my parents were in a lifelong monogamous relationship, but the profession believes it's safer to assume all men are unfaithful, so you may think you're safe, but....doctors know better.
It's yet another example of paternalistic thinking, it just doesn't occur to them.....that should be our call. Women have never been given the information they need to assess their risk anyway...all women who've ever had sex, even once, should have two yearly pap tests to age 70, that's still the advice here....and of course, sex includes any genital contact.
I also find the "assumptions" unacceptable...I was not yet sexually active at age 21, I was working, studying at University, sleeping and eating...they claim they don't want to miss anyone with an issue and so cast a wide net...no, that just harms lots of women unnecessarily and it's inefficient...and of course, it's a disgraceful way to treat women.
We have a right to protect our bodies and health from this testing and from medical assumptions.
Sue, I was reading one of your excellent articles and came upon something that made my flesh crawl...as a woman in your early 20s you were asked by a male doctor to remove all your clothing and he examined you stark naked....THAT is very concerning.
I know Dr Bernstein has said it is inappropriate and rarely, if ever, necessary to examine someone nude...he's American. I know some European countries are casual about modesty and some doctors expect you to undress in front of them and don't provide a gown or cover...Germany is an example. It would be interesting to hear what the Canadian Medical Board says is appropriate in the circumstances...I assume you were having a "well woman" exam. I suspect an older or unattractive woman would have been treated differently. It is just so easy to take advantage when the profession has such power and doctors are encouraged to ignore informed consent for women, and even consent. Coercion negates consent.
When you make target payments, link the Pill to testing, encourage opportunistic testing....IMO, you also feed and protect predatory behavior.
I think most doctors engage in lip service when it comes to informed consent, they can't "see" how inappropriate their comments are and that's why nothing will change until we challenge them and refuse to play their game.
I was speaking to a young woman (23) recently who has decided not to consider pap tests until she's older....she has fought off male doctors (opportunistic screening) by saying she only permits pap testing by female doctors and with female doctors she says she's menstruating...listening to her I felt angry to think this bright young woman has to go to such lengths to protect her health...and get medical care for asthma and serious allergies. She changes her doctor frequently and doesn't seek medical care as often as she should because she fears the confrontation about pap testing...thankfully, she doesn't need the Pill, her boyfriend is older and has had a vasectomy. Once you ask for the Pill, that usually triggers the pap pressure - hardly surprising when you have people like Rupert linking the Pill with pap tests...there has never been a clinical connection, but they get away with it so many now believe the try-on amounts to a clinical requirement. Change is difficult while the Old Guard are still in charge....most know it has nothing to do with the Pill and knowingly mislead women...no doubt feeling it's acceptable with all the, "for her own good" propaganda that has always been a major feature of women's healthcare. We're mere bodies and they do things to us, we're not competent individuals respected to make our own healthcare decisions, like men.
When you listen to the pro-pap people I wonder whether some actually now believe the lies and when pushed to provide a reference they point to what I'd call propaganda....medical myth has become "the facts" over decades of pap testing..."since testing began cc rates have plummeted"....this is convenient, but not a fact, pap testing may partly explain the fall, but other factors have likely contributed to the fall, it was always a rare cancer and in natural decline, but they're happy to make assumptions when it suits their agenda.
9003 - Elizabeth (Aust)
Sue, was a chaperone in the room during that exam? When did this exam occur, roughly what year? Just to confirm, were you having a well-woman exam, which included a breast exam? Was it an opportunistic exam? I just wanted to get the facts straight...also, would you mind if I run this past Dr Sherman? I think women need to read about the things they may face in the consult room, know what's normal or suspect and to understand their rights, to refuse any exam or test they don't want - at all, at that time or with that doctor....or even to have some tricks up her sleeve to enable her to get out of the consult room unscathed.
9004 - OverItAll
Just thought I'd share this. I scared my fiance when I screamed joyfully at this (poor thing was changing our son's diaper and rushed in!).
