Woman; 102; Why Women are Dissatisfied with their Gynecologist

With an in-depth look at the raging of the world the woman today with Sandra hello good evening and welcome to woman. The question we're going to consider on tonight's show is why some women are dissatisfied with their Gynecologists. My guests this evening are Ellen Frankfurt who is a health columnist for The Village Voice and the author of Bad you know politics and Barbara seaman who has written Freien female and the doctor's case against the pill. Welcome. Thank do I have to tell you I conducted my own private poll in preparation for the show and I talk to lots of women and I asked them about their gynecologists are you satisfied what you feel and the answer I got 100 percent was I love my gynecologist. Well that makes sense on one level I think if we didn't love them we wouldn't submit to them but surgery and the pills they give us but on a more serious vein I think there is actually an explanation for women who say they love their gynecologist. How else

can you result. The psychological dilemma of having a stranger deal in so intimate a way with our body without in some way developing some kind of romantic feeling. So I think you Eva love your gynecologist and you see this among older women who have just had hysterectomy and they spend hours setting their hair for the few minutes the gynecologist is going to take when he comes along on his rounds. It's really sort of pathetic. And you know I think this is not an unusual thing. I think it's changing with younger women though who have a very different attitude. I haven't done my own poll but I think it's I would agree with Al in that there is a temptation to invest them with more good qualities and they may really have. When you're up there on the table it's a very humiliating position. And also many women have such loathsome feelings about their own bodies that they feel grateful and they assume that it's an unpleasant thing that if he's the least bit nice that he's really been terrific to them. I would like to add that it may be that the particular women that you

asked really do have wonderful gynaecologist I would say. That in gynecology as in most medical specialties. My impression is that about 15 percent of the doctors are first rate conscientious. They really keep they really relate to their patients as human beings. And another 15 percent at the bottom are really bad irresponsible sometimes unethical lazy don't care. And then there's that vast middle range. You know I really think that it's falls more into two categories rather than you know that nice bell curve of some good some bad than the middle are just so so that there are the kibbutzes who really pay a lot of attention they've learned in a manner that they think women like

and many women have learned this manner as women and so they like it when a doctor flirts so calls and says honey and will when you come back here and there's some a little pat. And women think this is attention it's just the whole psychology of feeling grateful for any attention a man will give you the tickling I think when you're in that very humiliated position of having to drape yourself which just emphasizes this shame so many of us were brought up to feel about our bodies anyhow and particularly looking at that section. A friend of mine was just in a medical examination the nurse said Will you please wash you goosie Watts's. My parents my well I'm trying to get the nurse to say the word the nurse has seen lots of oozy once he could not melt any word having to do with the genitals. And I don't think this is on Tom and even with doctors when I mean the most common complaints that women have about their gynecologist that the media has been flooded recently with articles and the

complaints that I hear most frequently are great contemptuousness about the woman's time so that they schedule patient ing in the office for three hours waiting for doctors into specialties where they treat males assume that the men are more busy and they're much less appetizing actual patients in in such a suit you know kind of. Authoritarian an autocratic way not answering questions. They are a common complaint and particularly now as women are becoming aware that a lot of drugs that have been promoted as very safe for the simple have dangerous side effects that surgery isn't fun and so on. They want very concrete answers to many of the questions that many women do. Some women prefer to let the doctor do the worrying for them and very few the gynecologist are really trained or or apt to to

think in terms of really giving patients full explanations of things. Then there's this whole humility and humiliating treatment of being stuck up there with your legs on the stairs and left there to wait. I don't know why they don't put the reading material in that room. That's why you have the longest wait in it. Usually cold but it's gold and sometimes they leave the door open. There's often a kind of an impersonality or else too much personality and too much personal stuff. I love that if a doctor calls me sweetie pie. And also I've noticed that many doctors expect me to call them doctors so I went south whereas they call me Barbara or sweetie pie and that is not treating somebody like an equal. And it's not treating them with respect and I think along the lines you've been talking about the feeling not only that doctors don't answer questions but that you're imposing on the doctor's time if you dare ask any particularly any that don't relate to specifically that genital area that you're you know you really are to a

gynecologist so you wouldn't think of asking gynecologist about an earache. You're just so fragmented you're just that one part and it is it's also it's a very bad way of thinking about our bodies a very unhealthy way to not connect up all the parts with one another because in fact they are. But I think that goes along with the whole lack of preventive medicine and that gynecologist don't tell us how to eat even though that's probably affecting our gynaecological health and I think the other thing is also money. I don't even like it if we treat our own bashful infections with a little yoga. Or anything by ourselves unless it's something they don't want to do and they can't make profit from gynecologists is the routine work that nurses do the not interested in if it's either boring or unprofitable in most routine preventive care is so called boring if you don't take the person into account. If you don't take the feelings into account I think the other real complaint isn't

