“Recommend a good gynecologist” is perhaps the most common request in “women’s” groups on social networks, but the recommendations of friends often do not become a solution to the problem. The most polite doctor may not have a modern approach to the treatment of infections or the management of pregnancy – and vice versa, the doctor may practice evidence-based medicine, but spoil the whole experience by turning to the patient “you”. Nevertheless, there are excellent specialists who are a pleasure to visit – and we have collected ten signs that it is time to look for such a doctor and get away from the usual.
They speak to you condescendingly
Paternalism in doctor-patient communication – the attitude of an “adult” to a “child” – has been a normal practice for centuries, but modern medical ethics presupposes partnership. This means that the patient should be told what is happening to him, be interested in his opinion and even allow him to participate in making medical decisions. But if the doctor adheres to the classical attitudes – paternalism implies sympathy, care and responsibility, and not condescension and rudeness, which he often turns into.
Appealing to “you”, a condescending tone, accusations of licentiousness are manifestations of rudeness and unprofessionalism and should not be tolerated. Personal data protection is also the most important point of medical ethics; in Russia, you can count on strict confidentiality with a gynecologist from the age of fifteen (which, frankly, is quite late). If they call from the clinic to report the test results, they should be reported only to you personally, and not to your mother, sister or husband; this also applies to e-mail – any medical data can be sent only to the address you have left yourself.
You are ashamed for your love life
The task of the gynecologist is to collect the information necessary to determine your general state of health, diagnose diseases, select treatment, or, for example, contraceptives. It is perfectly normal if the doctor asks if you are sexually active and if you have one partner, if you want to become pregnant in the foreseeable future, if there was a change of sexual partner after the previous visit. All these questions are needed not to condemn you or hint that it is “time to give birth,” but to understand which examinations and contraceptives to recommend.
But questions about how many sexual partners you have had in your entire life are superfluous and certainly should not be repeated at every visit. The doctor should not comment on the specifics of your personal life, whatever they may be. Phrases like “what is it with you, so young and beautiful, no one is there” is a reason to at least ask not to discuss non-medical issues, but as a maximum – to start looking for another doctor. And, of course, the gynecologist should not scold you for epilation, tattoos, piercings or insufficiently white socks – they have nothing to do with a medical reception.
Are you afraid to ask questions
Actually, there is no place for any accusations at a doctor’s appointment – including accusations of ignorance. Of course, a general idea of the structure of the human body or the work of hormones will not hurt anyone – but everyone knows that the situation with sex education is generally not very good. The relationship with the doctor should be such that you do not hesitate to ask even seemingly stupid questions – and the doctor calmly answered them.
Even a specialist cannot remember everything – and it is normal for a doctor to check the compatibility of different drugs in a reference book. It happens that the diagnosis cannot be determined the first time and you need to undergo several examinations. There is nothing wrong with the fact that the gynecologist clarifies the data in various sources, and vice versa, excessive self-confidence is bad, especially in combination with the requirements of the same from the patient.
You are being persuaded to give birth as soon as possible
Of course, if you are planning a pregnancy in the coming years, and the reproductive age is already approaching the senior, it is logical to hear the doctor’s advice not to delay this moment if you are interested in children. But persuading to give birth simply “for health”, without taking into account your personal situation – the presence of a couple, financial conditions, views – is unethical, and not very competent.
Indeed, there are situations when general health and well-being after the hormonal shock associated with pregnancy and childbirth become better – but it also happens vice versa. There are no diseases that can be guaranteed to be cured by pregnancy. A child is a new life, an individual person for whom his parents are responsible, and not an opportunity to improve their own health.
You are being diagnosed with non-existent diagnoses
Erosion of the cervix is perhaps the most common example of a non-existent diagnosis in gynecology. In fact, erosion, of course, exists, but in the post-Soviet space, in a huge number of cases, ectopia is given for it – one of the variants of the norm, when the “junction” between the epithelium of the outer part of the cervix and its canal is visible during examination. Ectopia does not need to be treated – moreover, its “cauterization” can lead to the fact that when truly important changes appear, they will be difficult to notice.