ON THE NEWS: Doctors went ON THE RECORD AND SAID/ASKED for birth control pills to be available OTC WITHOUT RX! They said it was due to the safety and reliability!
My guess is, enough of "us" type of women are putting serious pressure for bcp to be otc OR are demanding answers as to why GYN exams are forced on them.
This was a Southern California news station.
9005 - OverItAll
Oh and I saw my midwife Saturday. She asked if I wanted a pap smear, cervical check (I gave birth at 9cm, not 10), or to check any cuts (or check my stitches from when I tore due to the manual removal). I told her everything seemed to be healing just fine, etc. I also threw out every fact I've found on pap smears and told her I was NEVER doing them. She simply said, "Good for you, researching it all. Legally, I'm required to tell you that as your midwife I have to highly recommend it...even when I've been DES-exposed and refuse them as well".
So, my clothing stayed on. With no symptoms of any problems, we left. She did push on my belly a little to check for any hard lumps (mainly to see if there was any calcified placenta pieces).
Long story short, Midwives rock!
9006 - Sue
Elizabeth, I love this information you shared:
".she has fought off male doctors (opportunistic screening) by saying she only permits pap testing by female doctors and with female doctors she says she's menstruating . . ."
Brilliant, and a very good defense if one does not feel up to engaging in an argument/is in dire need of medical attention.
Yes, it was very concerning regarding the examination in the buff. I never knew any better as it was my first pap and pelvic. He was VERY thorough, started between my legs, checked both orifices, then moved his way slowly up my body, palpating all parts extremely carefully.
I had not gone for the purpose of a pelvic/pap. I was there for a twisted ankle and was aggressively pressured into it. I had no family dr as there was no need for one, so it happened at a walk in clinic affiliated with the university I attended. He was shocked I wasn't on the pill and I made it very clear I had no intention of going on it. Not only did he pressure me into the exam, he wrote a prescription for the pill and forced that on me as well. On my way out I left the prescription with the ladies at the front desk. And of course you have my blessings to share this with Dr. Bernstein, thank you for asking.
9007 - Sue
Elizabeth, I meant to say Dr. Sherman. I also forgot to say it happened in the mid 90's, and there was no chaperone in the room.
Chrissy, I appreciated how you summarized all the tactics the dr took as it clarified the full damaging extent of his approach. All I could see was red when I read it, so it helps to better understand why I felt so PO'd! It was great, the first thing I thought was "I have to go for help from the troops here", and am so thankful for all of you here.
Alice, I am in complete agreement regarding the accuracy of the "lie" comment, that commenter was spot on of course.
OverItAll, thank you for the bit of good news. I agree that is scream joyfully worthy! I also agree Midwives rock. Or any alternate health care provider for that matter.
9008 - Chrissy (UK)
Interesting also isn’t it that with people being ‘so bad at monogamy’ it is the female that is under medical surveillance and not the male. It takes two to tango doesn’t it?
Is there an equivalent medical speciality in America that recommends that 13 â€" 15 year old boys start genital exams? Are young men encouraged to attend yearly sessions with a doctor to check for STDs or testicular cancer or other problems?
Is there a screening programme in place for men in which they are denied information that will enable them to make an informed choice? And then subjected to over-treatment ‘for their own good’?
I think the answers to these questions speak for themselves.
Mary, the analogy ‘sheep through the sheep dip’ is spot on.
Sue, when we are admonished not to ‘breed animosity against the medical profession’, do you think they realise that they are achieving that quite adequately on their own?
9009 - Graeme NZ
Yes Chrissy but in fact the doctors tell the wives the husband is probably unfaithful. The medics rare clever they accept the wife is monogamous but infer that it is the dirty old husband who could get her infected. In fact if husbands are unfaithful I am sure there are many other std possibilities that beat having a preventive pap smear hands down.