probably the most common one that is not the ones that the health activist have been talking about is the cause even. Any woman you know average woman who doesn't hasn't read these books and hasn't been part of the movement so-called. There I think resents the cost of having to pay $25 to cure an itch many just go in the New York City they charge 50 and $75 to put it in the eye you dig which they spend about two minutes doing most of them don't even take the time to use little local anesthesia first which would make it a lot less pain. They lied to the families about how it's not going to hurt and then very often it's excruciating they go through the ceiling. I wasn't aware that there were even some doctors during the eye itself is worth a few cents. I don't know it's just. That is not tenable that this little piece of plastic or whatever it is and five minutes of the doctor's time I mean the other thing is just an illustration I think of a small thing in which the gynaecologist does not consider the comfort of the patient but his

own bed. Many women mention is how cold the metal speculum feels and when it goes in it so it feels like a shock to the body and it's very simple to warm them. But the only reason doctors don't have you can just keep the heating pad below the table new examining tables actually have them built in. It's because it takes up more toll on their water the doctors take up more time because they can see fewer patients and just the feeling that you're part of a factory and you know whether it's an infection or anything that you're to be you come in and go out as quickly as possible and that certainly discourages asking questions about our health. And since a gynecologist is a doctor that deals with all sexual in the anime it doesn't make it very conducive to speak freely about any questions we may have and then if we do want to the assumptions of most gun ecologists are so conventional that it makes it very hard for women who don't fit into the conventional lifestyles of doctors too. This is a very common complaint among younger women.

There's another fact here. That has been mentioned often and complaints that that I've heard from women about their grandpa just that we have brought up the gynecologists are trained to think of women as having a lot of psychosomatic problems. They have a sort of a it's all in your pretty little head attitude. Many of them I mean again of course I'm not speaking of all of them. And you can see this in their medical school. Let's go let's talk about the Trinitarian and well into for example one of the most widely used textbooks a textbook by Dr. Wilson at the University of Michigan says the traits that compose the core of the female personality are feminine narcissism masochism from and past 70. So even if the medical student starts out as a nice kid he's likely to be a screwed up sexist by the time he finishes memorizing passages like that. Then the drug company advertising which shows women with all the psychosomatic. So if a woman is for example taking the birth control pill.

And is having symptoms and she comes in to see her gynecologist over and over. Women have reported to me that they feel as though they were up against a stone wall that the gynecologist makes them feel as though it must be all in their heads and that term hysteria comes from the Greek word for you at risk. Men have always assumed that somehow because we have you to ride we're doing this is that we're more emotional than they are and not to be taken seriously if they're anything positive about a banjo medical school training I mean well it's funny because this thing of assuming we're too hysterical has the almost everything with women's health issues it has to start. We're both so hysterical that we have to be knocked out or overly sedated I mean or the other side we're treated like corpses and I was telling you earlier that I think one. Factor in explaining why doctors treat all patients including male patients. As if they're little more than living corpses because they're introduced to the human body

with the cadaver for an entire year they work on something that is cold and ERD and cannot respond I think that's a very profound experience. That's hard to do know I would say in addition to studying anatomy via the co-op's I'm not advocating we should cut up live people medical students could be introduced to real patients at the same time so it isn't one year of something they can never respond. I think everyone seeing who has been in the hospital has seen doctors standing around having a conference among themselves within a few feet of a patient's bed talking as if the patient cannot hear. There's something really bizarre about that until you think back to that whole year of working on a cadaver. Why don't men complain more about health care and you know something you just said where yeah I was away. But I think. They don't use the health system as much as we do so that's the first most obvious reason that a healthy male of 40 has had very few routine experiences with a doctor whereas a healthy woman of 40 has been

poked and probe been pelted so many times. And then if you take into account the pediatric visits the percentage which she uses the doctor is so much greater than that of the men that I think we just have so much more contact that we. Are. You know we are the health consumers up to a certain age. If I could just get back to your last one moment about medical school. Yeah I really think that every. Male doctor who wants to go about ecology should be required to get up on a table and put it like a life in the stairs and have somebody call speculum into his. What did she call it. Do they what it says. They really have many of them have no sense at all of how humiliating and unpleasant the experience is I know some doctors have actually done that well. Yeah I got a rather nice one I think there are there is a change certainly among younger medical students and even some of the other doctors they are trying very hard and I think the women's health movement has made an impact and doctors have beginning to

wonder what they can do to make things better and some are warming the speculum. One thing I think we have to be a little bit wary of are the hip young doctors who think well we'll just take a very detailed sexual history this is what they want they are women and that's not what a better health care is I resent that unless it's something I feel like talking to I mean my idea of improve gynecological services not you know someone should do a health sexual survey on me unless I. Feel like talking about that I'd much prefer to have routine care before that or have that is my choice but there are a lot of doctors I think who quite that. With women's demands and gynaecology I don't know Bob or if you have any feelings you have really well with her you heard I know this story about a rather admired gynecologist in New York who has this fantasy of setting up a sex clinic where he can teach women how to masturbate. Yeah and that is a lot of the ones who were being aware of the ones that seem young and hip.

