Patient Safety at the Gynecologist

A USC staff gynecologist was recently accused of sexually assaulting hundreds of young women. This is saddening and also appalling. I believe that one of the ways that we can stop this criminal behavior from occurring at large is by educating women about what is appropriate for a gynecological exam, as well as what they should do if they feel that they have been violated in some way.

A standard OB GYN visit typically begins with taking a general medical history and then addressing any particular concerns that a patient may have.
Once the interview is completed the physical exam is performed. Most often, the exams performed are a general physical exam and an external and internal genital exam.

During the general exam, your height, weight, and blood pressure will be checked. You also will be examined for any health problems you may have. An examination of your heart, lungs, an abdomen is performed as well as a breast examination.Then an external and internal genital exam is performed. In an external genital exam, the doctor looks at the vulva (which is basically the outside of what you consider your vagina because the term vagina actually just refers to the inside).

The internal exam the doctor will first place his or her gloved hands on your thighs and then take one hand to separate your labia and will place a speculum into your vagina with the other hand to visualize your cervix. If you need a pap smear this is when it is performed with a brush to take a sample of cells from your cervix. Please note you do not need a pap test until you are 21! If you are sexually active an exam for STDs will also be performed. Following a speculum exam a manual exam with the doctor’s hands will be performed. The doctor will again separate your labia and then place one or two gloved, lubricated fingers into your vagina and up to your cervix. The other hand will press on the abdomen from the outside. This exam is uncomfortable but it shouldn’t hurt. Mainly it just feels like a lot of pressure in your vagina.

For adolescents that are not yet sexually active and are not having any problems with their menstrual cycle or any complaints an internal pelvic exam is unnecessary.

There should always be a chaperone in the room other than the doctor such as a nurse. If you would feel more comfortable with an additional person such as your mother, sister or friend, feel free to bring them. You can also ask the doctor to describe what will be done prior to them doing it. Most doctors do this anyways, but some do not. If you would like them to not talk during the exam, you can ask them this as well.

Some key points to remember are:
-Physicians should avoid sexual innuendo and sexually provocative remarks.
-Physicians should explain to patient what to expect before they touch and examine them.
-Physicians should use gloves for any internal exams.

If you feel you have been a victim of sexual misconduct by a physician:

1.) Report the abuse to the local police

2.) Contact the administrator/medical director at the medical facility that the abuse happened at. Many major hospitals have complaint forms that you can fill out.

3.) File a complaint with your state medical board.

Please share so that we may keep women safe.