Resident totally messed up gyn exam performed on me. How big of a deal is this?

[uggggh]

Hello all!

This is a throw-away account for reasons that will soon become obvious. I have been a member of SDN for over three years, and would truly value this community's input on a very private/ painful/ sensitive issue.

Today, I had a routine gyn/well-woman check up. Everything went great with the nurse, I told her I got a PAP smear in 2014 that came back normal (as did all the ones before that) and she informed me that I would not need one today. Things started to go bad when my doctor entered the room. He was a young resident (about same age as me). He was clearly uncomfortable with the situation from the start. He couldn't even say the word "period" to me. This, of course, made me feel uncomfortable and awkward. He told me I would need a PAP smear. I didn't question him, because I assumed he knew more than I did about the guidelines. He asked if I had the guardasil vaccine. I told him I had the first round of it in 2014, but didn't follow up. He told me I should restart with the first vaccine today. Sure. I changed, and he came back into the room. He didn't say hi or even make eye contact with me, he just started the exam as soon as the nurse got in the room. This made me feel so awkward and embarrassed, as if it was my fault for putting him in this uncomfortable situation. He took the PAP smear sample. I didn't feel him perform a visual exam, and he didn't perform a breast exam, which I know should have been a part of the well woman exam. He left quickly, without another word. I didn't get the chance to ask him for a refill of a birth control prescription. I got changed, and the nurse came back into the room to give me the guardasil vaccine. The nurse then left.

After that, my doctor and his attending came back into the room. The attending explained that I didn't need a PAP smear, and that if they ran the sample, my insurance might not cover it. She also informed me that the guardasil vaccine might not be covered by my insurance, because I am too old.

I was shocked. How could this resident perform an exam so incompetently, and be so ignorant of these basic guidelines? I was already really uncomfortable and embarrassed. Then, I get news that this guy's careless ignorance of screening/vaccination protocol could cost me money. I was so mad at this point that I felt my face turning red while the attending doc was still speaking. I was, and still am, furious at her. How could she let someone so incompetent lay his hands on me? How could she let someone with so little knowledge and experience conduct such a private exam on me? I felt violated and disgusted with the whole experience- meanwhile- this attending doc is prattling on with patronizing instructions regarding the birth control I have already been taking for 3+ years. I cut her off, and left the office.

I felt so bad/ violated/ terrible that I cried all the way home from the doctor's office. I am very mad and upset. Given these feelings, I need a fresh perspective. Should I file a complaint with the hospital or any other entity? I really want to threaten to sue, just to make a point that it is NOT OKAY to treat young women this way. (This happened at UVA by the way). I was recently accepted into medical school, and obviously understand that student doctors need patients to "practice" on, but, I don't know...Am I being unreasonable? Please let me know what you think before I sue the hospital into the ground.

TL; DR- Inexperienced resident royally ****ed up my gyn exam, making me feel embarrassed and violated. He took an unnecessary test sample, and gave me an unnecessary vaccine my insurance might not cover. Should I file a complaint with the hospital?

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[dntke1518]

Hello all!

This is a throw-away account for reasons that will soon become obvious. I have been a member of SDN for over three years, and would truly value this community's input on a very private/ painful/ sensitive issue.

Today, I had a routine gyn/well-woman check up. Everything went great with the nurse, I told her I got a PAP smear in 2014 that came back normal (as did all the ones before that) and she informed me that I would not need one today. Things started to go bad when my doctor entered the room. He was a young resident (about same age as me). He was clearly uncomfortable with the situation from the start. He couldn't even say the word "period" to me. This, of course, made me feel uncomfortable and awkward. He told me I would need a PAP smear. I didn't question him, because I assumed he knew more than I did about the guidelines. He asked if I had the guardasil vaccine. I told him I had the first round of it in 2014, but didn't follow up. He told me I should restart with the first vaccine today. Sure. I changed, and he came back into the room. He didn't say hi or even make eye contact with me, he just started the exam as soon as the nurse got in the room. This made me feel so awkward and embarrassed, as if it was my fault for putting him in this uncomfortable situation. He took the PAP smear sample. I didn't feel him perform a visual exam, and he didn't perform a breast exam, which I know should have been a part of the well woman exam. He left quickly, without another word. I didn't get the chance to ask him for a refill of a birth control prescription. I got changed, and the nurse came back into the room to give me the guardasil vaccine. The nurse then left.

After that, my doctor and his attending came back into the room. The attending explained that I didn't need a PAP smear, and that if they ran the sample, my insurance might not cover it. She also informed me that the guardasil vaccine might not be covered by my insurance, because I am too old.

I was shocked. How could this resident perform an exam so incompetently, and be so ignorant of these basic guidelines? I was already really uncomfortable and embarrassed. Then, I get news that this guy's careless ignorance of screening/vaccination protocol could cost me money. I was so mad at this point that I felt my face turning red while the attending doc was still speaking. I was, and still am, furious at her. How could she let someone so incompetent lay his hands on me? How could she let someone with so little knowledge and experience conduct such a private exam on me? I felt violated and disgusted with the whole experience- meanwhile- this attending doc is prattling on with patronizing instructions regarding the birth control I have already been taking for 3+ years. I cut her off, and left the office.

I felt so bad/ violated/ terrible that I cried all the way home from the doctor's office. I am very mad and upset. Given these feelings, I need a fresh perspective. Should I file a complaint with the hospital or any other entity? I really want to threaten to sue, just to make a point that it is NOT OKAY to treat young women this way. (This happened at UVA by the way). I was recently accepted into medical school, and obviously understand that student doctors need patients to "practice" on, but, I don't know...Am I being unreasonable? Please let me know what you think before I sue the hospital into the ground.

TL; DR- Inexperienced resident royally ****ed up my gyn exam, making me feel embarrassed and violated. He took an unnecessary test sample, and gave me an unnecessary vaccine my insurance might not cover. Should I file a complaint with the hospital?


PS- This is a useless response: "Calm down, you're overreacting."

I don't believe breast exams are part of guidelines for well woman exams anymore, I could be wrong though. He could be a resident on an off service rotation and hasn't gotten a hold of every nuance yet, not saying it's an excuse. I understand you are upset, but why are you jumping to sue?! And you said that you were recently accepted and will be matriculating? You will learn soon that you are not perfect. But sure, cast the first stone.

Also, don't come to a message board and tell people what is a "useless response". It's about as ridiculous as saying you will sue the hospital into the ground.

 

[Trauma Surgeon]

I'm sorry for your bad experience!
But, remember that we all do mistakes, some of them are not excusable, some even punishable, but his mistake is neither in my opinion (not being a OBGYN). One of my residents put a patients through a totally unnecessary MRCP last week, the patient did feel extremely claustrophobic, so she had to administrate a "lot" of sedatives to complete the exam. I know after me talking to her she will never do this mistake again…
I'm assuming the residents supervisor/attending did have a talk with him in regards to the unnecessary PAP smear, so for you to make things even harder or worse for him by filing a charge against him will not make him a better doctor nor make you feel better.

 

[uggggh]

I don't believe breast exams are part of guidelines for well woman exams anymore, I could be wrong though. He could be a resident on an off service rotation and hasn't gotten a hold of every nuance yet, not saying it's an excuse. I understand you are upset, but why are you jumping to sue?! And you said that you were recently accepted and will be matriculating? You will learn soon that you are not perfect. But sure, cast the first stone.

