Real exam - “is this okay?”

I (female) had my annual today and I had a young female doctor for the first time. She was very verbal throughout the pelvic - narrating everything she was going to do, asked permission in advance, and then asked if it was okay - for every step. Has anyone else had this? It made it feel ritualistic and the opposite of matter-of-fact. It seemed like something I’d more expect from a play doctor!! Ie:

her: “And now I’m going to insert the speculum. Is it okay if I insert the speculum?”

me: “uh, sure.”

her: inserts. “the speculum is inserted. can you feel that? Is that okay?”

me: “yes I feel it, it’s fine.”

her: “Great. And now I’m going to open the speculum. Is it okay if I open the speculum?”

Literally every step!!! Has anyone else had this happen? It seemed damn weird to me. I liked the doctor otherwise, but that aspect was very weird.

My gynecologist is an older male. Late 50s. He also asks permission at every step. That's why I keep going back!

Excuse this old man who was just looking around the different posts for something new or interesting . But that seems much better than what I usually get as in “this is what you get". . “ this is what every one gets”. . “its this or you are going back into a diaper", I should clarify, I live with a catheter and that it needs to be changed once a month. For medical reasons it has to be a certain size (large). I have had different nurses that know and insist that they know better and I don't know crap and had just better do as they say.

To be politely asked or politely told would be a relief and nerve calming. Twice now I have had to go to emergency room because of pain and bleeding “down there”. All because they had no problem in discounting anything I had to say and to hell with how I felt about what is going to be done to my body. Oh how I wish I could find a Doc or nurse that show's at least a little respect or care about what they are about to do to my body, I would be sure to always go back to them no matter the cost, {my medical bill's are high}

her: “And now I’m going to insert the speculum. Is it okay if I insert the speculum?”

me: “uh, sure.”

her: inserts. “the speculum is inserted. can you feel that? Is that okay?”

me: “yes I feel it, it’s fine.”

her: “Great. And now I’m going to open the speculum. Is it okay if I open the speculum?”

Literally every step!!! Has anyone else had this happen? It seemed damn weird to me. I liked the doctor otherwise, but that aspect was very weird.

The kind of gibberish that doc was saying would be a real turn-off to me. Seems a little sing-song'ish or juvenile and repetitive. It would seem that a simple: “I'm going to insert the speculum - okay? (or ready?)”. would be more concise and less talking down to you.

Sounds like a very NEW doctor to me, one that didn't get a lot of training or experience. I, for one, would be getting irritated very quickly.

BLUE55… yes, we men can and do have similiar issues with medical personnel, especially doctors… my experience is you have to make it clear YOU are an adult and expect to be treated as one! Simply tell the young doctor, “I have been to this rodeo before”, just do it and move on!!!

I had an incident at a hospital when young nurse attempted to give me a Fleet enema, first covered my bottom and missed the mark hitting my rectum wall (that hurt) and I turned over bare ass up with everything hanging out and said just do it… I had a doctor who could not manage his patient appointment time, as first patient of the day he was nowhere to be found for 25 minutes… II walked out into the hall and asked “is there a doctor here?” He later entered the room and said if I was too upset, were could reschedule. I told him I was not upset but clearly he was and I wanted to proceed and we did!

Sounds like a very NEW doctor to me, one that didn't get a lot of training or experience. I, for one, would be getting irritated very quickly.

Or it might be a young doctor who has been taught about all the malpractice cases…. or he / she read all the stories bout doctors who were sued / arrested for touching their patients inappropriately…. or…. you may be right @demure

Or it might be a young doctor who has been taught about all the malpractice cases…. or he / she read all the stories bout doctors who were sued / arrested for touching their patients inappropriately…. or…. you may be right @demure

Yeah this makes sense to me, I bet it was this. It had a ritual-repetition feel to it, like it was something she‘d been trained to repeat automatically for box-checking. Like when the TSA goes through the “and who packed your suitcases?” catechism for international travel.

If you watch any new videos on the female pelvic exam that is how they are teaching doctors and nurses to perform the exam. It shows respect to the woman.

