Hospitals Now Require Written Consent For Pelvic Exams, How Was This Not Already a Thing??
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- Опубліковано 4 кві 2024
- This week on Personal/Political, Erin and Alyssa are joined by Dr. Heather Irobunda to discuss an announcement from the Department of Health and Human Services regarding consent for “sensitive” procedures like pelvis and prostate exams.
Political commentator and comedy writer Erin Ryan and former White House Deputy Chief of Staff Alyssa Mastromonaco are joined by a bicoastal squad of funny, opinionated women to talk through everything from reproductive rights to romcoms. They break down the political news of the week, plus the topics, trends, and cultural stories that affect women’s lives. New episodes drop every Thursday. Get in touch: hysteria@crooked.com.
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#hysteriapodcast #pelvicexam #prostateexam
I have been through a fair amount of surgeries and the thought of this occurring during any of them just turns my stomach and brings back the trauma of SA. I’m so relieved the guidelines have changed; it *never* should have been allowed. Also, if this practice is so mundanely acceptable to patients, as some teaching hospitals defend, why did they go to the extent they did to obscure (*hide*) it in the consent form?
At 5:30ish she states the problem exactly. There were physicians who chose to hide this information because they felt like patients would say no. That's an incredible breach of trust. If they have shown that they are comfortable doing things to my body that they think I wouldn't want done, why should I trust them to touch me at all?
Where do I have to move so Dr Irobunda can be my GYN? Packing now.
Same!
Dr. Heather Irobunda, MD is an Obstetrics & Gynecology Specialist in Bronx, NY.
❤ Google, y'all.
If you want wait 4 -6 weeks for an appointment.
I graduated from nursing school almost 35 years ago. In our first lectures and labs, we were taught extensively about patients' needs for physical autonomy. We were taught to talk and teach before touching, as in : "I'm going to check your IV site now. I need to look at it to see if it's leaking,could you show me your arm? ", or " I need to check your incision site to see how it looks, is it ok if we do that now? " We learned this until it was second nature. In our labs, we had to do this with the demonstration dummies too and if we forgot, we failed the lab. I've noticed recently that younger doctors do this too and I'm so glad to see it happening.
Re: refusal to educate. I was diagnosed with endometriosis at 22. After surgery, I was put on Danocrin (and later Ovral to counter breakthrough bleeding - Crazy, right??). When I asked about side effects, he literally patted my hand and said "just let me know if you have any problems. " I had to hunt down a PDR. This was 40 years ago.
Later, when I found a lump on my cervix, he said " what are you doing putting your fingers up there?." "It's MY body and my responsibility!" I responded. I finally dropped him.
Wow! That's appalling!
That is so inappropriate to ask omg
I am not a Christian but, but good god!
Keep your mind out of my fingers in my vagina!
I'm around your age and didn't have access to a female GYn, until I was 55yo. My old male gyno had the ceiling of the exam room plastered with cut out photos of Teen Beat style pics of heart throb pretty boys. As a Lesbian I had to lie there spread open looking at that crap wondering what was the inspiration and motive behind that collage of teen boy images.
If I'm given the choice I'd love to get my pelvic exams done while under anesthesia. But that's the operative word - choice
I’m freaking out right now because I just had a hysterectomy and I am terrified that this might have happened to me. I already have trauma from past experiences and the thought that someone I didn’t give explicit consent to touching my body in that way is giving me a very real panic attack.
Just ask your surgeon. And take it to your therapist so you can reduce the trigger.
There are probably a lot of patients that would've allowed them to do pelvic exams for educational purposes under anesthesia *if* they had been honest about this occurring. That doctors felt the need to hide it because patients would say no makes it not only a breach of trust, but potentially traumatic for any patient who MIGHT've been subjected to a nonconsensual exam, whether or not they actually were and whether or not they had pre-existing trauma along those lines. This of course would been even more awful for those who did have such past trauma, and could very easily retraumatize them again and simultaneously kill their trust in doctors in general.
I don't understand how women in practice or working at the hospitals didn't say something sooner.
My VA Gynecologist was excellent, she knew I was a MST person and always explained everything, checking in with my mental state. VA doctors are wonderful with the service they give. Miss that powerhouse of a woman, glad she is retired and traveling the world.
I am a male, so not fully attuned to all of this discussion. But I can identify with dealing with arrogant doctors and staff. I have been to the ER several times with severe chest pains, difficulty breathing and tingling and/or numbness in my limbs. I was always told that it was not heart attacks. Later, my PCP, looking over my records and charts told that all had been heart attacks. Did they think that if I didn't know, I wouldn't be as angry about the 8-12-hour wait to be seen, and denial of food or even hydration?
What is the difference between doctors and God? God doesn't think that he's a doctor.