Also, don't come to a message board and tell people what is a "useless response". It's about as ridiculous as saying you will sue the hospital into the ground.

Thanks for your feedback.

 

[uggggh]

I'm sorry for your bad experience!
But, remember that we all do mistakes, some of them are not excusable, some even punishable, but his mistake is neither in my opinion (not being a OBGYN). One of my residents put a patients through a totally unnecessary MRCP last week, the patient did feel extremely claustrophobic, so she had to administrate a "lot" of sedatives to complete the exam. I know after me talking to her she will never do this mistake again…
I'm assuming the residents supervisor/attending did have a talk with him in regards to the unnecessary PAP smear, so for you to make things even harder or worse for him by filing a charge against him will not make him a better doctor nor make you feel better.

Thank you so much for replying! I am so, so upset right now. I am sure when I calm down, I will be able to see things more clearly. Despite the melodramatic language in my original post, I seriously doubt I will even consider suing. Both of my parents are malpractice lawyers, so this is (unfortunately) a very easy knee-jerk reaction for me to have. I am also acutely aware that the lawsuit would get nowhere. In my moment of weakness, I was honestly just comforted by the idea of my dad yelling at someone for making me feel so bad.

Thank you for your kind and comforting response. I really appreciate it!

 

[gracie369]

Obviously the resident is not up on the current guidelines, which led to some frustration. There is a real good chance that the attending already made him feel like a complete idiot. I would cut him some slack on this one. After med school you will see how insanely stressful residency can be at times. If you will be starting at UVA this summer there is no way I would bring a lawsuit against the hospital. Just not a great way to start.

 

[uggggh]

Obviously the resident is not up on the current guidelines, which led to some frustration. There is a real good chance that the attending already made him feel like a complete idiot. I would cut him some slack on this one. After med school you will see how insanely stressful residency can be at times. If you will be starting at UVA this summer there is no way I would bring a lawsuit against the hospital. Just not a great way to start.

Thank you for your reply!
I'm not starting at UVA, but suing a hospital still would be a very ominous way to begin med school My original post was certainly melodramatic. I was definitely speaking more out of anger and sadness. Responses like yours are exactly why I posted my story on here. I think the only way for me to calm down/ feel better/ build empathy will be to gain insight from residents about what my doctor was going through. I really appreciate your response!!

 

[qwerty89]

Jesus Christ.

So basically all the resident did wrong was tell you that he was going to give a vaccine and do a pap smear.

Thats it.

Note that he didnt actually give the vaccine or send the smear to the lab. He went to his attending to present the plan and confirm/change it. That's exactly what you are supposed to do as a resident.

And you feel insulted because the attending actually took the time to explain your birth control? Dear god. You do realize that this is all a part of good medicine because many women f*** up taking their bcps. Not to mention the fact that the attending needs to document that "counciling was provided" in the progress note.

I almost thought this was a troll post at first with the combination of narcissism + malpractice attorney parents + thoughts of suing.

Copy and paste your post for safekeeping somewhere. Then in a few years when you are a resident I want you to read your post and then you will realize how ridiculous it is.

Because of course a special princess like you would never make a mistake...

Also I love the irony of a medical student threatening to sue a resident. You will soon discover what kind of a nuisance people like your parents are to the practice of good medicine...

 

[uggggh]

Jesus Christ.

So basically all the resident did wrong was tell you that he was going to give a vaccine and do a pap smear.

Thats it.

Note that he didnt actually give the vaccine or send the smear to the lab. He went to his attending to present the plan and confirm/change it. That's exactly what you are supposed to do as a resident.

And you feel insulted because the attending actually took the time to explain your birth control? Dear god. You do realize that this is all a part of good medicine because many women f*** up taking their bcps. Not to mention the fact that the attending needs to document that "counciling was provided" in the progress note.

I almost thought this was a troll post at first with the combination of narcissism + malpractice attorney parents + thoughts of suing.

Copy and paste your post for safekeeping somewhere. Then in a few years when you are a resident I want you to read your post and then you will realize how ridiculous it is.

Because of course a special princess like you would never make a mistake...

Thanks for your reply! No, this is not a troll post. I had a really terrible experience at the doctor's office today, and am seeking balanced, thoughtful feedback from a community that is in a good position to help me understand the resident's side of things. I will admit that my reaction was melodramatic. I will certainly not sue- I was speaking more out of sadness and anger- and reached for the nearest empty threat I could think of. This was uncalled for on my part.

However, I must say that I am surprised at the vitriolic tone of your post. I do not think the only thing the resident did wrong was "going to give a vaccine and do a pap smear." He did give me the vaccine, that I will be obligated to pay for out of pocket, as I 'aged out' of the HPV vaccine guidelines for my insurance. Furthermore, for me, PAP smears are super uncomfortable. I am still awake (3:30am my time) due to the cramping that I always get after this procedure. It is extremely annoying to be in pain and know that it was totally avoidable- if only my doctor had prepared himself properly for my appointment.

I would also draw your attention to the increased discomfort, embarrassment, and violation that I felt during an already horrible exam, that was caused entirely by the incompetency of my doctor. I understand he is a resident. However, I feel there are very simple steps he could have taken towards making my visit less traumatizing. Treating me with kindness (or at the very least, respect) would have gone a long way towards mitigating my discomfort. I do not think that asking a resident to treat me in a dignified manner qualifies me as "narcissistic" or "a special princess." If you disagree on this point, I think we fundamentally disagree on how doctors should treat their patients, and I doubt we will get very far in the context of this thread.

I also can't help who my parents are- I mentioned this information solely to give context for the form my anger manifested in.

I was not aware that doctors are obligated to council their patients on medicine that the patient has been taking for a long time. Thank you for bringing this to my attention. I thought she simply hadn't read my medication history.

Overall, the two mistakes my doctor made in treatment protocol (giving me the unnecessary PAP smear and vaccine) would have been totally and completely forgivable if he had just treated me with the respect and dignity that all patients (including me) deserve. I work at a hospital, and I have made a lot of mistakes! I never claimed to be infallible. I completely understand how easy it is to forget details in the midst of such a chaotic environment. What is unforgivable to me is that my doctor did not show an ounce of compassion, nor make any effort to preserve my self-respect or dignity during a private, awkward, and sensitive exam. I felt violated as a result of his treatment.

I appreciate your feedback, and hope my response was elucidating!

 

[Ray D. Ayshun]

Sorry about your experience. on some level, there was negligence involved here, but it's the damages, or lack of substantial ones, that would make this a less than a worthwhile case. On the other hand, as a future doctor, it is important to remember this, but not because residency is hard, like the crybabies above are saying (If you're a resident and don't know the appropriateness of what you're prescribing, then don't f***ing prescribe it). Rather, remember what it's like to be a patient.

As for medmal lawyers, some are good some are bad, just like doctors. Importantly, they protect us from the incompetent practioners that the resident mentioned here is on his or her way to becoming.

 

[j4pac]

Clearly the resident didn't know what he was doing. But he was a resident. I'm sorry your experienced sucked...but next time get a female attending to do your well woman exam.

 

[giantswing]

Just wait till youre a resident. On some level youll feel sorry for the poor bastard.

 

[VA Hopeful Dr]

So I'm going to take a swing at this from a more clinical angle...