9010 - Torrance * Connecticut, U.S.A.
I hope The Pill becomes over-the-counter soon, but picture all the shoplifting when it does.
unny how they're looking to make marijuana legalized, but a woman cannot arm herself with contraceptive pills without being literally and physically assaulted and forced into barbaric testing.
Wishing you all a Happy Thanksgiving.
9011 - JeanArt
Good news here in the US. As OverItAll noted there is actually a group of doctors that are recommending birth control pills be available over the counter. And that group of doctors is the ACOG (American College of Obstetricians and Gynecologists)!! What a surprise. I hope it actually happens. This story was posted on the NBCnews website (health tab). Of course if you read through the comments there are still people that think it is a bad idea. Women should consult a doctor, know the side effects, etc. There is always this assumption that people are not responsible enough to look after their own health. That a doctor should be involved to "protect" them, like they are children. I say those who are too dumb or stubborn to read about the side effects on the label should responsibly accept whatever bad side effects they may encounter (however rare). So many people here are hollering about personal responsiblity but then go on to say a doctor is necessary to monitor you to properly take your meds, control your diet, watch out for your sexual health, on and on..... It's absolutely ridiculous. And I agree that it is mind boggling that women are always targeted for "sexual" check-ups assuming that their partners are straying. Men can be tested for STDs also but you rarely hear that being pushed. Men also get testicular cancer but you rarely hear them being advised to see a doctor for an exam nor self examining. Women are targeted because they have been "captured" by pregnancy concerns and/or by seeking out birth control pills. Once they are in the doctors office for those things they are pushed and fear mongered into returning as regular cutomers. And the vast majority of them, at least here in the US, fall for it. Hopefully this news about the pill being possibly made available over the counter will change some of that: slowly but just maybe.
9012 - Christine Litwin-Sanguinetti
April 23, 2001 -- Christine Litwin-Sanguinetti, MD, says: "You don't need to be a brain surgeon to see why female patients are flocking to practices like hers!"
"I've had women say to me,'I can talk to you about things I would never say to my male gynecologist,' especially if he was young and handsome," says Litwin-Sanguinetti, founder of the Women Physicians OB/GYN Medical Group in Mountain View, Calif. "If a women is 59 years old and having sexual difficulties, it's hard to say that to a 30-year-old man."
Her all-female practice in California's Silicon Valley, which started with just her and another physician 19 years ago, was once something of a novelty.
Not today. With many women patients preferring to talk about issues like pregnancy and sex with another woman, the demand for female obstetrician-gynecologists is at an all-time high -- so much so that some male doctors believe they're being discriminated against in hiring.
While most ob-gyns are men -- some 64%-- but that's mainly because a generation ago, most physicians were men. This year, over 70% of ob-gyn residents are women, and medical schools are reporting that as many as 80-90% of students planning to enter the specialty are women.
Some doctors say that male medical students who express interest in becoming ob-gyns are frequently talked out of it by their advisors.
John Musich, MD, chairman of the Council on Resident Education in Obstetrics and Gynecology, says he's recently heard of some medical practices in Florida that were openly advertising for women doctors, a tactic some male doctors believe is discriminatory. And some medical journals have been carrying advertisements that state, "All-female practice seeks associate."
A colleague told Musich he could not recall a male ob-gyn hire in the San Francisco area in the past decade.
"I don't know if that's good for the marketplace," Musich says.
Erin Tracy, MD, who chairs the junior fellows advisory council of the American College of Obstetricians and Gynecologists, says she frequently urges male medical students to become ob-gyns, often to no avail.
"I hear a lot of anecdotal reports from male medical students that they've had teachers or advisors tell them this is not a good field for men," Tracy says. "The reality is that while sometimes a patient does prefer a female provider, many just want the best. My male partners are just as busy as I am."
Tracy also notes that while women patients may be looking for doctors who have shared common experiences, she's never had a baby herself.