Give me a nice all conservative. Do you get out of college gentlemen or woman. Barbara do you go to a gun coma No I don't. Know. I go to an internist and I'd like to tell your viewers that many women go to a gynecologist as their main doctor because they think that the gynecologist is the only one. That can do a pelvic and. Pap smear and the check up in that area and it's not to a great many Internists are willing to do it and they're perfectly competent to do it now. Then if the internist finds some special condition that needs further attention. He sends me to a gynecologist but I want the internist looking over. The gynecologist shoulder and I want the internist to be my main doctor in the gynecologist just to be a consultant because internist are trained as the traditional guardians against unnecessary surgery and they think of surgery as a last resort

whereas gynecologists are trained as surgeons and like generals who are trying to fight and want to fight the gynaecologist of trying to operate and they want to operate. And it's really quite scandalous I think. How many unnecessary surgical operations are performed on you have this do you recall the figures and once direct me you know according to a study done by nater in cooperation with doctors in a hospital who supplied him with the figures with up they're revealing their own names to protect their jobs. It was a conservative estimate that one third of full hysterectomy is performed in the hospitals they studied were totally unnecessary and then there was a fairly large percentage that were questionable there was some pathology and it was a you know well a real question whether they should be performed. But one third which were definitely on this are I'd hate to think of how many unnecessary Da Vinci's are before because that seems to be something that a gynecologist will say to have done if you have any complaint that the gun call just can't.

Explain and I can confirm Barbara's advice about your experience with gynecologist operating I mean I've tried to liberate myself from my gynecologist if you haven't got a cold. No I have had a gynecologist and I have had a lot of operations and I had one very good Diana colleges two who. Advised me not to have operations that others did and I. Feel I should mention his name even though he's retired because I think one of the things we should start doing in medicine is name names his name is grey Twamley. We're so accustomed to protecting doctors that even when we want to say I had this terrible experience we still don't mention the name of the doctor and yet I think to be very useful if we could get a directory of good doctors and bad doctors. This is very hard to know how does or does that so inexcusable and which we in the Women's Health are going to try to counter is that there's this old school tie feeling about protecting their colleagues so that all the doctors in the community know who the

incompetent ones are and they also know who the unethical ones are. And yet they cover up. And they still assume. And women are still told you know call your county medical society as long as he's licensed he must speak koshary and home and. Make him a bed for another interview. Anyhow at in New York City at one of the women's health groups that Alan and I have both been involved in. We've been doing a Health Watch where we collect women's reports on their gynecologist. And there were several reports from different women about a gynecologist who. Was doing something about it may have been performing clinical massage and said look I was making sexual advances. And. So whenever doctors have said to me oh Has your Healthwatch coming. And I've mentioned that. Well we've discovered a few doctors who seem to be making sexual advances. They always know who they are.

I mean every doctor in New York City you know because you know but they had don't turn then it's another thing that's come out of this which is interesting and shows that there is a real influence I think is that there was one doctor that consistently was described as just being different from any other gynecologist His name is Ed Stedman. Enough women reported this so that finally when a woman's clinic was looking for a director they approached this head stem who just had a little shabby office in the Bronx and he says he's now a new director I mean because so many women independently had written such. Good things not he's great not he's marvelous not he's a god but it's just a different kind of experience he explains everything and he is quite an unusual person. The other thing I want to mention just along these consumer lines of where we we don't mention names and doctors protect one another is when you start to think about it in any detail it sort of becomes shocking. I mean the fact that we pay for X-rays and yet we don't own them. If that would be true of any other product that we had

purchased we would make a big fuss if we did it in town and then the other examples I think that make the point of how little we question established ways in medicine are for instance if you went to a lawyer who said Sure Will you write up a contract but it will be in Latin and we would think it very odd that we don't question that with prescriptions and my third is if we went to say an architect who said he drew up a plan for a house but wouldn't show it to us we would certainly think something on yet we don't question the fact we can see our medical records. We don't see ourselves as consumers. I think we don't see ourselves as consumers I think there's a lot of fear this is going back to Barba zero point about the body as mysterious doc particularly the who's the watch here. You know a great reluctance because we've been trying to be very fearful in the body's been mystified the doctor has been mystified it's done in a very early age when we're five or early on. I still recall my first experiences with a doctor being bribed with lollipops and things like that. And so I think the doctor has such an