If you were kept in the ER for that period of time cardiac enzymes would show ANY significant heart damage even non Q wave MI and tingling is not a symptom of a heart attack. Overlooking abnormal labs on more than one occasion would be unforgivable and highly unusual because that lab would be only thing to clear your discharge if your EKG was OK.
I too think doctors, even burnt out ones should watch their bedside manner and treat every patient with respect and dignity. We can criticize the medical profession without unnecessary embellishment. I am glad you are ok and I hope you are getting the specialty cardiology care you need.
As for non-consensual intimate exams, NEVER in my training did that occur thankfully. That is completely unethical. And even in surgery there was utmost decorum and respect, as if the patient were conscious throughout. I am appalled.
This discussion was so interesting to me because I went through exams for my baby in Japan where I was shocked to find out the doctor was behind a curtain. Not only the doctor but who knows how many other people. I felt violated and it was strange to feel that the doctor did not want to see my face or talk to me during the exam.
Privacy officer here. Number one rule of thumb for health care professionals: ask yourself, “How would I feel if I was the patient?” Most days we wear the scrubs. Some days we wear the gown: we’re all someone’s patient.
Wonderful video. Dr Irobunda is the kind of doctor I'd want in any situation.
It provoked a lot of memories, having experienced both the UK and US systems for childbirth.
I'd say most of the things which she says are desirable in the US are the default in the UK - communication, respect for the patient, properly informed consent, humble caring doctors.
The problem in the UK is that the medical professionals are excellent but the systems are massively overstretched and understaffed which leads to unnecessary crises and panic.
So my experience is that in the US you get your own room and a dedicated nurse from a very early stage of labour and an epidural as and when you want it. Though your husband needs to remember to check whether the anaesthetist is in network (to avoid a $1000s bill) while also trying to help with your contractions. The absence of midwives as a widespread medical profession is a real problem and the concept of a doolah as an intermediary between patient and often arrogant medical professionals is a poor substitute and sets up an adversarial atmosphere.
There are also still some incredibly arrogant male doctors in the US. For example the paediatrician who ripped the remains of the umbilical cord off my baby at the four day check up without gaining consent so he could apply some special treatment to the wound he had created and charge for it as an "additional procedure".
Giving birth in the UK was also not ideal because the overstretched nurses didn't have any capacity to admit anyone to the actual delivery ward. If you then go into full on labour and the heart rate monitor falls off you because your contractions are so heavy you have a problem. Cue crash call and panic that the baby's starved of oxygen. Emergency C-section only prevented by your husband advocating really forcefully and insisting that the reason the baby's heart rate seemed low is because the monitor fell off because the contractions were so painful.
Once actually on the ward the midwife and consultant are superb - empathetic, supportive, reassuring. But it's too late in labour to get an epidural.
So the very cheap British NHS system with the US' stratospheric but incredibly inefficient levels of funding would be great.
Holy crap. Just holy crap.
Some of the people you have on hysteria kinda annoy me..but I love dr Heather..I of course love Erin and Alyssa too!!
An expert doesn't completely understand something if they can't explain it to a non expert in regular english. I always require doctors to explain medications and procedures. I want to know how it's done, what results are expected, secondary effects expected or likely, and especially why. I'm a retired engineer, and was not a fan of "technospeak". Among experts specialized language can be a shortcut, but often such language can obfuscate. Take the time to translate to something the general public can understand.
How often do unconscious male patients get examined without their knowledge by med students, in comparison?
Right? Don’t proctologists and urologists need practice too?
@@bitchenboutique6953 What? No, this is about med students
Maybe you didn't hear it, but this whole thing was also about non-consensual prostate exams. Stop it with the battle of the sexes for a while, will ya? It doesn't help anyone.
@@Akron162 No I didn’t hear that. I heard pelvic exams. I’ll go back and listen again.
Regardless, “the battle of the sexes,” what? Haha! “It doesn’t help anyone?” What does that even mean?🤦🏻♀️😆
Oh goody, it’s another thin skinned, fragile, self important dimwit feeling the need to mansplain sexism to women. Sorry you didn’t get the memo but it’s a real thing that exists and only an ignorant fool would deny something so well documented.
Can’t help but wonder why you’re so triggered by the mere mention of it? Why so defensive? Hm🤨 You’re either old AF, clueless or a sexist as$hole (or all 3).
.
Either way you have nothing of value to contribute to this conversation. You pretty much disqualified yourself with the idi0tic “battle of the sexes” Who says that? That’s so stupid🤣
@@Akron162 documentation? We want to know. Male or female. I am fine being a learning subject, but I want to know.