"My father is a cardiologist, and he's an excellent cardiologist despite never having had cardiac [heart] disease," she says.
Still, the practice of medicine is a business, and many patients who are in the marketplace for ob-gyns are seeking women physicians.
Karen Lovett, of the Houston-based search firm Practice Dynamics, says she sees an increased demand to hire women ob-gyns, especially in urban areas where competition to lure away patients can be fierce. "If a practice is losing market share, they think a female can win it back," she says.
On the other hand, patients in rural areas can't be as choosy. In one widely publicized case, a New Jersey ob-gyn who said he was told he wasn't bringing in enough patients -- and was fired two months later -- sued the practice, charging breech of contract and sex discrimination.
David Garfinkel, MD, who ultimately opened up his own practice right next to his old one, said he also didn't get a $65,000-a-year raise he'd been promised, and that the stated reason was that he wasn't bringing in patients because he was male.
The practice has countered that Garfinkel was let go strictly for economic reasons. The case is pending before the New Jersey Supreme Court.
9013 - Elizabeth (Aust)
Sue,there are so many things about your experience that make we feel uncomfortable...leaving you naked and aggressively pushing you into the exam when you were there with a sprained ankle...my predator alarm is going crazy. It is likely to be more visually stimulating having a naked young woman before you.
When I read that it reminded me of the monster who practised "medicine" in the UK for decades assaulting young women, he'd examine them naked and a nurse even walked in and caught him masturbating while he was doing a pelvic exam...yet even that did not derail this pervert's opportunities.
Never feel you have to examine your conduct or justify what happened to you...you were treated at the very least in a most unprofessional way...most of us at one time or another have felt intimidated in a consult room and later regretted not saying something or leaving. At that age I saw what was happening to so many women, there was no choice of doctor in the late 70s/80s, female doctors were thin on the ground...I simply stayed away from doctors. I knew most of these women were being abused by a profession that allowed that to happen, I knew these exams had nothing to do with the Pill, I know some women felt they were being punished for asking for the Pill.
I think we need to think about some "get out of the consult room" strategies or even consider taking in a friend, even a jaded 50-something informed woman. I suspect the "requirements" or aggressive recommendations would not even be mentioned. Maybe we need a sister program, similar to the buddy program for children.
Jean, I smell a rat, why would they do a 360 like that? Is it because they can see women are waking up - the game is up and now the risk with coercion is too great?
I know a group of US doctors at the Centre of Reproductive Medicine have been calling for the Pill to be made OTC for many years.
Although I think you may see it long before we do...coercion has motivated some to fight an outrageous system, yet here you can get the Pill without an exam or pap test, you may have to shop around and suffer a lecture, but it's possible and more women are getting the Pill over the internet...so there is not much discussion here and there was a major fuss made by the profession when the Govt decided chemists could provide a short supply of the Pill if women were caught short (but only if they'd used the Pill before and their supply had just run out)
Dr, that's very interesting. I have no issue with men studying medicine, any branch, as long as they don't force themselves onto those who'd prefer female care. Somehow these men find themselves in places where women have no choice of doctor like the military, L&D and free clinics/care.
It's the same with male nurses and midwives, just having a male midwife on the floor means someone may be pressured to accept their care or they stand around doing very little. On Dr Sherman's forum a woman and her husband were distressed when a male midwife was forced onto them, it ruined the birth experience. ("no one else is available") The woman believed others had refused his care and she was younger and more reserved and so pressure to accept him.
I know women who see male doctors, that's their choice, I prefer female care.
There is no discrimination - there is an exemption in our laws that permits someone like Breast Screen to advertise for a female radiographer or a lingerie shop to employ a female assistant or a urology clinic looking for a male nurse...and the reasons are obvious. I think it's a positive step seeing all female and all male clinics, we need all female/male surgical teams etc as well, it would make many people feel a lot more comfortable. Sadly, though female doctors have not changed the unacceptable practices that exist in medicine, coerced women into unnecessary exams and elective cancer screening to get the Pill, ignoring informed consent, (and often consent altogether)...I could go on, but I'm sure most doctors know what I'm talking about...
