Checklist: 10 signs that it's time for you to change your gynecologist

Olga Lukinskaya

"Advise a good gynecologist" - perhaps the most common request in the "female" groups in social networks, but the recommendations of girlfriends often do not become a solution. 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 can practice evidence-based medicine, but spoil the whole impression by referring to the patient on "you." Nevertheless, there are excellent specialists, who are a pleasure to visit, and we have gathered ten signs that it’s time to look for such a doctor and leave the habitual.

1

They talk condescendingly

Paternalism in communicating a doctor with a patient — the attitude of an “adult” to a “child” - has been a normal practice for centuries, but modern medical ethics imply partnership interaction. 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 classical attitudes, paternalism implies sympathy, care and responsibility, and not indulgence and rudeness, into which he often turns.

An appeal to “you”, a condescending tone, accusations of licentiousness are manifestations of rudeness and lack of professionalism and should not be tolerated. The protection of personal data is also an essential item of medical ethics; in Russia, the strict confidentiality of a gynecologist can be calculated from the age of fifteen (which, frankly, quite late). If they call from the clinic to report the results of the tests, 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 only be sent to the address you personally wrote.

2

You are ashamed of your privacy

The task of the gynecologist is to collect the information necessary to determine your general health, diagnose diseases, select a treatment or, for example, contraceptives. It is perfectly normal if the doctor asks if you are having sex and whether you have one partner, whether you want to become pregnant in the foreseeable future, whether there has been a change of sexual partner after a previous visit. All these questions are needed not to convict you or hint that it is time to give birth, but to understand what tests and contraceptives to recommend.

But the questions about how many sexual partners you have had in your entire life are superfluous and certainly should not be repeated at each 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, nobody is there" - at least, there is an occasion to 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 hair removal, tattoos, piercing or not enough white socks - they have nothing to do with medical treatment.

3

You are afraid to ask questions

Actually, no accusations at the doctor’s appointment have a place - including charges of ignorance. Of course, the general idea about the device of the human body or the work of hormones does not hurt anyone - but everyone knows that the situation with sexuality education is not very good at all. The relationship with the doctor should be such that you feel free to ask even seemingly stupid questions - and the doctor calmly answered them.

Even a specialist can not remember everything - and it is normal if the doctor checks the compatibility of different drugs in the directory. It happens that the diagnosis can not be determined from the first time and you need to go through several surveys. There is nothing wrong with the gynecologist refining the data in various sources, and vice versa, overconfidence is bad, especially in combination with the requirements of the same from the patient.

4

You are persuaded to give birth rather

Of course, if you are planning a pregnancy in the coming years, and the reproductive age is already approaching the eldest - it is logical to hear the advice of the doctor not to delay this moment if you are interested in children. But persuasion to give birth simply "for health", without taking into account your personal situation - the presence of a couple, financial conditions, views - this is unethical, and not very competently.

Indeed, there are situations when the general health and well-being after a hormonal shake-up associated with pregnancy and childbirth, become better - but it happens the other way around. There are no diseases that could be guaranteed to cure 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.

5

You are given non-existent diagnoses.

Cervical erosion is perhaps the most common example of a non-existent diagnosis in gynecology. In fact, erosion, of course, exists, but only in the post-Soviet space for it in a huge number of cases give ectopia - one of the options for the norm, when the "joint" between the epithelium of the outer part of the cervix and its canal is visible during the inspection. Ectopia does not need to be treated - moreover, its “cauterization” may lead to the fact that with the appearance of truly important changes they will be difficult to notice.

To assert that a "precancer" was found on the cervix, according to the data of a single examination, especially with the naked eye, is also impossible. Of course, with colposcopy (examination of the cervix with a high magnification), it is possible to detect the changes that have been started, but any oncologic diagnosis can be confirmed only after examining the tissue under a microscope in a special laboratory.

6

You are forbidden during pregnancy

A normal pregnancy is not a disease, and waiting for a child does not mean at all that you need to give up sports, stop going to the beach or to the sauna and go on a strict diet. Indeed, there are a number of products and drugs that are not recommended for pregnant women - and for each of them there is a specific rationale. Ask why it is for you that something is prohibited - the answer must be unequivocal and accurate.

If the doctor intimidates with complications, reinsures, 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 "uterus tone", which in Russia is actively treated with pills and candles, is often quite normal for any stage of pregnancy, the fight Brecston-Hicks. The ban on any medication by default is also unfounded - for example, conventional remedies for treating cold symptoms can be safely taken (of course, only when indicated and with a short course).

7

You are being treated by unscientific methods.

We will not tire of repeating that there is no place in medicine for refusal to vaccinate without clear indications or treatment by homeopathy. The emphasis on treatment with only natural remedies and grandmother’s methods can make things worse for two reasons: first, the herbal remedies themselves can cause a completely unexpected reaction, that is, they are unsafe. Secondly, you can miss the precious time when you should be treated with normal methods with proven effectiveness, and the condition will become more difficult.

The doctor or midwife should not insist on natural childbirth without anesthesia, calling the anesthesia evil and scaring consequences for the child - this is simply not true. You should be aware of the options and have the right to decide for yourself whether you want to use pain relief - and no one should condemn you for your choice.

8

You are forced to treat "sexually transmitted diseases" when they are not

The human body is inhabited by bacteria and fungi - and this also applies to the genitals. Microflora shifts can occur for a variety of reasons; sometimes a certain type of microbe begins to multiply too quickly, and then there is a thrush (fungal infection) or, for example, gardneurlosis. Often this happens when changing a sexual partner - and a woman who does not possess deep medical knowledge gets the impression that she has become infected.

Even more difficult if the partner has not changed: there may be suspicions of treason, and this will not benefit the relationship. The gynecologist should not support such a position - on the contrary, he should explain that the vaginal microflora can change for a variety of reasons not related to the loyalty of the partner. Can affect and antibiotics, and the strong summer heat, and change the brand of condoms. If the doctor calls thrush sexually transmitted disease - look for another doctor.

9

Your doctor does not know the current treatment protocols.

Russian official recommendations for the provision of gynecological care are not inferior to international ones, but far from all follow them - therefore, instead of medication, surgical abortions continue to be performed, and adult women are not even offered vaccination against the papilloma virus. It is clear that patients can not be aware of the correct medical tactics on any issue, but some things should be remembered.

For example, HPV vaccination - powerful prevention of cervical cancer - can be performed not only during adolescence, and not only 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 to do it, according to the updated indications, can be up to forty-five years. If you are told that in the COC reception you need to take breaks, and the intrauterine contraceptive systems are suitable only for those who have given birth - the doctor is not familiar with modern approaches (or just breaks them).

10

Your doctor hides information and extorts money

Referring to "tested" specialists strictly in a certain clinic, the appointment of many unnecessary tests, demonstrative shifting packages with gifts from other patients - these are obvious reasons to part with the doctor. If you are in a paid clinic, then the calculations should be carried out through the cashier’s office, and not personally with the doctor - otherwise problems may arise, for example, when you need a medical statement, and there will not be half of the procedures performed in it.

It happens that you really need a complex analysis that is best done in a particular laboratory, but your doctor must answer your questions why this is so. For example, it is possible that in other laboratories there is no suitable analytical equipment — and you can check this information if you wish. In general, insist on the transparency of any data.

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