I know many physicians who will do paps on new patients assuming it has been at least 1 year since last pap. This is a risk-management type decision based on a long history of patients having no idea exactly what their test results show. There are also some of us who will do paps every 2 years on patients under 30 since they are a higher risk population to begin with. Its the same reason the HPV vaccine is suggested up to age 26.

Likewise with the vaccine, once you've started its a good idea to finish the series. Its not like there is something magical that happens on the 27th birthday that makes you invulnerable to HPV.

Now past all that, it does suck that the experience was not pleasant for you. This is, unfortunately, the risk you run with going to a resident clinic. I'd be willing to bet this was that guy's first or second pelvic as an actual doctor and that is nerve wracking. Try to look on the bright side - hopefully this experience will help him become better so his future patients have a better experience than you did.

 

[uggggh]

Sorry about your experience. on some level, there was negligence involved here, but it's the damages, or lack of substantial ones, that would make this a less than a worthwhile case. On the other hand, as a future doctor, it is important to remember this, but not because residency is hard, like the crybabies above are saying (If you're a resident and don't know the appropriateness of what you're prescribing, then don't f***ing prescribe it). Rather, remember what it's like to be a patient.

As for medmal lawyers, some are good some are bad, just like doctors. Importantly, they protect us from the incompetent practioners that the resident mentioned here is on his or her way to becoming.

Thank you!! I agree

 

[uggggh]

Clearly the resident didn't know what he was doing. But he was a resident. I'm sorry your experienced sucked...but next time get a female attending to do your well woman exam.

Lesson learned! : )

 

[uggggh]

So I'm going to take a swing at this from a more clinical angle...

I know many physicians who will do paps on new patients assuming it has been at least 1 year since last pap. This is a risk-management type decision based on a long history of patients having no idea exactly what their test results show. There are also some of us who will do paps every 2 years on patients under 30 since they are a higher risk population to begin with. Its the same reason the HPV vaccine is suggested up to age 26.

Likewise with the vaccine, once you've started its a good idea to finish the series. Its not like there is something magical that happens on the 27th birthday that makes you invulnerable to HPV.

Now past all that, it does suck that the experience was not pleasant for you. This is, unfortunately, the risk you run with going to a resident clinic. I'd be willing to bet this was that guy's first or second pelvic as an actual doctor and that is nerve wracking. Try to look on the bright side - hopefully this experience will help him become better so his future patients have a better experience than you did.

Thank you for your reply! I understand and appreciate the arguments you are making from a clinical angle. They do put my doctors actions in an important context. What confuses, and disturbs, me is that the nurse who checked me in, and the attending (after it was too late) were all on board with the treatment protocol I knew I was supposed to get. I brought the results and date of my last PAP. The nurse agreed that I did not need one today- an assertion the attending later confirmed. The PAP sample my doctor took was not sent to the lab. He was completely ignorant of the screening guidelines, and put me through and unnecessary and painful procedure.

Thank you for explaining why he might have decided to give me the vaccine. Unfortunately, I received the first round of it too long ago for it to "count" in this current series. I understand that people in their late 20's are susceptible to HPV. However, his ignorance regarding the insurance coverage for this procedure will result in me having to pay for this out of pocket. Had I known this before being given the vaccine, I would have declined it. I can certainly meet him halfway on this one- it might be unfair of me to expect residents to be familiar with insurance guidelines. It does not, however, make it any less frustrating that I will be financially culpable for his mistake.

Here is a question that might have prevented this whole experience- if you seek treatment at a hospital affiliated with a medical school, is it likely that you will be treated by a student? I chose to have my appointment at UVA because the hospital has an excellent reputation. I didn't realize there was a chance that I would be seen by a student for this exam, because I never would have gone there. Thank you for bringing this possibility to my attention!! I really appreciate you taking the time to respond to my post!

 

[VA Hopeful Dr]

Thank you for your reply! I understand and appreciate the arguments you are making from a clinical angle. They do put my doctors actions in an important context. What confuses, and disturbs, me is that the nurse who checked me in, and the attending (after it was too late) were all on board with the treatment protocol I knew I was supposed to get. I brought the results and date of my last PAP. The nurse agreed that I did not need one today- an assertion the attending later confirmed. The PAP sample my doctor took was not sent to the lab. He was completely ignorant of the screening guidelines, and put me through and unnecessary and painful procedure.

Thank you for explaining why he might have decided to give me the vaccine. Unfortunately, I received the first round of it too long ago for it to "count" in this current series. I understand that people in their late 20's are susceptible to HPV. However, his ignorance regarding the insurance coverage for this procedure will result in me having to pay for this out of pocket. Had I known this before being given the vaccine, I would have declined it. I can certainly meet him halfway on this one- it might be unfair of me to expect residents to be familiar with insurance guidelines. It does not, however, make it any less frustrating that I will be financially culpable for his mistake.

Here is a question that might have prevented this whole experience- if you seek treatment at a hospital affiliated with a medical school, is it likely that you will be treated by a student? I chose to have my appointment at UVA because the hospital has an excellent reputation. I didn't realize there was a chance that I would be seen by a student for this exam, because I never would have gone there. Thank you for bringing this possibility to my attention!! I really appreciate you taking the time to respond to my post!

Ah, I didn't realize you had the last pap results with you. That does change things.

If you get billed for the HPV vaccine, take it up with the clinic. They should eat the cost of that since it was their mistake.

Yes, going to university-affiliated clinics means there is a very good chance you'll have students/residents. For routine stuff, I would avoid university settings like the plague.

 

[Promethean]

I didn't start getting the HPV vaccine until well after 27, because it wasn't available when I was younger. I still got the whole series because a vaccine that can help prevent a devastating communicable cancer seemed worth the expense to me. If your parents are both malpractice lawyers, I'm going to guess that you can likely afford the modest expense (under $200 per dose), even if it does need to be paid out of pocket.

It does suck that you got an exam that you didn't need. But, there are many lessons in this experience. Rather than looking to punish someone for a mistake, you have now had a first person experience of why it is so important for patients to advocate for themselves, and to be listened to when they have concerns/objections. You could have asked questions that you didn't ask, because you placed too much faith in the young physician's authority. Now you know, from personal experience, how it feels to be in that situation, how easy it is to go along with what a doctor is telling you and to push aside your own misgivings. Now, you will know to look out for that and to encourage your own patients to question what you are telling them until they are satisfied that they understand, rather than getting annoyed that they won't just listen to what you are saying and "be compliant."

It is still on him to know the guidelines, and he did make a mistake. As others have said, I'm sure that he is going to catch hell from his attending for that. A threat to sue isn't going to make it not have happened, or make anyone do better in the future than they would have done without the threat.

 

[uggggh]

I didn't start getting the HPV vaccine until well after 27, because it wasn't available when I was younger. I still got the whole series because a vaccine that can help prevent a devastating communicable cancer seemed worth the expense to me. If your parents are both malpractice lawyers, I'm going to guess that you can likely afford the modest expense (under $200 per dose), even if it does need to be paid out of pocket.

It does suck that you got an exam that you didn't need. But, there are many lessons in this experience. Rather than looking to punish someone for a mistake, you have now had a first person experience of why it is so important for patients to advocate for themselves, and to be listened to when they have concerns/objections. You could have asked questions that you didn't ask, because you placed too much faith in the young physician's authority. Now you know, from personal experience, how it feels to be in that situation, how easy it is to go along with what a doctor is telling you and to push aside your own misgivings. Now, you will know to look out for that and to encourage your own patients to question what you are telling them until they are satisfied that they understand, rather than getting annoyed that they won't just listen to what you are saying and "be compliant."