9014 - Alice (Australia)
"...some medical practices in Florida that were openly advertising for women doctors, a tactic some male doctors believe is discriminatory."
Aha! that's when male doctors acknowledged discrimination - when it hurt their profits!
Well, fine. Let's be equal. How about starting raping young boys from the age of 18/21 on every medical appointment with speculums, forcing them into invasive screening for a rare cancer, misleading them, coercing, withholding the truth and manipulating? Do that to men, and then we'll speak about equality.
It's plain ridiculous: first a male CHOOSES to become an ob/gyn to rip the benefits of causing the pain he will never have to endure himself, manipulating a weaker gender and exercise his paternalistic ambitions, and then complains that he is not on high demand in the women-only are.
No one would call it discrimination when a man is not welcome in a women's toilet. It is accepted as perfectly normal that women don't want a stranger male in the room where they remove some of their clothing, even behind the cubicle doors. So why should the same women embrace a stranger male to spread their legs and shove things in their genitals? What's the difference? The fact that the other stranger went to a medical school? Not enough!
9015 - Mary (uas)
""My father is a cardiologist, and he's an excellent cardiologist despite never having had cardiac [heart] disease," she says."
He has a heart. An male OB/gyn doesn't have a vagina or uterus. It's a stupid argument.
Do you know how may female urolgists are in NSW? Just one! Do we hear of any complaints from anyone about that? No of course not. It's male doctors with their sense of entitlement that are always whining. Furthermore, we only have to look at the male gyn/OBs track record to know that they have been spectactular failures in caring for women and their issues.
9016 - Graeme NZ
For some reason I was blocked here.
9017 - Elizabeth (Aust)
When women had no choice, well, that's when this unhealthy and dysfunctional thinking developed...it was a boys club with unchecked power over women. I agree, their domination of the profession has been a shocking episode, but I'd hoped for more from our female doctors...I see the problem, they had to identify with the males and their teachers to find acceptance in medical school and in the profession. We do have the odd outspoken ob-gyn, but they're still rare, most are keeping their heads down and sticking with the old guard.
I have always believed women are the only ones who can change the system, by refusing to play their game. Most of this abuse relies on our compliance...that means saying no, educating women and finding ways for women to escape predators in white coats.
9018 - Elizabeth (Aust)
It might be a problem with the system, Graeme, the preview option doesn't seem to be working today either and two of my posts have just posted...sorry, I didn't get a chance to tidy up here and there.
How are things going in NZ anyway? I assume the campaigns roll on...
9019 - Mary (uas)
Jean Art I read few of the comments on that site.There's one poster Leslie, who has posted on several other sites, who disagrees because she personally knows three women who have deveoped clots, which she thinks was caused by the pill. She's eeven got a website dedicated to "stopping the blood clots" (lol) and it gets more laughable, she wants to contact Ellen GeDeneres about it. The women had a hysterectomy (I dont know when, but she says because she had lots of "scar tissue") yet she's only 29 and she was put on HRT.She says she developed a clot and blames the estrogen. Except nobody explained to her that the greatest riskfactor for blood clots causing problems is having a hystectomy. Because the uterus produces prostacyclin which lines our blood vessels and that's what stops blood clots sticking to them.So we have this illinformed women leaving comments everywhere opposing the pill being offered OTC. And it went over her head that a womans' more at risk of having blood clots when she's pregnant than being on the pil.
9020 - Mary (uas)
Here's her website. It's worth a look.theclotmustbefought
9021 - Graeme NZ
Of course Elizabeth woman doctors are just as susceptible to target incentive bonuses or as I call them scalp fees. Even women can succumb to greed. Target incentives are unethical.
