Let’s jump right in, or even better, scoot right on down:
Reason number one that you should see your Gyne every year… because! Okay, that’s not a reason. A real first reason is to review your personal history. You may not know what’s normal and what’s not.
Many women don’t realize how many things happen to them in the course of a year and how those things can affect their overall health. I have had women forget that they had surgeries or new diagnoses until I ask questions about scars and new medications. Knowing how these issues all work together is vital to keeping you safe.
Norms are also established. One woman’s “normal” period flow may be actually considered excessive when put in perspective. I can look for signs of anemia, hormonal abnormalities or reassure my patients when everything is actually normal. Unless you really spend time discussing your symptoms and comparing them to a group of normal friends and family, it may be hard to know if what you are experiencing is safe. As I always say, Dr. Google will try to kill you. (Not really, but the Google search is consistently an inadequate and often inaccurate way of evaluating medical concerns.)
Reason #2. To review your family history- It really matters! Family history can save you from experiencing the same fate.
Say, for example, you are on birth control, but since last year, a family member was diagnosed with blood clotting disorder? Or more commonly, your blood pressure is substantially higher this year than last and you have a family history of high blood pressure. These pieces of information could easily change the type of birth control that I recommend for you. If a family member was diagnosed with colon or breast cancer, that information can change when your recommended screening should begin- often sooner than average.
Let me take this moment to highlight the importance of asking your older family members about their medical problems and the importance of sharing your medical problems with younger family members. Many think sharing medical problems like diabetes and cancer is “claiming it” or telling your “business.” Instead, consider it a preview for things that you can see coming. Would you like to know when crossing the street that some cars and trucks may be coming around the corner beyond your line of sight? If you knew they were coming, would you cross a little more carefully? Would you try to see certain things coming? Be a little more defensive? If three of your family members developed diabetes, you may want to be screened younger or be more careful with your own weight. That way you may be able to either prevent the diagnosis altogether, or at least catch it early before it causes too much harm.
Reason #3. To undergo a physical exam. I catch things that you may not.
Blood pressure, weight, height (especially approaching or in menopause when osteoporosis can cause you to lose height), and physical exam findings can be vitally important to your health. I personally have diagnosed a number of thyroid masses and discovered breast lumps that were unknown to my patients. An enlarged uterus may point to fibroids. I want you to know your body, but it is my JOB to know it too.
4. To get your Pap test. Cervical cancer is one of the most preventable cancers that there is.
In one of my first posts, What’s Pap-pening, I explained what a pap test is. If you have had a number of normal pap tests, according to guidelines established in 2009 and reaffirmed in 2013, you may not need a pap test every year. Since the pap guidelines changed to less frequent screening, people often try to tell me that their “other doctor” told them they can have annual exams every 2-3 years. Well, change the name then. Call it your Everytwotothreeyear exam. The only problem is, that isn’t “a thing.” Screening guidelines for women still call for a yearly exam. During said visit, health history and family history are reviewed, a clinical breast exam is performed, a pelvic exam is performed to assess the size and contour of the uterus and ovaries, and testing for sexually transmitted infections is offered. Most insurance plans still cover these exams as well, as long as the topics covered are within the realm of prevention. I will also provide an order for a mammogram if you are 40 or older. I remind ladies of the need for a colonoscopy if they are 50 or older (45 if African American per guidelines).
5. To address any new medical concerns and potentially be tested for sexually transmitted infections.
Consider this a brief explanation of benefits- an EOB for you. The copay-less, no out-of-pocket annual preventative check covered by your insurance policy covers basic yearly things like updates in your history, a routine physical exam, and cervical cancer screening. If you have more medical issues that need to be addressed or tests that need to be performed, additional charges may be incurred that may require a copay, deductible or co-insurance pay-out. It is not I, but your insurance company who makes these rules.
Medicine is one of the few service industries that has a third party decide if and when you get paid for services rendered. The hay day of medicine is over. Docs are not rich beyond belief anymore. If I wanted to be rich, I would have tried to be the CEO of a private insurance company, not a doctor. Between abundant student loans and sparse reimbursements, a doc could EASILY live check to check. The point is not for anyone to cry for me. It is to understand that giving of time during a consultation about multiple medical problems that I have paid, and am still paying richly to know about and solve, is not going to be free. If a business hired a consultant to fix problems on multiple levels of administration, they would bill and expect to receive payment for the services rendered and time spent tackling each issue. Medicine is no different. The struggle is real.
Take home point:
What is an annual exam and how frequently should it be done? It is a verbal and physical exam, and it should be done annually. Just because you may not need a yearly pap, that doesn’t exempt you as a woman from seeing your gynecologist annually. Excuse all of the pictures of perennial flowers. What can I say, they come back every year (rimshot, thank you, thank you.)
To drive home the point, check out my latest video, which has almost 10,000 views on Facebook so far. This video now holds my record for the number of views, second to the SWV, Weak (Bladder) ditty which had almost 6500 views. Enjoy it here on YouTube (which doesn’t have nearly as much love as Facebook video views, but here’s hoping) and don’t forget to follow us for more from The Gyneco-bLogic!