It is still on him to know the guidelines, and he did make a mistake. As others have said, I'm sure that he is going to catch hell from his attending for that. A threat to sue isn't going to make it not have happened, or make anyone do better in the future than they would have done without the threat.

Thank you so much for your reply! It certainly was a learning experience.

I am glad for you that you were given the opportunity to make a financially informed decision about the HPV vaccine. I was not afforded this opportunity, and would have declined the vaccine if I had been given the appropriate information.

You have made several incorrect assumptions about my financial situation. Despite my parents' occupation, I currently cannot afford to pay out of pocket for this unnecessary medical procedure. This is not a "modest expense" for me. If I am billed, I most likely will pay for it with student loans.

I did not get an exam I didn't need. I was given a PAP smear I didn't need. These are two different scenarios. PAP smears are extremely uncomfortable for me. I was awake until 3:30am last night with cramping. It is frustrating to be in pain due to someone else's ignorance.

Yes, there are questions I could have asked. However, I think it is dangerous to place the blame on me for having "too much faith in the young physician's authority." As I have said before, his mistakes in treatment protocol (incorrectly administering a PAP smear and giving me a vaccine I will have to pay for out of pocket) would have been completely forgivable had he treated me respectfully. It was his bedside manner that made me uncomfortable and embarrassed during an already awkward exam. He has an obligation to preserve the dignity and self-respect of his patients, regardless of how invasive a medical procedure may be. This is where he failed me. The way he treated me made me feel violated.

As I have said before, my threat to sue was an empty one- I was speaking more out of sadness and anger- and reached for the nearest empty threat I could think of.

You are right! This experience will stick with me for the rest of my life. I am sure it will make me more aware of my patients' need for clarification. Thanks for taking the time to read my post! : )

 

[DokterMom]

I didn't start getting the HPV vaccine until well after 27, because it wasn't available when I was younger. I still got the whole series because a vaccine that can help prevent a devastating communicable cancer seemed worth the expense to me. If your parents are both malpractice lawyers, I'm going to guess that you can likely afford the modest expense (under $200 per dose), even if it does need to be paid out of pocket.

It does suck that you got an exam that you didn't need. But, there are many lessons in this experience. Rather than looking to punish someone for a mistake, you have now had a first person experience of why it is so important for patients to advocate for themselves, and to be listened to when they have concerns/objections. You could have asked questions that you didn't ask, because you placed too much faith in the young physician's authority. Now you know, from personal experience, how it feels to be in that situation, how easy it is to go along with what a doctor is telling you and to push aside your own misgivings. Now, you will know to look out for that and to encourage your own patients to question what you are telling them until they are satisfied that they understand, rather than getting annoyed that they won't just listen to what you are saying and "be compliant."

It is still on him to know the guidelines, and he did make a mistake. As others have said, I'm sure that he is going to catch hell from his attending for that. A threat to sue isn't going to make it not have happened, or make anyone do better in the future than they would have done without the threat.

Beautiful post -- The takeaways are that:

• Yes, you DO need the vaccine, even if your insurance won't cover it. Sucks financially, but clearly, the right thing to do.
• The self-advocacy bit and experience of frustration and dissatisfaction for not having been given the opportunity to express your concerns and question the doc's care plan. SO important. Now you know how it feels from a patient's perspective. Please don't forget that as a physician.

Just wait till youre a resident. On some level youll feel sorry for the poor bastard.

I know it was miserable for you and can empathize with your pain, frustration and embarrassment. It's a nasty combination that rankles for a while.

It's probably too soon, but try to relive this experience from this poor resident's point of view. If his incompetence was so visible to you, imagine how embarrassed and incompetent he must have felt. I'm sure that's why he rushed through and went all 'robot protocol' on you. It's extremely likely he got 'ripped a new one' after your visit. If you can empathize with him, and finally laugh at the poor guy, it might actually make you feel better.

 

[Promethean]

Yes, there are questions I could have asked. However, I think it is dangerous to place the blame on me for having "too much faith in the young physician's authority." As I have said before, his mistakes in treatment protocol (incorrectly administering a PAP smear and giving me a vaccine I will have to pay for out of pocket) would have been completely forgivable had he treated me respectfully. It was his bedside manner that made me uncomfortable and embarrassed during an already awkward exam. He has an obligation to preserve the dignity and self-respect of his patients, regardless of how invasive a medical procedure may be. This is where he failed me. The way he treated me made me feel violated.

I'd like to clarify that I am not seeking to place blame, and certainly not on you. It is a fine hair to split, but I'm not as concerned about what should or shouldn't have happened, or who bears what percentage of the fault for it, as about whether what you take away from it now is beneficial to you. Reframing to find the silver linings is the most adaptive response to a bad experience like this.

I'm sorry that it happened, and that it made you feel that way. You shouldn't have had to go through that. Since you did, I hope that you can take comfort that suffering is the origin of compassion, and know that you have the power to make good come from the bad experience.

 

[uggggh]

Beautiful post -- The takeaways are that:

• Yes, you DO need the vaccine, even if your insurance won't cover it. Sucks financially, but clearly, the right thing to do.
• The self-advocacy bit and experience of frustration and dissatisfaction for not having been given the opportunity to express your concerns and question the doc's care plan. SO important. Now you know how it feels from a patient's perspective. Please don't forget that as a physician.

I know it was miserable for you and can empathize with your pain, frustration and embarrassment. It's a nasty combination that rankles for a while.

It's probably too soon, but try to relive this experience from this poor resident's point of view. If his incompetence was so visible to you, imagine how embarrassed and incompetent he must have felt. I'm sure that's why he rushed through and went all 'robot protocol' on you. It's extremely likely he got 'ripped a new one' after your visit. If you can empathize with him, and finally laugh at the poor guy, it might actually make you feel better.

Thank you so much for taking the time to respond to my post. I feel very lucky to have so many knowledgable and experienced people helping me work through this experience!!

I am aware that I need the vaccine. I simply cannot afford it right now. Had I known that I would be paying out of pocket, I would have waited until I was in a more financially stable position to initiate the vaccine protocol. I am frustrated because I was not given this opportunity.

The self-advocacy part is something that I am working towards!! I will be honest and say that I am not ready to let this guy off the hook for his ignorance regarding well-woman exam protocol. I think once my anger fades, I will be able to look back on this experience more clearly, and see where I could have stepped in to make sure that I was getting the treatment I knew I needed. I think it's a matter of being confident in questioning authority figures- which is an important skill to develop!

I will certainly carry this experience with me into medical school. It has made me acutely aware of how difficult it is to speak up as a patient! I am a naturally outspoken person, but something about the gyn office makes me just want to grit my teeth and get through the whole thing. I know now, more than ever, to check-in frequently with my future patients, and make sure they are on board with their treatment. I want to save them from the humiliating and embarrassing experience I just had.

Thank you for recognizing my pain, frustration and embarrassment. I was thinking in the shower about how if this had been any other type of exam, I would have been completely unaffected by my doctor's treatment! Pelvic exams are so awkward, and already make me feel so uncomfortable and vulnerable. Given these traits of pelvic exams, the young resident was not really set up for success- which is something I am on my way to forgiving him for ; )

I am sure he felt terrible. He looked so out of place, and overall was a nice guy. He was trying, just like I'm trying now to really give him the benefit of every doubt.

