I know this is an older thread, but to me, the very idea of medical fetish play is BDSM oriented. If you are the patient, you are engaging in consensual submission (and in my case, some nonconsensual / consensual submission). I only explain in general terms what's going to happen in the exam, and often then only when asked. That way, there are plenty of surprises, and opportunities for the woman to submit. I like INexperienced submissives for this, since many have had only perfunctory gyn visits. I think I had only ONE woman walk out, and she texted me later with an apology that she was having boyfriend trouble and the intensity and attention to her body was too much for her emotionally. That was after the exam was mostly over, so I encouraged her to get her issues resolved (leave him, he was an asshole). I have turned down one or two women, one when almost the first thing she told me was that she had been raped in a hotel room. I didn't know her, so I couldn't tell if she was looking for a "forcing" experience, or if she would be too terrified and freak out. I didn't want to reject her (I am a sensitive guy), but I felt I had to say "no," since she had so many issues. I was also pretty inexperienced myself at the time. Now, I think I would question her further and determine her motivation. She might have had that strange reaction with which we are familiar, seeking what we once hated, like the moth and the flame. On the other hand, she might have made a foolish choice, and I didn't "get" her enough to know.
In order to be a good Dom, I believe that a man must truly like women (or his woman), and understand that she is giving you something important to her (to put it in "Lord of the Rings" terminology, it's her "precious"), and she may be giving that to you because she is seeking an experience she feels must be relatively anonymous, because she wants to be "vanilla on the outside, kinky on the inside." I think this is why I've also had so many intimate conversations with women who live 'way too far away to meet--they deeply fear being found out, and as long as their "kinks" are
A. Apparently forced on them,
And
B. Anonymous,
They feel they are still "good." I like @SwitchableSusie's comments about whores vs. "Frigid" women a lot. They are true in the extreme. One thing medfet does is to force a woman's sexual nature on her. She is being "used," but she is also using her "Doc." I well remember one encounter with a nurse, who wanted to play. She experienced the full gamut of the play that I do, and had multiple orgasms (nearly 2 hours' worth, truth be known), but she did NOT want to play again because she thought it "perverted." Translated, she had too much fun...