My doctor does the same thing except she talks about different things with me. Like if she is doing the breasts exam she may say, "I see you got some sun. Where did you go?" Then she may say okay let us lay you back. Then she will finish the breast exam. Then tummy. Then press on my toes and feel for pulses etc. Then she will say scoot down for me and put your feet in the stirrups for me. Then let your legs fall open for me. Then she will tell me that she is doing the external. She may ask if I have any plans for a vacation or if am I ready for school to get back in session and be back at work. Then she will break that and say okay I am going to insert the speculum now. I mean it would be rude to shove something in someone without warning. Once it is in she will usually ask if it is okay, no pain? Then she will continue talking about updates like are my periods still regular etc. All this time she is getting handed what she needs from the nurse. Same thing when she inserts her fingers. Even when she is pressing my belly she asks if I feel any pain. She is really protective of pain. This last time was the first time I was asked by the nurse if that was my name on the samples. I started laughing. She asked why I was laughing and I said, "who else's name would it be?" I don't know why it struck me as funny but it did. I never asked that when I worked at the OB/GYN clinic or the hospital. I mean I have been going to that doctor for years now and they know my name. They also have my chart which is also on the computer in each room. Now on the L&D ward, we would match the wrist bands with the baby's name.

If you watch any new videos on the female pelvic exam that is how they are teaching doctors and nurses to perform the exam. It shows respect to the woman.

Ugh, it’s unfortunate if this is how it will be from now on. I don’t find it respectful at all - to me it feels the opposite, because I’m not realistically in a position to say no to steps that are part of the exam, so requiring me to say yes over and over offends my sense of autonomy. It’s like when a guy who’s a bad lay keeps going “You like that? You like that?” while he’s doing it. Like, not only do I have to endure this, but now I actually have to pretend it’s my choice too? Yuck.

I would say it’s respectful to tell the person in advance what you’re going to do so you don’t surprise them, and check in about discomfort for politeness (as well as diagnostic) reasons. But requiring the performance of Permission Theater is really annoying. I wonder what happens if you tell them to stop it.

I haven't had time to find a primary care physician as I work many hours so I end up at an urgent care place nearby. I do get some nasty sinus infections that can be a combination of allergy, bacterial and virus. I am usually already stressed out and my blood pressure runs high on that and then the stress of dealing with the people at urgent care. What shoots my pressure even higher is that they say I don't need antibiotics and citing the then current president and the CDC guidelines. I have to sit there and explain to them I have a long history of sinus infections and know better than they do about what I need and what to prescribe. After a bit of back and forth, they finally agree, however, I had one that didn't and the next evening my wife is taking me to a different urgent care where I get the drugs I need. I hate the way doctors try and put people into the routine they are taught and think they know more about a patient's body and history versus the patient themself who has more experience. Before anyone says I don't know what I am talking about, one of my friends used to treat me and he knew what I went through, and we didn't know for sometime that I can't take tetracycline drugs as they are ineffective on me. I know doctors run that little program in their heads as I do the same thing in my job, but I do take the effort to get all the facts I can before I start to determine what is really going on.

Several years ago, I had a chest cold on a weekend and was directed to the local urgent care. I was treated well, examined properly, had a chest X-ray, and was prescribed medication. The doctor called later and said the radiologist had seen something on the X-ray thst May have been an artifact, but could I return for another. I agreed. The next day I came and a different nurse treated me like she was reading from a script. I was just there for the X-ray, but she wanted me to undress, put on a gown, and do a full workup. It was the worst experience I had in a medical office. The X-ray was fine, no problem, but I won’t ever go to that urgent care again. I did explain my issue when I received a survey request, but got the standard form response.

Same outfit tried double billing me for having stitches removed which were already paid for with the first visit, called and the billing person checked and closed out the account for the over billing which I had suspected at the time they removed the stitches, sneaky bitches.

When i am seeing a new patient who never had pelvic, i always ask/explain the procedure even before they undress. My nurse/ MA often stays back and asks if she has any questions or needs help and verbal consent is obtained for exams.. If any procedures are planned, then i get informed written consent.

During the procedure, if patient never had pelvic exam i explain the main steps especially with prior to touch/speculum or procedures. Every patient is different, some prefer to chat/discuss during the procedure and others are silent.

As mentioned above, i also ask mostly about pain during exam.. (Either due to procedure/exam or abnormal finding)

I may have done all the detailed narration during my training. I am guessing it probably did make some uncomfortable with the conversation.

Literally every step!!! Has anyone else had this happen? It seemed damn weird to me. I liked the doctor otherwise, but that aspect was very weird.

To me this sounds like a doctor who is afraid of having a sexually neurotic patient accuse them of inappropriate behavior while conducting a genital exam. It's not like doctors aren't afraid of being accused and sued by overly suspicious patients or weirdos.