Thank you for your thoughtful response!! I really appreciate you taking the time to read through my posts : )

 

[uggggh]

I'd like to clarify that I am not seeking to place blame, and certainly not on you. It is a fine hair to split, but I'm not as concerned about what should or shouldn't have happened, or who bears what percentage of the fault for it, as about whether what you take away from it now is beneficial to you. Reframing to find the silver linings is the most adaptive response to a bad experience like this.

I'm sorry that it happened, and that it made you feel that way. You shouldn't have had to go through that. Since you did, I hope that you can take comfort that suffering is the origin of compassion, and know that you have the power to make good come from the bad experience.

Yes! Thank you!! With the help of you and others in this thread, I am definitely working towards understanding what the guy was going through. There are a lot of important lessons here, and once I stop being so angry (and maybeee a little defensive) I will be able to see them more clearly.

Thank you for your thoughtful responses!

 

[vanasme]

Wow. Talk about making a mountain out of a molehill. Please save this post and re-read it in 5 years when you're an intern/resident. I hope you'll see how dramatically you reacted to a very non-dramatic experiences.

So, you were seen by a resident and things didn't go "perfectly." Surely, as someone starting medical school, you realize that residents are not the same as fully trained attendings. If the resident introduced himself as a resident (working with attending Dr. blahblahblah), your expectations should have adjusted and they didn't. This isn't necessarily your fault - as someone who hasn't gone through the training process (and hasn't been to teaching hospitals in the past) it's hard to understand the resident vs. the attending's role. Usually the resident recommendations align with the attending's. But not always. In this instance, for you, they didn't. It's not like the resident recommended something totally outlandish. A PAP smear and Gardasil... maybe not indicated at this time, but within the realm of possibility for your visit.

I get it. PAP smears cause cramping. They won't last forever. Sorry, not a lot of sympathy for this complaint.

You received a recommended vaccine that your insurance might not cover. Call the office. Speak with their billing. Explain the situation. Most likely you won't be charged. If you are charged and can't pay now, just explain that you'll pay them when you can (with loan money). This is not the end of the world. You got a vaccine you needed and can (very likely) pay for it at a later date.

And I get that you were bothered by his bedside manner. Maybe he was just as nervous as you were! One day you're going to have to perform these very private exams and guess what - they can be just as uncomfortable and embarrassing to perform! Perfecting your bedside manner is also something that occurs during residency - it's a learning process, just like everything else.

As someone going into the medical field, you need to know that YOU ARE GOING TO MAKE MISTAKES (which you claim to understand, but don't sympathize with this resident on any level). You WILL likely harm someone as a resident. Is this "fair" to the patient? Probably not. But residents learn from their mistakes. This is how we train competent attendings (and even attendings still make mistakes).

Lastly, when I read, "How could she let someone so incompetent lay his hands on me?" All I could think was - get over yourself.

 

[Law2Doc]

OP,
Sorry you had a bad experience. I agree with the posters above-- if you get a bill for the unnecessary PAP you should take it up with the billing people and have that taken off your bill.

I am unclear how you "never felt" someone doing a "visual" exam, and I'll defer to other colleagues as to whether you really can't get the HPV vaccine at your age or whether the breast exam is always part and parcel of a routine gyn visit at all facilities.

But suggesting you need to sue over this is really a bit troubling. The guy is in training, something we all go through. you as a premed are really not in a great position (both figuratively and, due to the stirrups, literally) to evaluate his overall examination performance - we only have your impression, and frankly by so quickly screaming "lawsuit" it just doesn't sound like you are the most understanding of patients.

But more concerning, do you really think you are going to get through med school and residency without a few such glitches of your own? Sorry but you absolutely will make mistakes as you learn. Most (like this one) don't really matter, most you'll be able to smooth over or fix. Some will be much worse than a duplicate Pap smear I'll wager. Once in a while you'll deal with an irate person who jumps right from being annoyed to screaming lawsuit. As doctors we try to mollify, but generally try to avoid, this kind of patient.

If you really believe that you are going to flawlessly get through training without ever making a mistake, you should probably change careers now, because odds are extremely high you (all of us, really) will be sued. And my bet is, at that time, you are going to complain that the patient was being hypersensitive and arrogant by thinking they know how to do your job better than you. Just saying.

We all strive to do what's best for our patients, but even the best of us are going to fall short of that goal sometimes, more so in your training. The truism in medicine is if you haven't experienced a few errors or complications, you haven't done enough cases/seen enough patients.

 

[gutonc]

Not sure I've ever actually "liked" one of @Law2Doc's posts before. Just rectified that.

 

[Law2Doc]

... I was thinking in the shower about how if this had been any other type of exam, I would have been completely unaffected by my doctor's treatment! Pelvic exams are so awkward, and already make me feel so uncomfortable and vulnerable. Given these traits of pelvic exams, the young resident was not really set up for success- which is something I am on my way to forgiving him for...

I think you probably came with your own sense of "vulnerability" and expectations about the sanctity of pelvic exams and in this particular situation he wasn't likely to "succeed" regardless. In med school and training you get fairly desensitized about all these exams -- pelvic, rectal, prostate, penile -- it's just an orifice, no big deal, not per se "awkward" once you've done a bunch-- just something you deal with as swiftly and clinically as you can.

 

[uggggh]

OP,
Sorry you had a bad experience. I agree with the posters above-- if you get a bill for the unnecessary PAP you should take it up with the billing people and have that taken off your bill.

I am unclear how you "never felt" someone doing a "visual" exam, and I'll defer to other colleagues as to whether you really can't get the HPV vaccine at your age or whether the breast exam is always part and parcel of a routine gyn visit at all facilities.

But suggesting you need to sue over this is really a bit troubling. The guy is in training, something we all go through. you as a premed are really not in a great position (both figuratively and, due to the stirrups, literally) to evaluate his overall examination performance - we only have your impression, and frankly by so quickly screaming "lawsuit" it just doesn't sound like you are the most understanding of patients.

But more concerning, do you really think you are going to get through med school and residency without a few such glitches of your own? Sorry but you absolutely will make mistakes as you learn. Most (like this one) don't really matter, most you'll be able to smooth over or fix. Some will be much worse than a duplicate Pap smear I'll wager. Once in a while you'll deal with an irate person who jumps right from being annoyed to screaming lawsuit. As doctors we try to mollify, but generally try to avoid, this kind of patient.

If you really believe that you are going to flawlessly get through training without ever making a mistake, you should probably change careers now, because odds are extremely high you (all of us, really) will be sued. And my bet is, at that time, you are going to complain that the patient was being hypersensitive and arrogant by thinking they know how to do your job better than you. Just saying.

We all strive to do what's best for our patients, but even the best of us are going to fall short of that goal sometimes, more so in your training. The truism in medicine is if you haven't experienced a few errors or complications, you haven't done enough cases/seen enough patients.

Thank you so much for replying to my post. As I have said in previous posts on this thread- I fully admit to my reaction being melodramatic. I will certainly not sue- I was speaking more out of sadness and anger- and reached for the nearest empty threat I could think of. This was uncalled for on my part.

The PAP smear was never sent for testing. I am expecting an unnecessary bill for a vaccine that my insurance will not cover.

A clinical breast exam has been part of every other well woman exam I have received. Additionally, the nurse at this office who checked me in left a sheet out "for the doctor to use during the breast exam" as she put it. This leads me to believe he was supposed to do one, and forgot.