It is also impossible to assert that a “precancer” was found on the cervix, according to only one examination, especially with the naked eye. Of course, with colposcopy (examination of the cervix with a strong magnification), neglected changes can be detected, but any oncological diagnosis can be confirmed only after examining the tissue under a microscope in a special laboratory.
Many things are forbidden to you during pregnancy.
A normal pregnancy is not a disease, and expecting a child does not mean at all that you need to give up sports, stop going to the beach or sauna and go on a strict diet. Indeed, there are a number of foods and medications that are not recommended for pregnant women – and there is a specific rationale for each of them. Ask why exactly something is forbidden to you – the answer must be unambiguous and accurate.
If the doctor intimidates with complications, reinsures himself, prescribes bed rest without a clear diagnosis, insists on a caesarean section “just in case” – it may be worth looking for another specialist. Recall that the “uterine tone”, which in Russia is actively treated with pills and suppositories, are often completely normal Braxton-Hicks contractions for any stage of pregnancy. Banning any medication by default is also unreasonable – for example, conventional remedies for treating cold symptoms can be safely taken (of course, only if indicated and for a short course).
You are being treated with unscientific methods
We will not tire of repeating that in medicine there is no place to refuse vaccination without clear indications or to treat with homeopathy . The emphasis on treatment only with natural remedies and grandma’s methods can make things worse for two reasons: First, the herbal remedies themselves can cause completely unexpected reactions, that is, they are unsafe. Secondly, valuable time can be missed when it should be treated with normal methods with proven effectiveness, and the condition will become more serious.
A doctor or midwife should not insist on natural childbirth without anesthesia, calling anesthesia evil and scaring the consequences for the child – this is simply not true. You should be aware of your options and have the right to decide for yourself whether you want to use pain relief – and no one should judge you for your choice.
You are forced to treat “sexually transmitted diseases” when they are not there
The human body is inhabited by bacteria and fungi – and this also applies to the genitals. A shift in microflora can occur for various reasons; sometimes a certain type of microbes begins to multiply too quickly, and then thrush (fungal infection) or, for example, gardnerellosis appears. Often this happens when changing a sexual partner – and a woman who does not have deep medical knowledge has the impression that she has become infected with something.
It is even more difficult if the partner has not changed: suspicions of cheating may arise, and this will not benefit the relationship. A gynecologist should not support such a position – on the contrary, he should be explained that the microflora of the vagina can change for a variety of reasons that are not related to the loyalty of a partner. Taking antibiotics, strong summer heat, and changing the brand of condoms can also affect. If a doctor calls thrush a sexually transmitted disease, seek another doctor.
Your doctor does not know current treatment protocols
Russian official recommendations for the provision of gynecological care are not inferior to international ones, but not all comply with them – therefore, instead of medical abortions, surgical abortions continue to be performed, and adult women are not even offered vaccination against the papillomavirus. It is clear that patients cannot be aware of the correct medical tactics for any issue, but some things should be kept in mind.
For example, HPV vaccination – a powerful prevention of cervical cancer – can be done not only during adolescence and not just for those who are not yet sexually active. It is known that the vaccine helps to reduce the level of the virus when it has already been identified – and, according to updated indications, it can be done for up to forty-five years . If you are told that you need to take breaks in taking COCs, and intrauterine contraceptive systems are suitable only for those who have given birth, the doctor is not familiar with modern approaches (or simply violates them).
Your doctor is hiding information
and extorting money
Referral to “proven” specialists strictly in a specific clinic, prescribing a lot of unnecessary tests, demonstrative shifting of packages with gifts from other patients are obvious reasons to part with the doctor. If you are in a paid clinic, then the calculations should be made through the cashier, and not personally with the doctor – otherwise, problems may arise, for example, when you need a medical statement, and it does not contain half of the procedures performed.
It happens that you really need a complex analysis, which is best done in a specific laboratory, but the doctor must answer your questions why this is so. For example, other laboratories may not have suitable analytical equipment – and you can check this information if you want. In general, insist on the transparency of any data.