I think women are really tired of the scare tactics, coercion, manipulation, dishonesty and even aggression. I don't think doctors are respectful of women. There seems to be an attitude of, "well, you're a woman so you're not entitled to make your own health care decisions and as a woman, you should forget about dignity, bodily privacy & autonomy, you're not entitled to those things either."

My husband received risk information about prostate screening and a choice, his doctor said, "read the pros and cons information and let me know if you'd like screening." My ex-Dr DEMANDS screening and is happy to hold all sorts of medications, not just birth control, UNTIL you agree to the exams and test. He even refused me my steroid cream for a skin condition until I went in for my gyn exam. I decided to change my Dr because I won't accept treatment like that; yet so many women do, which encourages doctors to keep treating us like objects or third class citizens. I tend to avoid doctors these days, I'm so sick of the pressure over gyn things. I haven't seen a Dr in about 5 years. It should be possible to have a working realtionship with a Dr. Like men, we're entitled to honest information and a choice.

The other point is prostate cancer affects 200,000 men every year, cervical about 11,000. Even with no screening at all, the figure would only be slightly higher. Looking at the figures from pre-screening days, this cancer was never a huge threat to women and even though claims of a reduction since screening of 50% or 75% - if you look at actual numbers, not relative risk, the numbers are small. Dr Andrew Rouse, a lecturer in public health at Birmingham University, produced some figures that really shocked me. I had no idea how few women benefit from screening. Those statistics were published in the British Medical Journal. Lots of women have had hysterectomies these days and there is better treatment. I think other things are bringing down the death rate besides screening.

I'm not sure how we got to this point. The WHO, the US Food and Drug Admin and the American Society of Obs and Gyns all say smears, breast and pelvic exams are NOT required for birth control pills, yet doctors have decided to make it a law, to set their own rules for women. This doesn't happen to men. It's almost a guardian thing, "we know what's best, so do as you're told". A friend's Dr even demands annual mammograms now she's 40 or her birth control will be yanked. This is coercion...and scary. The changed recommendations are being dismissed as well. Many of my friends still face demands for annual smears and mammograms (from 40) OR no birth control. (and some refuse other meds as well) It sounds like doctors don't care about risking our health and don't respect our risk to choose. It gives doctors power and control over women which is unethical. One Dr told a 22 year old friend, a virgin, who wanted birth control to stop her periods while she was on a climbing vacation, that he'd have to do a "visual" inspection and rectal check before giving her the script. This was because she was a virgin and didn't want the full exam. He said she'd have to have "the works" after her 3 month script ran out. She refused and put up with her periods on the vacation. Speaking to an Aussie doctor on the trip, she was told there could be no clinical basis for that request and that she should report the Dr. She made enquiries when she got back and was basically told doctors can do "whatever they think is necessary" before writing out a script. In Australia, that Dr would have been reported to the Medical Board and possibly the Police. You cannot demand anything of your patient without a clinical basis. The doctor-made laws expose young and vulnerable women to the risk of abuse. I think this is shameful. I know a few women who've refused to be manipulated like this and risked unplanned pregnancies. We should have free access to reliable birth control. Thankfully, we now have HOPE at Planned Parenthood, but not every woman has access to a PP. I don't entirely blame doctors for this situation, the profession was always paternalistic and that has been slow to change, doctors are fearful of law suits and profits and performance targets are a factor too. I understand the risks for a Dr, so why not ask women to sign off on their decisions? It shouldn't be necessary, but if it means women can have a say in their health care, I'd be happy to sign. I visited Europe last year and it was wonderful picking up birth control over-the-counter at the pharmacy. I really envy those women....healthy and happy and able to see doctors on their terms in an equal relationship. I even decided not to volunteer for an overseas aid organization a few years back, yep, you guessed it, smears, pelvic and breast exams were compulsory for all female applicants. The Aussie and UK volunteers had a general health check without those three things. It's so unfair and upsetting.

Please leave this patronizing. Are you a relationship/child counsellor? a psychiatrist? Or a spiritual guide? Why on earth should a gynaecologist look for "my mojo"? Or give me childcare advice??? Im not a slab of meat around my reproductive organ, that a gyn should be my main provider- btw my GP is PROFESSIONAL enough, to not want to give me relationsip counselling or look for "my mojo".

btw- as you probably see from my inadequate spelling- im a europerson, here ITS NOT RECOMMENDED to have pelvic exams, if asymptomatic- NEVER. i've lived in 3 different european countries so far, no routine pelvic exams. Next time i "lose my mojo", i can maybe go and spread my leg for some stranger instead of having a drink? great idea! Holistic health or totalitarian over medicalisation - sorry, not the same. Behind all the pink god etc its the same old über-patriarchy argument- that all misery stemms from the female organs, the faulty weak female body, that needs checked and monitored, and the intervention of science and medicine. Otherwise, i appreciate you providing information and leaving the choice for the patient. Thats what matters the most at the end, so thank you for this!