I have never said, anywhere on this thread, that I expect to make it through medical school and residency without making mistakes. I truly do not know where you are getting that impression from. I posted my story about a traumatizing experience I had during a pelvic exam given by an inexperienced physician who was clearly unprepared for my visit.

When it comes to receiving a pelvic exam, or an medical treatment for that matter, I expect to be treated with kindness, or at least respect, or at the very, very least, have my dignity and self-respect in some way acknowledged by my physician. None of these things occurred during my visit. Pelvic exams are already horrible experiences for me (and many other women) and I felt violated during the pelvic exam given to me by this doctor. If expecting not to feel violated during a pelvic exam makes me a difficult patient, then so be it.

Thanks for taking the time to read my responses! I really appreciate your feedback and will carry this with me through my medical training.

 

[Law2Doc]

...
I have never said, anywhere on this thread, that I expect to make it through medical school and residency without making mistakes. I truly do not know where you are getting that impression from...

Um, you said a resident screwed up and you were thinking of suing. I don't know what other conclusion we can come to if you think the kind of error is actionable, other than you can't picture yourself screwing up similarly.

 

[uggggh]

I think you probably came with your own sense of "vulnerability" and expectations about the sanctity of pelvic exams and in this particular situation he wasn't likely to "succeed" regardless. In med school and training you get fairly desensitized about all these exams -- pelvic, rectal, prostate, penile -- it's just an orifice, no big deal, not per se "awkward" once you've done a bunch-- just something you deal with as swiftly and clinically as you can.

Maybe to a trained medical profession, pelvic exams are merely the exploration of another orifice. To me, pelvic exams are extremely awkward, painful, and invasive. They make me (and many women) feel vulnerable and embarrassed. It's fine that doctors are desensitized about all these exams, but as a patient- I am not. Knowing that my doctor is simply too removed from the process to honor the inherent vulnerability women face when receiving pelvic exams is not encouraging.

 

[Law2Doc]

Maybe to a trained medical profession, pelvic exams are merely the exploration of another orifice. To me, pelvic exams are extremely awkward, painful, and invasive. They make me (and many women) feel vulnerable and embarrassed. It's fine that doctors are desensitized about all these exams, but as a patient- I am not. Knowing that my doctor is simply too removed from the process to honor the inherent vulnerability women face when receiving pelvic exams is not encouraging.

Sounds like you aren't the right kind of patient to get her gyn care at a teaching hospital and were setting the both of you up for failure.

 

[uggggh]

Um, you said a resident screwed up and you were thinking of suing. I don't know what other conclusion we can come to if you think the kind of error is actionable, other than you can't picture yourself screwing up similarly.

Hmm. That's an interesting take. If I made a mistake as a resident, I would expect to get sued. Isn't that risk inherent to practicing medicine?

 

[uggggh]

Sounds like you aren't the right kind of patient to get her gyn care at a teaching hospital and were setting the both of you up for failure.

Thank you for your response. I didn't know that hospitals affiliated with medical schools use students in their clinics. I chose to make an appointment at UVA because the hospital has an excellent reputation.

I reject the idea that it is my fault I received substandard care. My doctor was unprepared for my visit, which resulted in a horrifying, traumatic, and financially burdensome experience for me.

 

[Law2Doc]

Hmm. That's an interesting take. If I made a mistake as a resident, I would expect to get sued. Isn't that risk inherent to practicing medicine?

No. You expect to get sued when you significantly screw up, cause significant harm. But if you got sued for every minor glitch during residency you would be uninsurable by the end of your training. Your attitude is a symptom of our overlitigious society for sure. But in general the patients who get their care at teaching hospitals are thankfully much more tolerant. You'll likely learn from a couple of mistakes a year during residency, and the hospital will likely eat the bill. But you can't emerge from residency with a dozen lawsuits hanging over you and it's troubling that you think that way, or worse that you think you won't make that many mistakes.

 

[Law2Doc]

Thank you for your response. I didn't know that hospitals affiliated with medical schools use students in their clinics...

You said this guy was a resident, not a student.
But yes even as a student you'll learn to do gyn exams on patients. You have to learn somewhere. And those who come to teaching institutions are implicitly agreeing to be learned on.

 

[22031 Alum]

I chose to make an appointment at UVA because the hospital has an excellent reputation.

Because they are a major academic hospital, where students and residents learn. This is something I always point out to patients who want the big name hospital but nothing that comes with (or directly leads to) that big name.

My first thought was that a male intern could honestly be behind his peers because of the number of patients who do not allow him to participate in their care.

 

[uggggh]

Wow. Talk about making a mountain out of a molehill. Please save this post and re-read it in 5 years when you're an intern/resident. I hope you'll see how dramatically you reacted to a very non-dramatic experiences.

So, you were seen by a resident and things didn't go "perfectly." Surely, as someone starting medical school, you realize that residents are not the same as fully trained attendings. If the resident introduced himself as a resident (working with attending Dr. blahblahblah), your expectations should have adjusted and they didn't. This isn't necessarily your fault - as someone who hasn't gone through the training process (and hasn't been to teaching hospitals in the past) it's hard to understand the resident vs. the attending's role. Usually the resident recommendations align with the attending's. But not always. In this instance, for you, they didn't. It's not like the resident recommended something totally outlandish. A PAP smear and Gardasil... maybe not indicated at this time, but within the realm of possibility for your visit.

I get it. PAP smears cause cramping. They won't last forever. Sorry, not a lot of sympathy for this complaint.

You received a recommended vaccine that your insurance might not cover. Call the office. Speak with their billing. Explain the situation. Most likely you won't be charged. If you are charged and can't pay now, just explain that you'll pay them when you can (with loan money). This is not the end of the world. You got a vaccine you needed and can (very likely) pay for it at a later date.

And I get that you were bothered by his bedside manner. Maybe he was just as nervous as you were! One day you're going to have to perform these very private exams and guess what - they can be just as uncomfortable and embarrassing to perform! Perfecting your bedside manner is also something that occurs during residency - it's a learning process, just like everything else.

As someone going into the medical field, you need to know that YOU ARE GOING TO MAKE MISTAKES (which you claim to understand, but don't sympathize with this resident on any level). You WILL likely harm someone as a resident. Is this "fair" to the patient? Probably not. But residents learn from their mistakes. This is how we train competent attendings (and even attendings still make mistakes).

Lastly, when I read, "How could she let someone so incompetent lay his hands on me?" All I could think was - get over yourself.

Thank you for taking the time to reply to my posts. I think you bring up some good points.

My doctor did not introduce himself as a resident. I did not know he was a resident until the end of my visit, when he said that his attending had to explain some things to me. In fact, I didn't even know it was a possibility I would be treated by a student when I made my appointment.

The nurse, attending doc, and I were all on the same page with exactly what was supposed to happen during my appointment. It was confusing and off-putting when the doctor did not follow what I was expecting. I didn't know that protocols can change throughout appointments.

I have never been treated by a student before. It is an alien idea to me that doctors can also be nervous. Knowing this now is helpful, thank you for bringing this to my attention.

It's okay you don't feel sympathy for my cramping. What bothers me more than the actual pain is that it was completely avoidable.

Regarding the vaccine- as I have said before, it is frustrating to be financially culpable (in any capacity) for someone else's mistake, especially at a time when I do not have a lot of money. I will contest the bill. It is a new and shocking experience for me that a doctor would not know or check on something like that. Not to say that this doesn't happen. It just has never happened to me before.