Perhaps she was being too careful (and annoying) by describing every move she was going to make, but I think I could understand her possible concerns.

Yeah. I don't think I'd like that so much either, mostly I know I'd get more nervous with them asking questions and talking things through than if they just got on and did it. The weirdest thing happened to me last time actually. The nurse wiggled the speculum whilst it was in me but not open. I remember just laying there, trying to breath and not freak out but thinking WTF did you just do? There might have been a sensible reason for that, maybe not in a good position? - I'm quite small and I've never given birth. I hate getting smears so much. They always hurt. I hate any kind of small talk too. I want to pretend I'm not there, get it over with and leave.

I haven't had time to find a primary care physician as I work many hours so I end up at an urgent care place nearby. I do get some nasty sinus infections that can be a combination of allergy, bacterial and virus. I am usually already stressed out and my blood pressure runs high on that and then the stress of dealing with the people at urgent care. What shoots my pressure even higher is that they say I don't need antibiotics and citing the then current president and the CDC guidelines. I have to sit there and explain to them I have a long history of sinus infections and know better than they do about what I need and what to prescribe. After a bit of back and forth, they finally agree, however, I had one that didn't and the next evening my wife is taking me to a different urgent care where I get the drugs I need. I hate the way doctors try and put people into the routine they are taught and think they know more about a patient's body and history versus the patient themself who has more experience. Before anyone says I don't know what I am talking about, one of my friends used to treat me and he knew what I went through, and we didn't know for sometime that I can't take tetracycline drugs as they are ineffective on me. I know doctors run that little program in their heads as I do the same thing in my job, but I do take the effort to get all the facts I can before I start to determine what is really going on.

Oh how I know you're felling and frustration . where I live there is only urgent care . The nearest Doctor lives in Garnerville about 80 miles away .{yes I live in the sticks} We have two nurses that handle day to day “stuff ” An E.R. with a rotating schedule DR.s and two overnight rooms . If you need anything serious they pack you into a helicopter and fly you out . Other wise you get a nurse that knows that she is right you are wrong and you had better do as she says or accept what ever she is going to do or get out and suffer or die , This is who was supposed to take care of me after my stroke . Their “care” put me into the e.r.

I (female) had my annual today and I had a young female doctor for the first time. She was very verbal throughout the pelvic - narrating everything she was going to do, asked permission in advance, and then asked if it was okay - for every step. Has anyone else had this? It made it feel ritualistic and the opposite of matter-of-fact.

@Blue55 You seem frustrated with this approach on the part of your practitioner.

In fact, the cause of this change in practices is to be found in the sex scandals that broke out several months ago leading to the "mee too" movement.

In France we had to face movements of the type “balance your pig” which deviated into “balance your gynecologist” or “balance your uterus”

In fact, doctors have considered it useful to protect themselves and professional organizations have communicated on the obligation to ensure the patient's consent before any action.

We therefore come to question the patient if she is OK before a palpation of the breasts, if she agrees to inserting a speculum and if she does not see any inconvenience to a vaginal examination and, all the more reason for rectal exploration.

No, it is not a question of lack of professionalism or gestures of beginners, it results from the fear of being prosecuted for a misinterpreted gesture.

Many people who have commented on your post say that it is frustrating and unacceptable, I ask you to understand that, for gynecologists, it is more than frustrating, it represents a systematic questioning of the merits of their actions. for diagnostic purposes

Many people who have commented on your post say that it is frustrating and unacceptable, I ask you to understand that, for gynecologists, it is more than frustrating, it represents a systematic questioning of the merits of their actions. for diagnostic purposes

I hear you - and I do understand the need for doctors to protect themselves. I just do not like being “asked” about each step of the exam, because it feels like we're playacting since we all know I have to say yes. I wish they would just tell me what they're going to do, and trust me to speak up if I have a problem with it. I wish they could give us a waiver to sign and opt out of the call-and-response ritual!

@Blue55

I hear you - and I do understand the need for doctors to protect themselves. I just do not like being “asked” about each step of the exam, because it feels like we're playacting since we all know I have to say yes. I wish they would just tell me what they're going to do, and trust me to speak up if I have a problem with it. I wish they could give us a waiver to sign and opt out of the call-and-response ritual!

This reminds me that recently I had appendicitis which ended up being operated on, quite urgently.

