I know two women who use non-prescription birth control because they don’t want to get Pap tests. And I know at least one man who won’t go to the doctor because he’s certain the doctor is going to do a DRE (though he doesn’t precisely call it that).
Can or do these sorts of tests cause more harm than good since they can or do discourage people from seeking appropriate medical care?
How can it be “appropriate medical care” if it doesn’t include all necessary tests and examinations?
Would it be nice if more pleasant alternatives were availiable? Of course, but at the moment they aren’t, so patients just have to learn to but their long-term health in front of their short-term comfort.
I do not think they cause more harm than good because what is the alternative? That no test exists at all?
I think it is safe to say any medical test is as non-invasive and causes as little pain or discomfort as possible while still managing to achieve its desired goals. Unfortunately some tests are simply going to be uncomfortable/painful and there is no way around it till we get Star Trek style magic wands that can assess anything wrong with you from 10 feet away and nothing more than a spacey humming sound to bother you.
If someone foregoes testing because it is uncomfortable that is their problem but at least the test exists and its existence means it can help many other people who do put up with it. As I said the alternative is no test and then everyone is out of luck.
No, the alternative is not requiring the test, not getting rid of the test altogether.
You always have the right to refuse any medical procedure. Very rarely is something “required” by the government or other entities.
It’s just that such procedures are necessary to ensure proper medical treatment, especially if they could be linked to whatever you’re seeking medical attention for, or if you’re in a high risk group. It’s “required” for proper health, but not by any other power.
It’s true that no one can force you to have the test, but they can force you to have the test as a condition to getting other care (for example: Don’t have a Pap test and you don’t get a birth control prescription). And many people find it very difficult to resist pressure from a doctor, so they will avoid putting themselves into the situation at all.
I just wonder if our medical attitudes make the perfect the enemy of the good. It’s better for people to get some care than to get no care, I think we’d agree. I’d say it’s better for women to get birth control pills than to get a Pap test, and it’s better for a man to get his heart checked than his prostate. That’s where I’m coming from, but sure, I could be crazy.
Right. You aren’t required to get, for example, a pap test. But I don’t think the doctors I’ve known would prescribe BC pills for someone who would not agree to a complete gynocological exam, including this test. Otherwise, s/he might be prescribing a substance that could be harmful if, for example, the patient had cancer, which is what the pap test is intended to find.
There is some discussion that doctors test too much to cover their asses from litigation. Whether or not a person feels a given test is necessary is between them and their doctor. If the person does not like the answer they can seek a second or third opinion. Perhaps another doctor will be willing to persue a course of treatment without further tests.
That said testing to some extent is required. A certain amount of certainty of what the problem is needs to exist before a doctor will suggest a course of treatment (most treatments carry their own risk so they want to be sure that the upside is greater than the downside). Depending on the issue in question uncomfortable/painful testing may be the only route. Usually they seem to build up to it. Do a simple physical, maybe an x-ray or ultrasound or the like. If anything seems a bit odd they go for the next test which will zero in on what is really happening.
I can’t comment on what percentage of physicians prescribing birth control pills (including Planned Parenthood clinics require Pap tests beforehand, but one definitely is not required to have a digital rectal exam as part of a physical (unless mandated for insurance purposes)
I don’t think it’s better to have cervical cancer than to run an increased risk of an unwanted pregnancy.
And my take (through observation, and personal experience where applicable) is that both procedures cited in the OP are painless, mildly unpleasant experiences, assuming the physician or PA are even halfway competent.
Actually, I can think of a handful of women of my aquantance (probably including me, when I was younger) wouldn’t have gone for a pelvic except that it was required for OCP. Ergo, the requirement is bringing some women in to their health care providers.
If the doctor is especially skilled, then you might even fall in love with the doctor performing the DRE.
Perhaps, but it can’t be helped. If some doctor invented a method of examining your vital functions by having attractive naked people of your preferred gender feeding you peeled grapes, he’d be able to buy his own Carribean island in six months.
I have seen debate about the efficacy of screening for both breast cancer and prostate cancer in recent years. Here is a piece about prostate exams and the PSA test. Here is a British Medical Journal article about the debate over breast screening.
In both instances opponents argue that not testing may in fact be a better alterrnative in many cases.
OCP = what, exactly?
Thanks.
Oral Contraceptive Prescription?
That isn’t parallel. Is it better to risk undetected cervical cancer or to risk unwanted pregnancy? That would depend on the woman.
The statistics I’ve seen say there are 10,000 cases of cervical cancer a year. There are millions of unwanted pregnancies a year. I would consider unwanted pregnancy the larger “public health” issue, based on those statistics.
I’m not saying any cancer is unimportant. And I’m not trying to lie with statistics, so if I’m misreading them, someone smack me.
It really doesn’t matter if you think they are painless and mildly unpleasant. What matters is what the people who refuse to get them think. (Paps for me have always been quite painful, btw.)
Catching Cancer early can save your life. There are MANY forms of birth control that can give you ~ the same protection as ‘the pill’ (or other proscribed BC methods). That said precribing birth control without testing for cancer (amoung other indicators) can kill you; pretty sure having an informed view of the risks as well are rewards would fall under the ethics doctors are required to follow. If not consider it a downside of doctors being held liable of death.
Yes, and it would only take one woman dying from the interaction of birth control pills with her undiagnosed cancer to create a multi-million dollar lawsuit. Doctors require these tests to cover their asses. If they allowed patients to pick and choose what pills they take, what tests they want to have, etc, then they would be opening themselves up to all kinds of legal problems, people saying “well, he didn’t say I HAD to have the test, so I didn’t!” Most people do not know enough about medicine to know what tests can be safely avoided and what things won’t interact and etc etc. I think people should have the right to refuse tests and still get care in theory, but I also think doctors have the right to protect THEMselves from lawsuits or winding up with a dead patient. Works both ways.
(Weirdly enough, I was able to get birth control without a Pap test. I went to the student health center for something unrelated to girly parts and told them I used the calendar method and they just gave me these samples. I had no idea this was not the norm until recently.)
Where is everyone getting the idea that birth control pills + undiagnosed cancer cause some sort of interaction that is worse than cancer alone? As I understand it, you don’t need a pap smear to get BC, they just think you should have one and use the BC as a sort of carrot to put up with the stick of a full gyno exam. Prescribing BC without testing for cancer won’t increase your chances of dying from cancer any more than just not getting tested. Unless I’m totally wrong, but I’d like to see a cite that getting BC without a pap smear is more dangerous that just never getting a pap smear at all.
Actually that is backward (perhaps I wasn’t/we weren’t being clear), birth control pills put you at additional risk FOR cancer.
Since it puts you at additional risk for cancer, and is being precribed by a doctor; most doctors will require the exam.