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Let’s discuss one of the more common rituals that women should go through: the annual exam and Pap smear. This simply and quick exam has saved countless lives and keeps the woman on track with the health practices that she owes to herself and her entire family.
Quite possibly one of the most stressful times in a young teen’s life is when she goes for her first Pap exam. But there is quite a bit of confusion regarding appropriate timing and performance of this initial exam.
I emphatically tell folks that there are three things that should prompt the young girl’s first visit to a gynecologist. The first is if she’s been sexually active, regardless of age. Much teaching needs be done if this is the case; parents or peers can rarely successfully accomplish this teaching. Secondly, when a girl turns eighteen she should start regular exams. Finally, if there is any concern whatsoever on the part of the teen going through puberty, a visit to a caring physician certainly is in order.
One of my most staunch beliefs is that this relationship between teen and physician is to be treated with the same respect and confidentiality as any physician/patient relationship. While most physicians agree, care must be taken because not all doctors do and some very inappropriate and tearful confrontations have prematurely happened because of this callousness.
No information regarding the teen’s care will be released by me to anyone, parents included, without the expressed consent of my patient. This is mentioned right up front with mom or dad present and is critical if I’m to earn the trust of my patient in order to best care for and advise her in times of need.
Another "ground rule" that I believe is important when a young girl is facing the prospect of her first gynecologic exam regards the issue of control. I make it perfectly clear that I’m not in control, the teenage patient is in control. If she gets uncomfortable at all and wants anything to stop, it stops immediately. No exam or procedure is performed without the complete consent and comfort of this most fragile patient.
I make a habit of meeting first with the new teen patient and discussing any issues that need be discussed. Further, I make it clear that she is not committed to an exam during this first visit. That way she gets comfortable with the surroundings and can return at a future date for the actual exam.
This most tense time can be a breeze with the right amount of time spent and a healthy dose of concern by both parents and the medical staff. The diseases and pregnancies that may be prevented will be well worth the effort.
Philip Suarez, M.D.
philip@icsi.net