Hopefully this is what advance directives are for. I can just have it state in big letters, 'DO WHAT YOU NEED TO DO AND GET ON WITH IT.' I am not picky about what medical professionals do, never have been, over the many procedures I've had done. I'll ask questions (something far too many people I know /don't/ do because they assume they won't understand the answer), but I'm not about to say 'don't do this or that' because finding an alternative can take ages and I'd rather get the problem sorted asap.
Well done ✌️💜
During recent consultations and exams for my hip problems,my doc actually asked me if it was ok with me if his students could come in the room and observe. He asked each time and i of course said yes😊
Oh my my. I had an unplanned "soapy enema". Talking 45 years ago, absolutely torture! I thought I would die. Still gave birth through the trauma.
That kind of reminds me of how some doctors with God like syndrome that felt like they are taking advantage of us because they know better.
They do, unequivocally! Pfft. When I had 4 children, 12 day long clot filled periods, a male doctor, I kid you not, I would not do a hysterectomy unless you were bleeding to DEATH!
He actually said that.
I went to a woman and she said, how many kids do you have? How old are you? (4 and 36) tubes tied.
And she said we could do a bunch of tests, but we don't have to.
Best decision ever!
oh hell, if I could get my pap smear done at the same time as my colonoscopy while I'm fully unconscious sign me up. if you're going to examine me, 1) tell me and 2) do something useful while you're in there so I don't have to do it while I'm conscious because they are painful for me and i have trauma around SA.
It's just words, we need it before we can do your surgery.... they're professional, hem haw, are you going to sign?....
We need more Dr.'s and the profession to be based on knowledge and understanding, not numbers and profit...where profit doesn't skew results, and Dr.'s are practicing for a genuine passion for understanding the body, not .... there's good money in that field.
How is this different from rape?
It’s not as far as I’m am concerned, not different at all.
Why did I get an ad at the beginning claiming to reveal the "Truth" about how liberalism leads to despotism? Shouldn't a channel be able to exclude ads for things that are opposed to the contents of the video itself?
That's YT, not the channel.
I agree wholeheartedly that it is better the have explicit consent practices. However, when trying to explain a patient and getting content for each and every action that may happen during the surgery one needs to weigh pros and cons.
Patients are generally anxious and have to consent for all 20 items on the legal form, they have to sign 15 items on the medical complications and financial forms etc. It is tough to ask one more consent to the list right before the surgery. You must be in the same room to understand how stressed patients are during this process.The pre-surgery window is pretty small, and the patient is already 24 hours nill by mouth (starving and thirsty). Is it the right time to ask for X number of questions?
A vaginal exam or rectal exam under anesthesia without consent amounts to sexual assault. The point is when to ask for consent from the patient? Who should ask it? How explicit the description of the consent should be? Because once denied the consent there is no turning back- (Updated based on @CoffeePlease's comment)
Even in India, we had to talk with the patients upfront that it is a teaching hospital / university-attached hospital and whether they would feel comfortable if we trained medical students using cases or by examining them under supervision. But you can't expect to be called out on every procedure on a legal form to sign as consent. After 2nd form, the patient will just reflexly reject all other consent forms because they got annoyed (the American healthcare system and the bureaucracy are already complex enough that they need to sign 50 forms; this consent is another thing the patient will have to mind. If I were the patient, I would reject it just because I am annoyed with the rest of the 50 forms).
Then that is their right to do so. I can't even believe this comment. It is their body, and if you can't adequately communicate a reason for an invasive examination, then that is your fault, not the patient's.
All this writing, so much BS.
@@Chinshaw21 It seems like you missed the "I whole heartedly agree" part. At no point I said that it is not a person right to reject. Also you missed the rest of the part where I presented my experience back in India when I was a student doctor and consent was necessary before any procedure
It is also my job as a healthcare worker to tell you that the discussions are more nuanced that what you are making it look like. I explained the nuance. It is not just an inconvenience from even the patient's point of view. Right before the surgery no patient is in the mindset to agree (or even think about) especially when their burden to process so much additional information like legal, medical, insurance etc at the time of the surgery.
@merulaamethyst2248 please read my response to @chinshaw21. I am stating that even in India it is a practice to ask the patient first (just that right before the surgery may not be the best time to do so - that's where the nuance is.)
@@mkarhadeShouldn’t the “nuance” of this discussion abruptly stop when a patient *denies* *consent* of a medically *unnecessary* procedure? I’m a doctor as well and am frankly shocked that any medical professional would practice as if it doesn’t or shouldn’t; alas, here we are.
Addendum: The aforementioned doesn’t even discuss the implications of the invasiveness of said procedure(s) because a patient’s bodily autonomy is paramount.
It's just words, we need it before we can do your surgery.... they're professional, hem haw, are you going to sign?....
You're free to decline.
@@HLBear ad easy as no to the Internet, or power company when the power is out and 20 below....bottoms up... lol