I've always been concerned about respect for informed consent with these tests, breast cancer screening as well. I want far more information than is ever offered and end up spending hours doing my own reading. My long suffering doctor is used to my questions. My husband and I fall into a group that is largely overlooked. We were virgins when we met and didn't start a sexual relationship until we were in our early 20's. When I was 25 a Dr refused to give me the Pill unless I agreed to cervical screening. I left the surgery without my script and spent some time speaking to academics in the medical faculty and reading. How could I be infected with HPV when my only partner was a virgin? I knew over-detection was a problem with this cancer and also knew it was not a cancer that happened all that often... I couldn't see how I could benefit from screening, but I was still denied the Pill. I'm afraid I can't do what doesn't make sense to me. I'm a forensic accountant and assessing evidence is something I do every day. Instead I studied the Billings Method and have used that successfully for 20 years. I could get the Pill now, doctors in Australia don't make smears a pre-requisite for the Pill any more. ( that has been the case for a fairly long time) I'm happy though with the Billings Method. I've never had any sort of gyn issue, and never had a urinary tract infection. If I were higher risk, I'd have to go back to the drawing board. I've heard the argument that my husband might be unfaithful and expose me to risk, but I'm prepared to take that risk, I've known him for a long time. I firmly believe we need more honesty with screening. We don't have annual gyn exams in this country, but we need more honesty with breast and cervical screening. Breast cancer is a very common cancer and concerns me far more than cervical cancer. The reality is almost any other sort of cancer is more likely to get you before cervical cancer. I will be offered mammograms at 50. I'm feeling uneasy about that test as well and will follow my instincts...back to the books and more questions for my Dr! Today we seem to think we must be doing something to cover risk, but if the cancer is rare, the test is unreliable or carries risk, sometimes we're better off finding a great doctor and acting quickly if we develop a new and persisting symptom or find something out of the ordinary. I have a great female doctor...my main health problem is asthma and allergic dermatitis. My family history is heart disease so I keep an eye on BP, cholesterol and my weight. I also exercise and have never smoked... In my opinion, knowing your risk, what is most likely to get you and living a healthy lifestyle is the answer.

Pelvic exams in asymptomatic women are basically useless and can lead to over treatment; they are also not effective in detecting ovarian tumors. Every time something has been wrong with my body it has let me know and I try me.

I refuse all gyn exams because I researched the risks and benefits and have decided I'd take the tiny chance of cancer over the 75% lifetime risk of having a colposcopy or bioposy.

It's horrible that women try to scare each other into these exams. I'm an adult, I have a job, a college degree, I support myself, I live on my own and, personally, I can make my own decisions. But when this subject comes up I'm told I'm "immature" and "a stupid child."

If one man can help you, I stand with you over the issues of mammograms and pap smears. If it makes you feel any better, though, the Journal of the AMA has in fact questioned the need for annual prostate screenings for men. New guidelines for practitioners may be closer than you think.

It seems to me like for-profit insurance, out of control healthcare technology costs (if you don’t use the latest and greatest technology you’ll get sued for malpractice), and lawyers have all inserted themselves into what was once an interpersonal relationship between patients and doctors.

Doctors have been forced into a position where they are mechanics for the body, isolating sickness and attempting to cure those sicknesses. But most doctors didn’t go into the field because they wanted to follow instruction manuals to fix parts, they went into it because they wanted to heal people. And patients aren’t satisfied being poked, proded, and prescribed meds in the impersonal production line atmosphere of most medical offices seeking to cover costs with lower and lower insurance reimbursements, higher malpractice costs, and the need to buy the latest and greatest new gadgets.

The healthcare system isn’t going to be fixed until some effort it made to reestablish the sacred contract between doctor and patient, where doctors focus on healing the patient, not merely curing their current ailment, and where the patient feels that the doctor has had the time to see them as a whole person.

Unfortunately, deep pocketed health insurance companies, healthcare technology companies, and legal lobbies are dominating the debate. These are not people looking to restore that sacred contract. They are seeking instead to validate their middleman status and continue to divert healthcare dollars away from healing and into their own pockets.

Fortunately, there are people out there who see this need, and who are finding their own unique ways to restore this sacred contract. Here is a great article about a doctor in Oregon who has set up a wonderful office where she is successfully doing this http://bit.ly/40ilUj. Thank you Lissa, for sharing your thoughts on the subject. We need more doctors out there like you and Dr. Wible who want to see sanity restored to the system.

The sad thing is that we all see where this is heading: insurance denials of coverage. They are taking away our choice to have these tests, unless we pay put of pocket.

We should have the choice to have or not have the screenings.

Anne,

Thanks for sharing your perspective. I am glad that the tests, no matter how "medieval" they may appear to be, do exist and that women visit their doctor for them. Those tests saved both of my grandmothers, one of them twice, my step mother, myself and several friends. As every woman does, you can chose not to have the exams, but I think that they value can't be underestimated.

A pap smear saved my life. Without a LEEP those nasty little cells would have continued to grow and who knows, I might have gotten cancer.

As I said earlier, this nonsense is a precursor to the kinds of rationing every American will see should this health care garbage pass (and I pray it does not). Everyone will see an increase in cost and a decrease in service.

Conspiracy? Who knows but this just adds one more item to my "It's Sucks to be a Girl" list.

I'm with you both on this, Erin and Amber. I'm PISSED OFF. Don't get me started. Okay- do. Someone needs to shine a light on this. Women need to speak. Eve Ensler? Someone? Step up to the plate!

If this isn't insurance company/cost-cutting related, I will truly be shocked. That's the underlying impetus for almost everything in our country these days - we are a far more capitalistic society than democratic.

I agree completely with what you said. Women don't go to the doctor for yearly physicals, the OB/GYN is the one opportunity a lot of women get with a doctor. My doctor is hilarious, I quite adore her. She likes to say they wrestle women in once a year for birth control refills. :)

It's incredibly sad that they're going after preventative care for women. I don't even have words for how it makes me feel.