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Health Information An Expert Opinion: You and Your Ob/Gyn (Part 1)

Asking questions will help you learn about your doctor — and your health.

Going to the gynecologist is about more than just getting a PAP test; just as visiting your primary care doctor helps you maintain your overall health, annual ob/gyn appointments are essential for a woman's gynecologic health.

Gynecologists and ob/gyns address a full range of health issues in girls and women, from the teens through the postmenopausal years. But for a variety of reasons, including the often embarrassing or stressful nature of gynecologic issues, many women aren't making the most of their relationship with their ob/gyn.

In part one of this two-part interview, Discover Rush Online asked Ranoo Sabnis, MD, an ob/gyn at Rush University Medical Center, to give advice on how to find the right ob/gyn — and how to establish a meaningful doctor-patient dialogue that will last a lifetime.

Q: There are so many gynecologists and ob/gyns out there. How do you find the one that’s right for you?

A: I would say start by asking family members — your mom, sisters, aunts, cousins — who have found a gynecologist they like. It's always reassuring when someone you respect and trust has seen this doctor and has had a good experience with them. Friends, co-workers and neighbors are also good sources.

You'll want to ask your relative or friend some questions about the doctor — is he or she available, does he or she call you back, does he or she address all of your concerns — to determine if this is the kind of doctor you’re looking for. So just talking to women you know and getting a personal recommendation is a great first step.

Q: When you're meeting with a gynecologist for the first time, are there specific questions you should ask to make sure it's a good fit?

A: I wouldn't say there are specific questions to ask. I think it's more about how the doctor answers whatever questions you do ask. Generally speaking, nothing should be off limits, even at that first appointment, and the answers you get will tell you a lot about the doctor's demeanor, personality and approach to care.

Which questions you ask depends on what you want to get out of your relationship with your gynecologist. Some women simply want to come in and have their exam and their PAP test and get out as quickly as possible, whereas other women come in with a laundry list of questions and really want to gather information and discuss their concerns. Just make sure the doctor you're seeing is addressing the issues you want to be addressed.

Some of the things gynecologists deal with can be embarrassing, like painful intercourse, incontinence and sexually transmitted diseases (STDs). What I try to do is bring those issues up myself to take the pressure off of the patient, but you shouldn't be afraid to ask your gynecologist sensitive questions. If you feel uncomfortable discussing these types of issues, then it's probably not the right doctor for you. You have to be able to be honest, because if you aren’t, it can affect both your health and your doctor's ability to appropriately care for you.

Q: Once you've chosen your gynecologist, what topics should you try to cover during each appointment?

A: Certainly, there are the issues I mentioned in my previous answer: sexual health, STDs and incontinence. You should also discuss any problems with your periods, such as irregularity, excessive bleeding, bleeding between periods or painful periods.

I also recommend asking your gynecologist about screenings, because screenings are the best way to prevent problems in the future and he or she can tell you which screenings you need given your age, health history and personal risk factors. And I'm not just talking about breast and cervical cancer screening, but also cholesterol, thyroid, bone density, blood pressure and diabetes.

Your ob/gyn should be aware of when all of these screeningsare recommended, so if you don't have a primary care doctor or need clarification, don't hesitate to ask your ob/gyn.

Of course, breast cancer and cervical cancer screenings are really important things your gynecologist will do, and he or she can explain what the latest guidelines are. The guidelines change all the time and it can be confusing.

Q: As you pointed out, some issues can be difficult to discuss, even with your doctor. How can women get past the anxiety of bringing up embarrassing or sensitive issues?

A: Well, for example, sexual health is an important topic that a lot of women don't ask about. So when I see a patient, I usually ask them if they're having any problems with sex. And some women say "No!" very quickly and some kind of think about it and they're like, "Well …" and that's my cue to ask more questions about what's going on.

If the doctor doesn't ask that specific question and you then have to bring it up, it's hard. It's really hard, I know, but the gynecologist is there for that reason. That's what we're trained for. That's what we do day in and day out. We're not embarrassed by it, so you shouldn't be.

Sometimes, things don't come up until many visits later. For instance, we had an expert who came to talk to our practice about intimate partner violence, and that's something we screen for and I ask every visit. But she said sometimes she has women she sees for years, and then all of a sudden they're willing to bring it up.

You might see your gynecologist a couple of times and then start feeling like, yes, I can trust this person, this is someone I can talk to about this problem. So some issues are like that; you don’t want to share with anybody, and then you finally feel ready.

If there are things you want to talk about during your appointment and are worried that you'll forget or feel uncomfortable bringing them up, I recommend bringing a list of questions or topics with you to the appointment. It’s difficult, when you're up in stirrups and feeling very exposed, to try to ask questions. Take a few moments the day before your appointment to write the questions out. Then go through the list with your doctor before your pelvic exam. After the pelvic exam you may just want to get out of there as soon as possible, and the last thing you want is to get flustered and walk out the door and realize you’ve forgotten to ask something important.

Q: What if you do forget to ask something?

A: You can always call your doctor, any time. If a patient calls our office, she can talk to one of our nurses, who will send me a message. When I come in each morning, there's a list of messages waiting for me, and I'm then able to return those calls throughout the day. It's never a nuisance when patients ask questions, so please don't ever hesitate to call, whether it’' something you’ve forgotten to ask or a new question pops up between appointments.

If it's simply a case of running out of time during your appointment, you should consider scheduling a follow-up appointment. It's often hard for us to spend adequate time with each patient because we're scheduled to see patients every 15 to 30 minutes and there are so many things to complete during an annual exam: screening questions, the pelvic exam, PAP test, etc.

If a patient has a lot of issues and we can’' finish in the 30 minutes, I always schedule a follow-up appointment with her just to address those issues. Sometimes it's frustrating to have to come back in, but at least that way you'll have dedicated time to cover the topics you weren't able to discuss during your annual exam.

Read part two of the interview with Ranoo Sabnis, MD, in which she talks about how to have conversations about issues related to pregnancy, infertility and menopause — and why your gynecologist won’t be upset if you get a second opinion.


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Please note: All physicians featured in Discover Rush Online are on the medical faculty of Rush University Medical Center. Some of the physicians featured are in private practice and, as independent practitioners, are not agents or employees of Rush University Medical Center.

If you enjoyed this article and are not already a subscriber, subscribe today to Discover Rush Online. You'll receive health information, breaking medical news and helpful tips for maintaining your health via e-mail. To subscribe, send an e-mail to DiscoverRushOnline@rush.edu.

November 2012


 

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