early psychological start I mean all professionals have a mystique teaches and lawyers and whatnot but we don't deal with lawyers when we're five years old so children develop at a very early age certain distinct feelings about doctors. And then it's very easy to to work on these feelings and it's very much the doctor's advantage to be mystified aside from giving him a sense of power. He can then charge prices and we we don't question his we think what he does is just so. So difficult to do and so end is dealing with such a mysterious thing. Once we start to learn a little bit about it we realize it isn't at all difficult and we start to question then all these other areas and you will be more in charge as you mention in your book. One incident where you looked under a microscope at us through Internet was sort of interesting I was just lying on the table and the doctor had taken his smear. I had symptoms of an infection and rather than live there in that state of terror which I think ignorance creates i the microscope was right

there and I asked if I could look under the microscope and see those really an eye opening experience just to see those little things. Nose. Swimming about they came from my body. It was interesting because for one I could see what the doctors looking at. I could see what process is involved. When you look put a slide underneath and what had happened and then I also I realize it wasn't that difficult to do that one could be trained to do that and then then I start to question well how come $35 a soul takes five minutes. Another $10 for Flagyl 10 15 whatever you start headed up in one you know begins to question the whole thing but demystify what he was doing it demystified my body so much and it also made me feel less passive you know than just lying there feeling frightened. Now you talk about impractical think anything that isn't. Right out of time we have an in the in the women's health movement that as women take courses in their bodies and get to feel at home in them. There they feel born at

home in the world. It's just and often their sex lives improve too that's not what I mean. Then if I was working you probably ended up going to be bad what are some questions that a tough woman should ask her gynecologist and what's a criteria. Well I think one of the things that we should you know a general rule is that we should realize that the gynecologist has been taught about our bodies in general even though he doesn't behave that way. So if we have cramps in our legs and we're on the birth control pill it's quite important to mention what we know is some kind of funny clotting. That's not related to the genital area we should still bring it up and yet I think many women me hesitate. Another interesting thing that came out of a survey a group of women lead women did on gynecological services in New York where they found that the part of the examination most frequently omitted is the breast examination list. You know if you go in for an infection or an IUD or something rather than a thorough examination a doctor will not

automatically examine the breast and yet that's that's quite important. Was that a thing called How to get through. Yes with your feet it was terrible. Oh I don't know how. I got to the gynaecological maze with your feet mister but I went through the gynaecological maze of New York and produced a very useful directory this is the women's health and fortune of the. Project of New York that then became the Women's Health Organizing Project at Barber and I've been associated with the barber What about the public image of drugs. I think the public image until recently in this country was that if one pill is good two pills or twice is pretty good and he repeals or three times this. But I think Americans are gradually becoming aware that these modern form of sucrose are very powerful and should not be taken lightly in the city of Boston Allen may know more about this than I do they monitored all hospital admissions during a certain period and they found out that something like 5 percent or 8 percent of all hospital admissions were due to reactions to a

prescription drug. There are more people going to the hospital with reactions to prescription drugs than getting sick from pot and stuff like that if the truth be to know that. Also they found that among patients who are already in the hospitals a very high percentage had their stay prolonged because of a reaction to a drug. Or is it a drug given in the hospital. It was very scary and I think that among people who are fairly knowledgeable about how. There's been a great backing away from from drugs recently perhaps should a woman ask for the spec sheet on a drug or I would I would and I think if you don't start we should start having a Physician's Desk Reference is as are as we have a dictionary the not impossible to read. We've just been led to believe they are. We should check out everything we're not told the contra indications of drugs that were given very readily by doctors we just accept them. That's just frightening when you start to look at them in the cautions I mean just most recently I came across a booklet on

estrogen replacement therapy and at the very back where the list of contraindications and yet the booklet which was a very insulting style to women call it tunes it showed a woman in front of over a manufacturing company the shade pulled down it said closed forever with a big padlock on the door. And of course the whole a so was she wouldn't experience medicine masculine even though women were shown with beards and raises near that show yes but with a woman says in his big best selling sex tell it to a different room and a sad face you give the man more publicity but he's had so what I don't matter. He says. That was turned into. He says your hair on your head you start to get bald you start to grow hair on your face your breasts and your vagina shrivel. All this is happening because your estrogen is shut off. And then he says no longer a woman but not strictly a man either. You

inhabit the tragic world of sex on that note so tragic as hell. And I thank you very much for being here. Good night. See you again next week.