Of course I don't sympathize with the resident. How could I? I really didn't understand that residents are prone to mistakes because they are not experienced doctors. I thought that any doctor treating a patient is ready to do so (relatively) flawlessly. I guess not! That is the message I am getting from this thread. I have never been treated by a student before, and I have no idea what his level of training or experience is, really. All I know is that he made me feel terrible during a painful and awkward medical appointment. To me, that is his fault.

The idea that doctors are capable of simple mistakes is something that I am trying to wrap my head around as I'm reading this thread. I thought the resident treating me was uniquely incompetent. I guess not.

I really appreciate the time you took to respond to my post. I see that a lot of my perceptions about my appointment were caused by a lack of understanding of what teaching hospitals are, and that residents really aren't fully trained doctors (in the sense of how I am accustomed to thinking of fully trained doctors). Your post has made a lot of the vitriol in this thread understandable! I clearly (albeit unknowingly) touched a nerve. Thanks again! I'll let you know if I ever reach my life long goal of "getting over myself" : )

Edit: I should also add that this thread has made me aware of what I should have expected from a male resident performing a gyn exam. As my anger/embarrassment over the whole experience subsides, I definitely feel more and more sympathy for him. I understand he was just trying to do his best. I think if I had known that I was going to be seen by a resident, and that residents are not very experienced doctors/ prone to mistakes (two things I learned today) I would have been much more comfortable during my appointment.

 

[uggggh]

You said this guy was a resident, not a student.
But yes even as a student you'll learn to do gyn exams on patients. You have to learn somewhere. And those who come to teaching institutions are implicitly agreeing to be learned on.

Are residents not students? I thought the words were interchangeable and I have been using them as such throughout this thread. Eeek! Sorry!

I was unaware of the possibility of being treated by a student during my appointment. I chose UVA because the hospital has an excellent reputation. Now I know! : )

 

[uggggh]

Because they are a major academic hospital, where students and residents learn. This is something I always point out to patients who want the big name hospital but nothing that comes with (or directly leads to) that big name.

My first thought was that a male intern could honestly be behind his peers because of the number of patients who do not allow him to participate in their care.

I didn't know it was a possibility that I could have been treated by a student during my appointment. If I had known, I would have found another place to go, or braced myself more for the experience. I'm glad you warn your patients about this! I'm sure it saves them a lot of trouble : )

 

[22031 Alum]

A student has not yet graduated medical school. A resident has graduated and is officially "Dr." They are a licensed physician, albeit with a training license. Their work must be supervised by an attending physician who had completed training. None of the above will practice medicine flawlessly. Just today I (a licensed attending) had a debriefing session about some things I could have done differently when caring for a patient.

 

[Doctor4Life1769]

I think the issue more or less has less to do with "unncessary" testing or vaccination, but more to do with how socially awkward the resident was with the patient. Cherry on top is that the resident was completely wrong and had her undergo an unnecessary test. The vaccine part is debatable. Vaccines in general have issues with insurance coverage, so plus/minus coverage shouldn't be the reason to get/not get it. The risks/benefits were hopefully discussed and adequate counseling provided. I generally don't overly counsel patients on medications they have been taking for years, but I'm sure the attending felt she should do counseling as it sounded like she was compensating for an inadequate resident.

When I have a new patient, I do not perform tests or labs unless they tell me they haven't been to a PCP in 2-3 or more years. I generally wait for records. Upon review, then I order/perform on follow-up. My new visits are generally meet/greets, discuss historicals, refills prn, and what is to be expected on the follow-up based on records. If I don't end up getting records, then I'll order labs, tests, etc. From my own perspective, a lab test/imaging test/pap smear etc isn't an urgent/emergent issue and if it is I'll refer to the ED.

The key thing is ensuring patients are comfortable. Being a patient is a vulnerable situation. You go from a position of control to one of lack of control. It's got to feel even worse when you're having your privates being exposed, touched, poked, etc. The key is lots of communication, reassurance, and knowing what the heck to do and when. He probably should have read up on the latest Pap smear guidelines and vaccine guidelines. However, you can do several things wrong, but if you are good with your patients generally they tend to be forgiving. I feel for the OP, and I'm sure she was pissed and frustrated and it's not unusual to jump to a law suit rhetoric, but at the same time she clearly wasn't and addressed it here (probably not the best of places, but I'm sure she may not have had too many other options to discuss with without being encouraged to actually sue). Hopefully she'll learn from this experience and be great with her patients. I'm sure the resident learned from this and will hopefully not make a similar mistake.

 

[22031 Alum]

An inability to make a patient feel comfortable before an eye exam or knee exam will not be as frequently and forcefully magnified as it is in the setting of a Gyn exam. This particular resident could very well have a lot of work left to do in that department.

 

[uggggh]

I think the issue more or less has less to do with "unncessary" testing or vaccination, but more to do with how socially awkward the resident was with the patient. Cherry on top is that the resident was completely wrong and had her undergo an unnecessary test. The vaccine part is debatable. Vaccines in general have issues with insurance coverage, so plus/minus coverage shouldn't be the reason to get/not get it. The risks/benefits were hopefully discussed and adequate counseling provided. I generally don't overly counsel patients on medications they have been taking for years, but I'm sure the attending felt she should do counseling as it sounded like she was compensating for an inadequate resident.

When I have a new patient, I do not perform tests or labs unless they tell me they haven't been to a PCP in 2-3 or more years. I generally wait for records. Upon review, then I order/perform on follow-up. My new visits are generally meet/greets, discuss historicals, refills prn, and what is to be expected on the follow-up based on records. If I don't end up getting records, then I'll order labs, tests, etc. From my own perspective, a lab test/imaging test/pap smear etc isn't an urgent/emergent issue and if it is I'll refer to the ED.

The key thing is ensuring patients are comfortable. Being a patient is a vulnerable situation. You go from a position of control to one of lack of control. It's got to feel even worse when you're having your privates being exposed, touched, poked, etc. The key is lots of communication, reassurance, and knowing what the heck to do and when. He probably should have read up on the latest Pap smear guidelines and vaccine guidelines. However, you can do several things wrong, but if you are good with your patients generally they tend to be forgiving. I feel for the OP, and I'm sure she was pissed and frustrated and it's not unusual to jump to a law suit rhetoric, but at the same time she clearly wasn't and addressed it here (probably not the best of places, but I'm sure she may not have had too many other options to discuss with without being encouraged to actually sue). Hopefully she'll learn from this experience and be great with her patients. I'm sure the resident learned from this and will hopefully not make a similar mistake.

I am tearing up as I read your post. It is very refreshing to have my feelings of anger and embarrassment validated. I know now that I should have expected less from the resident, but that really doesn't detract from how traumatizing the whole thing was. I also felt like the attending was overcompensating for her resident, which made me feel like she knew how badly her guy had messed up during an invasive and awkward exam.

You are right. I would have completely forgiven him for everything if he had just been kind, or respected me in any way, or greeted me or made eye contact or did anything to make me feel comfortable. He didn't, and that's where my anger and embarrassment stem from.

I know I overreacted by threatening to sue. I was truly so so upset and embarrassed after coming home from my appointment, that I lashed out.

I had no idea what I was in for when I posted my story on here! I am shocked by the vitriolic tone of most of these posts.