Now, when I was in the operating room, already laying on the operating table, IV line already in my arm, the surgeon and/or anesthesiologist (I wasn't wearing my glasses so couldn't see which) must have asked me about 3 times if I consented to the surgery and anesthesia. One of them explained they were going to remove my appendix (well duh, yes please, as soon as possible pretty please) and asked several times if I consented to the anesthesia (as if I would ask for a lead bullet to bite onto instead).

I found it all somewhat idiotic and needless. I was still feeling awful and just wanted to get the operation over as soon as possible. I think I stayed polite and didn't come up with a wiseass answer, but I know I started wondering what they thought the alternative to my situation might very well be otherwise. I am pretty certain I said something like ‘yes it’s OK, just get this thing out of me' or something like that.

And it still felt like an eternity before the anesthesia kicked in.

And this asking my permission while I was on the operating table, came after me signing consent and waiver forms of course.

I can see your frustration, but for those of us who have not had good experiences, it's a godsend. I will never go back to one gyn where I indicated at 3 different times in 3 different places that there was a history of SA, and they said the right things but the actions did not match the words. I'd 100% rather deal with is this ok, how are you doing, do we need to take a break, so on so forth than having a full-on dissociative episode and flashback. I reported there was a history of SA, but not everyone does, there are some providers who understand that more than others and will address all their patients as if there is possibility that something wasn't disclosed.

I haven't had a pelvic exam narrated yet. I've never had any doctors do anything that I've been uncomfortable with. I was recently curious to see what it looks like from the doctor's perspective, so I started looking at some videos on YouTube and https://brooksidepress.org/brooksidepress/?page_id=24.

I wish I had been more curious in my younger days but I don't know if I would have been more comfortable with someone explaining every step. I just wanted to get the exams over with. Many YouTube videos have the narration.

Seems like an overly cautious doctor with consent…

So why not say to the doc - “I'm okay with what are doing, so go ahead and do what you gotta do.”

I'd rather have a doctor asking to often then not enough. I am the kind of person not trusting much in doctors of any kind. I never go to any of them without my husband just in case that the doctor would do anything I do not agree on. He will and already did stop a doctor starting do do something I never agreed on.

So why not say to the doc - “I'm okay with what are doing, so go ahead and do what you gotta do.”

Yes next time I will definitely do this! I was too taken aback by it to speak up in the moment; I felt very pressured to cooperate because here’s this doctor standing there with her hand on the speculum and obviously you have to open it to proceed, but everything is being held up until I say the magic words, so I better hurry up and say them. It feels like a pressure tactic from a salesperson or a bad date - rely on a woman’s social conditioning to make her do what you want because it would be rude not to. Next time, having had time to think it over and be ready to assert myself in advance, I’ll say “Please don’t ask me about every step; just tell me what’s next and do it. If I have any issues I will speak up. Otherwise, yes I am okay with all the steps of an exam.”

I am someone who has a sense of humor about me, especially with medical providers. We all know when it’s time for the lung/ heart, breast, abdominal and pelvic exams. It’s definitely obvious. Me and my humor…. I’ve said many times to my physicians “Shall we dance?!” and ”Let’s do the time warp again!”

Roger Hammerstein The King and I, Shall We Dance?

Rocky Horror Picture Show, Time Warp

What you are describing reflects the current litigious climate over professional malpractice and the impact of monsters like Larry Nasser finally being brought to justice for non-consensual examination practices. Getting verbal permission for every step of a procedure prevents medical providers from being sued for what used to be routine but intimate examination procedures. Signing consent forms is not enough these days.

What you are describing reflects the current litigious climate over professional malpractice and the impact of monsters like Larry Nasser finally being brought to justice for non-consensual examination practices. Getting verbal permission for every step of a procedure prevents medical providers from being sued for what used to be routine but intimate examination procedures. Signing consent forms is not enough these days.

That is indeed part of the reason, but don't discount the general atmosphere of ever increasing prudery due to how society is reacting to the openness of former decades.

Many groups of people complain about sexual licentiousness and what they consider to be sexual depravity and permissiveness and now we have been seeing the backlash, which started around the turn of the century I would think. The 1990s were the last truly permissive decade and even then disapproving elements in society were able to make use of HIV as a way of denigrating sexual freedoms, what they saw as a righteous punishment for how low they thought society had become in sexual matters.

And now it is becoming worse as time goes by.