Has healthcare gotten so screwed-up that now healthcare professionals are trying to talk us out of having preventative procedures? Do we have to haggle for our health? I understand that we must be our own advocates. But shouldn’t we also be allowed to have some faith that our medical practitioners are looking out for our best interests? Is it dangerous to believe that they will advise us to have the tests we need and recommend preventative measures? Are we all just flying solo as far as healthcare goes?
If I have the choice between having a pelvic exam and not having a pelvic exam, I’m going to choose not having the pelvic exam. Clearly, I am not alone in this stance regarding uncomfortable and intimate diagnostic methods. Many men feel the same way with their prostate exams. Although it is an elective procedure you don’t do it because it is a good time; you do it so that if something is amiss it can be treated early. Nobody is saying “I can’t get to the bars any time soon, a trip to the doctor would be the next best thing.” Admittedly if you have ever had a trans-vaginal ultrasound the technician does seem to attempt to make it sexy when they lower the lights and put a condom and gel on the probe. But they can try to disguise it all they want and it still won’t be something I’d do if I didn’t have to.
I recently had an appointment with a nurse practitioner. I’m making an effort to be the kind of person who is responsible about their health care. I don’t know how much longer I’m going to have health insurance. I’m trying to get every exam, test and procedure I can. Eye exam- sounds good! Sleep clinic- alright. How are my bones doing? Let’s get an ex-ray! Having a pelvic exam was something I had put off doing, so I went ahead and made an appointment.
Finally the big day arrives and I make my way to the medical center and find street parking - a sign that everything will go smoothly. After waiting for a long time, so long in fact that I am up to date on some nameless soap opera that a woman was explaining in painstakingly boring detail to whoever was on the other end of her cell phone. “He has enough children already” she sighed. Obviously the soap opera character should have been begging his healthcare professional for storyline vasectomy.
Finally my name is called; I gather my things and follow the nurse right around the corner to a chair. “Oh we are under construction “she says apropos of nothing. Is she warning me that when I’m strapped down, construction workers will be coming in and out of the room with power tools and two by fours? This sounds more like a porno than a procedure. “Ok “I say, though it is so not O.K.” I’m not comfortable with this anyway and now you are telling me the examination room is a thoroughfare? I can get a pap smear and a catcall all at the same time? The nurse goes on to explain to me that I had a pelvic exam in Dec. 2009 and that it’s recommended that I get one every 3 years or so. On this day, I’m not due for one. Am I having any problems or anything? I am not. I’m just trying to thrive the way my HMO keeps saying it wants me to. Then she turns to me and says “Did you just want to have a pelvic exam for the hell of it?” No she doesn’t say the hell of it part but that was the inflection as if I’m there for kicks and giggles. The nurse continues “most women if they don’t have to have an exam then they won’t. I’m prepared to give you one even though you don’t need it.” The nurse is talking me out of the procedure! While pelvic exams are a rollicking good time, I’m going to have to pass on that awesome offer. The nurse has convinced me to go without getting what I came for.
When I was 16 and going away to camp, my orthodontist asked if I wanted my braces off then and have less than perfect teeth or wait and get them off in the fall and have a smile he could be proud of. I chose right then. He was an ass and did not know how to deal with teenagers. But what 16 year old is mature enough to say “Oh yes let’s wait. I would miss having the braces cut the inside of my lips. It is all about your glory, Dr. Ball.”
Was refusing the pelvic exam like getting my braces off early? Don’t offer me a choice and expect me to make a mature decision if it involves pain or discomfort. I decided to not have the pelvic exam feeling like I was being responsible and somehow still getting away with something. Oh I’m so sly, I’m walking out of here paying $30.00 and getting nothing done! Go me! As I was leaving, I began to think about how if this is the state of insurance and medicine, then our healthcare is in some very sorry shape. Are they required to spend time convincing people to not get procedures they probably should have? What a great way of saving money- filibuster people out of being smart with their health. Do you really want to have MRI or those stitches? Hopefully given enough time, your finger or spine will heal on their own or not. Whatever. Are you gambler? It might be nothing. It might be something. Take a chance with your life. Come on, don’t be a wimp, tough it out with that infection. Instead of having an expensive test, why don’t we just wish really hard that it goes away?
A couple of weeks after my appointment, I received a letter from the Dr’s office saying I was due for a pelvic exam. The nurse hadn’t talked me out of it to save money,she was just inept. But I realized that I should have stood my ground and insisted I have that exam right then and there. The construction workers could have held the light. I learned my lesson and now medical center will become like a used car lot for me. I am prepared to barter and cajole my way to better health and actually act responsibly about it.