Thank you again for your response!! You seem like a compassionate and empathetic person. Your patients are lucky to have you.

 

[NotAProgDirector]

1. You could call the clinic, and ask to speak to the "Practice Manager". They may have a different title, "Practice Administrator", etc. This will be a non-physician who is in charge of helping run the clinic. Explain your story in a calm manner, be diplomatic. Your goal is to get the cost of the vaccine removed from your bill, because it wasn't explained to you that it wouldn't be covered by insurance. That is a very reasonable request.

2. If they refuse to do so, then you can contact the billing department. They should have an ombudsperson. You could have the same discussion with them. But your chances are much better with the actual clinic.

3. If they didn't send the PAP, there will / should be no charge for that. But while talking to the people above, you could make the same argument about that.

4. About the whole interaction, this is very disappointing. It's very late in the training year, and most interns (assuming that's the case here) should have already had reasonable experience with pelvic exams. If the intern wasn't comfortable doing it, they should have asked for help. Under NO circumstances at all should a male intern perform a pelvic exam without a chaperone present, usually the nurse / LNA / MA. Bottom line is that you had an unpleasant experience. As a PD, I would absolutely want to know about that -- perhaps this is a one time thing, then I would address it but it wouldn't be a crisis. But perhaps it's a repetitive problem for this resident -- in that case, the more I know the better. You could find the name/email of the PD of the program and contact them. Again, it's important to be professional here -- simply explain what happened, that you felt uncomfortable, and that you thought they might want to know. Don't ask for the intern to be punished / fired / disciplined. There is no guarantee that the resident involved has any idea how upset you are -- the best way to address this is to contact the program involved. If you don't know how to do that, you can ask the practice manager how to do so.

 

[Doctor4Life1769]

1. You could call the clinic, and ask to speak to the "Practice Manager". They may have a different title, "Practice Administrator", etc. This will be a non-physician who is in charge of helping run the clinic. Explain your story in a calm manner, be diplomatic. Your goal is to get the cost of the vaccine removed from your bill, because it wasn't explained to you that it wouldn't be covered by insurance. That is a very reasonable request.

2. If they refuse to do so, then you can contact the billing department. They should have an ombudsperson. You could have the same discussion with them. But your chances are much better with the actual clinic.

3. If they didn't send the PAP, there will / should be no charge for that. But while talking to the people above, you could make the same argument about that.

4. About the whole interaction, this is very disappointing. It's very late in the training year, and most interns (assuming that's the case here) should have already had reasonable experience with pelvic exams. If the intern wasn't comfortable doing it, they should have asked for help. Under NO circumstances at all should a male intern perform a pelvic exam without a chaperone present, usually the nurse / LNA / MA. Bottom line is that you had an unpleasant experience. As a PD, I would absolutely want to know about that -- perhaps this is a one time thing, then I would address it but it wouldn't be a crisis. But perhaps it's a repetitive problem for this resident -- in that case, the more I know the better. You could find the name/email of the PD of the program and contact them. Again, it's important to be professional here -- simply explain what happened, that you felt uncomfortable, and that you thought they might want to know. Don't ask for the intern to be punished / fired / disciplined. There is no guarantee that the resident involved has any idea how upset you are -- the best way to address this is to contact the program involved. If you don't know how to do that, you can ask the practice manager how to do so.

It sounds like the male resident/intern performed the Pap smear with a nurse present. He just did it and bailed.

 

[uggggh]

No. You expect to get sued when you significantly screw up, cause significant harm. But if you got sued for every minor glitch during residency you would be uninsurable by the end of your training. Your attitude is a symptom of our overlitigious society for sure. But in general the patients who get their care at teaching hospitals are thankfully much more tolerant. You'll likely learn from a couple of mistakes a year during residency, and the hospital will likely eat the bill. But you can't emerge from residency with a dozen lawsuits hanging over you and it's troubling that you think that way, or worse that you think you won't make that many mistakes.

Good to know! I am sure I will make many mistakes, and will hopefully not get sued for them. As I have admitted before, I was being very melodramatic when I threatened to sue. I was upset, and it was an easy (empty) threat to say in a moment of anger.

 

[Doctor4Life1769]

I am tearing up as I read your post. It is very refreshing to have my feelings of anger and embarrassment validated. I know now that I should have expected less from the resident, but that really doesn't detract from how traumatizing the whole thing was. I also felt like the attending was overcompensating for her resident, which made me feel like she knew how badly her guy had messed up during an invasive and awkward exam.

You are right. I would have completely forgiven him for everything if he had just been kind, or respected me in any way, or greeted me or made eye contact or did anything to make me feel comfortable. He didn't, and that's where my anger and embarrassment stem from.

I know I overreacted by threatening to sue. I was truly so so upset and embarrassed after coming home from my appointment, that I lashed out.

I had no idea what I was in for when I posted my story on here! I am shocked by the vitriolic tone of most of these posts.

Thank you again for your response!! You seem like a compassionate and empathetic person. Your patients are luck to have you.

I think it's reasonable for you to have felt the way you did.
All clinics are different, but it would be acceptable for you to voice your concern with the practice manager about the resident encounter. I agree with aPD that you should do this when you're more in control of the situation and to not have the intern's head on the chopping board when voicing a complaint. However, it is your right to explain a concern about the encounter.

 

[uggggh]

It sounds like the male resident/intern performed the Pap smear with a nurse present. He just did it and bailed.

Yes, there was a nurse there!

 

[Damn_Daniel]

Good thing there was a chaperone... Otherwise this really was getting to be a disaster.

Maybe a July intern is forgiven for bungling this, but a resident? Do you really have that much sympathy for a person who has been in training for a year have that much trouble and difficulty with decency? Simple things "I'm a resident physcian, I haven't done many exams, so I'm sorry if you feel discomfort. If I cause any discomfort let me know, and we can take a beat or I can get my attending. At any time if you feel uncomfortable, we can just let my attending handle this. Okay, I'm going to touch your thigh first, okay you're going to feel the speculum, etc, etc." We did this practice crap with practice patients for a reason - so we knew to do it as residents and EVEN AS ATTENDINGS. Jeez. This resident sounds terrible. Not terrible for this world, I wouldn't execute him. Not terrible to enough sue. Just sounds lousy. Hopefully he practices a bit or asks for some advice or his colleague reads them and makes fun of him for the next 3 months. Good god.

You were melodramatic, but that's okay, young people tend to be that way. Ridiculous to sue. You'd have to prove negligence, breach of duty, and a bad outcome. The resident was incompetent, not malicious, and the outcome wasn't bad, except for your cramping. Jury wouldn't be pleased even discussing this. No one would take the case.

And, breast exams are useless. Especially in an asymptomatic, young woman with no signaling of significant breast cancer history. No need for that. There is also no evidence self breast exams do anything and are no longer recommended.

Take a deep breath. You're right that this person bungled it. It's not malpractice. It's not good practice. Unfortunately the way medicine is set up, it's "practice".

You're okay. You're healthy. You are going to F up, too. Have some compassion. Best of luck.

 

[candbgirl]

What did you think happened at a Teaching Hospital if not teaching? As a person starting med school where do you think you are going to learn to do procedures? As to the insurance not covering the Gardisal-no way the resident would know what your insurance covers, but you should and if there was a question you could have declined. I wonder if a few years down the road you will change your attitude about residents , like when you are one. In the mean time find a private practice doc and sign up.


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