Doobster (Shhhh… Don’t tell him I said his name. I don’t think he likes doctors!) mentioned a few weeks ago that his blog posts with the highest number of hits were the ones with the word vagina in them. So far my highest hits from search engines are about pantyhose and boobs. Sometimes together. Sometimes with poop. Eeeeew. I don’t even want to know.
Soooooo….. I am going to test this out.
I was reading a post the other day in which a woman was ranting about why her doctor asks when her last PAP was when she was only coming in for an ankle injury. The tone of the article was that physicians are money grabbing perverts.
Maybe we are.
But not for that reason…
So I thought I would take a few minutes today to set the record straight about your doctor and your vagina. If you have one. Or if you love one. I will also attempt to use the word vagina repeatedly so that Google or whomever takes notice.
First, doing a PAP is an inconvenience. It takes a lot of time. I make as much from a physical exam with a PAP as I do without a PAP. That does not mean I want you to skip your PAP. Hardly. I am in the business of keeping you well.
Fortunately guidelines have changed dramatically. I celebrate this as a woman (Woohoo!!!!) and as a physician (Double woohoo!!!!) Less vagina is better vagina in my opinion.
One of my biggest pet peeves, however, is physicians who refuse to follow or even discuss the new guidelines with their patients. I promise you are not going to go to hell if you space your PAPs out to every three years, or even every five years in certain circumstances. Check the guidelines here. Your doctor should not shame you into doing it more frequently or hold your birth control hostage unless it is medically necessary.
Don’t get me wrong. PAPs are necessary. I had a woman in her late 20’s with cervical cancer that ate a hole from her vagina to her bladder. She is certainly not an isolated case. Boys are an awful lot of fun but they are not good for our health, particularly when they are spreading around HPV. So protect yourself and get regular check-ups. You can then discuss with your physician if a hoohah check is warranted.
I make preventive care a priority in my practice. Each and every visit I am going to review your preventive care. That saves lives. So, I will ask. Did you get your flu shot? Your mammo? Your PAP? Even if you only have a sore throat. Want me to shut up? Get your dang colonoscopy done.
But, you say, you don’t want a PAP? No problem. I am not going to force you. I may ask you why, though, and not so I can get all up in your business. I like to keep my distance from your business if possible. Trust me. I am asking because I genuinely care. It helps me understand barriers to care. For instance, if you are worried about spreading your legs for me because you did not shave your hoohah that morning, I can reassure you that I DO NOT CARE. Not one iota. If you think your doctor does care, you should run away. You should run very far away very, very fast. When we look at your vagina, we are looking at it clinically. You absolutely cannot make it look better than it already is, even if you spend hours on it.
You should also know that your insurance company measures your preventive health as a measure of my quality and often links your copays to how well I do on these things. If I do better, you pay less. We all like to pay less, right?
So in summary: Vagina, vagina, vagina, Doobster, vagina, Google.