9022 - Elizabeth (Aust)
"And yes, it's embarrassing to be laying there like that. But if you're taking your clothes off for a guy you should be able to take you clothes off for a doctor. Besides, don't you want to know that everything is in working order? And no matter how careful you are there is always a chance you'll get pregnant."
Taken from the std.about.com site and the thread, "Does requiring pap tests for birth control amount to coercion?"
This comment was offered by a woman....I think we can safely put her in the category, "beyond reach"....
9023 - Sue
Chrissy: "when we are admonished not to ‘breed animosity against the medical profession’, do you think they realise that they are achieving that quite adequately on their own?"
Yes, right on Chrissy! I think most damning of all has been the media coverage concerning the practice of performing pelvic exams on unconscious women without their knowledge or consent. Those women who find out after the fact, or are unfortunate to waken enough to discover what is going on, are irreparably harmed and all of them most likely feel they have been gang raped. The fact the medical profession feels it is necessary to debate whether or not this practice is "ethical" says a lot.
Elizabeth: "Sue,there are so many things about your experience that make we feel uncomfortable...leaving you naked and aggressively pushing you into the exam when you were there with a sprained ankle...my predator alarm is going crazy".
Yes Elizabeth, my predator alarm was going crazy as well! I was immobilized by my own state of shock, I just could not comprehend how such an exam could be tolerated as acceptable. Even when done without any hint of predatory behavior they are far too invasive to expect any woman to ever be okay with these exams. I still feel the same way about pelvic exams - they should never be performed on asymptomatic women, ever. Offer us a reliable self-test or blood test and maybe I'll reconsider screening.
"I think we need to think about some "get out of the consult room" strategies or even consider taking in a friend, even a jaded 50-something informed woman. I suspect the "requirements" or aggressive recommendations would not even be mentioned. Maybe we need a sister program, similar to the buddy program for children."
I agree Elizabeth, we do need something set in place to help protect us in the consult room. A buddy system is a great idea. Also, as you previously posted, stating you only allow female drs to perform paps when seeing a male dr, and then when with female drs to state you are menstruating are great strategies to avoid coercion. Taking a tape recorder into the consult room might also help. Perhaps having a form the dr could sign stating he/she is refusing to offer health care based on the fact you have refused an elective screening test for would also be effective. That way if the woman ended up in emergency for having been refused care she would have solid proof to make it easier to sue.
It is amazing how many women are being bullied, coerced, and having healthcare withheld. Women's health is being put at risk with this type of behavior. All for the sake of money, power, control, and for the sexual thrill. Women need to arm themselves by preparing adequately as this would protect them from being captured off guard. You were so right when you said no one is protecting us, we have to protect ourselves. Power is never given, it is always taken.
9024 - Graeme NZ
Currently here in NZ we are getting a series of articles speaking out about the risks of overdiagnosis and mammograms. Predictably Breast Screen NZ is outraged. they are worried they may lose millions of tax payer funding. Remember these screening progerammes employ a lot of people and they want to protect their livelihoods. It makes me sick.
We are also getting a series of most outrageous cancer stories. A woman was bitten on the breast by a lion. When they treated the bites thay also found she had breast cancer. Her life was saved by a lion bite!!
In another case a guy did a home pregnancy test as a joke and it turned out showing he was pregnant. He joked about it till his friends told him it sounded bad. when he went to the doctor guess what they found? He had testicular cancer. As the doctors said and I kid you not they caught it in time but the testicles may still have to be removed!!
The latest is that woman on farms are at increased risk of breast cancer.
It is really past a joke now.
9025 - Alice (Australia)
"Perhaps having a form the dr could sign stating he/she is refusing to offer health care based on the fact you have refused an elective screening test for would also be effective. That way if the woman ended up in emergency for having been refused care she would have solid proof to make it easier to sue."
Sue, it's a great idea! It's just a pity that no doctor will ever sign anything like that. So far, only patients had to sign.