Hey Wimmenz

[SSG Snuggle Bunny]

How'd you like a bunch of college kids poking around in your cooch while you're unconscious?

Imagine that you are undergoing a fairly routine surgery – say, removal of uterine fibroids or hysterectomy. During or right after the procedure, while you are still under anesthesia, a group of medical students parades into the operating room and they perform gynecological exams (unrelated to the surgery) without your knowledge.

Do you consider this okay, or an outrageous violation of your rights?

Regardless of your feelings, you should be aware that this is standard procedure in many Canadian teaching hospitals.

Medical students routinely practice doing internal pelvic examinations while surgery patients are unconscious, and without getting specific consent, at least in Canada.

Guidelines in the United States and Britain say specific consent is required but, by contrast, Canadian guidelines state that pelvic examination by trainees is “implicit.”

The practice – one of those dirty little secrets of medicine – has been exposed in a thoughtful, professional manner by a young doctor.

The story goes back to 2007 when Sara Wainberg was a medical student at McMaster University. Her younger brother Daniel, also studying to be a doctor, phoned for advice: As part of his rotation in obstetrics and gynecology, he had been asked to perform a pelvic exam on a woman who was under anesthetic. He refused, saying doing so without consent would be unethical.

“It got me thinking,” Sara Wainberg said. “I had done this numerous times in my training and it had never occurred to me that it might be unethical.”

She polled her fellow students and found 72 per cent had also done exams on unconscious patients, without consent, confirming that it is routine.

http://www.theglobeandmail.com/life/health/time-to-end-pelvic-exams-done-without-consent/article1447337/

[JohnnyReb]

Oh but healthcare is free in Canada.

[Oceander]

Under the common law, that would be assault.

[debk]

If you go into a "teaching" hospital in this country...you need to expect to have both medical students and residents involved in your care.

If you have surgery in a "teaching" hospital ....on those surgical forms....that they rush you through to sign....in the fine print it says that both medical students and residents will be involved in your care.

My son was born at Duke University Hospital. I was a "private" patient, but because I had my son late on a Friday night, it ended up that a Fellow (he was from Greece, there doing an OB/GYN fellowship) delivered my son. I was then listed as a "public" patient.

I was left in the recovery room all night - from 11:30pm ...without a button to push for help....until 7am when one of the Urology professors and a couple Urology residents came looking for me (my ex was 3rd yr Urology resident) as they had come to see me the night before when I was in labor. The attending went off on the staff and I was quickly moved into a private room.

That still didn't stop a first year OB/GYN resident from coming in to see me and insisting on checking out my parts. I started out nicely saying no.....before it evolved into a HELL NO!!! and him finally leaving highly offended that I was not "allowing him to do his job". I told him to find someone else to practice on....it wasn't going to be me.

FYI ...most VA hospitals, if not all....are "teaching" hospitals.

Always always....have another person stay with you if you are hospitalized. Especially at night when you are not as alert. You need them for protection. It won't help in surgery....but take whatever family/friend assistance you can get.

[The Village Idiot]

Isn't that what happens at college parties?

Never went but I read stuff.

[DumbAss Tanker]

Under the common law, that would be assault.

A battery, actually.

[DixieBelle]

Totally agree w/Deb. I had my son in a teaching hospital and was treated like a science project because of complications. Everyone was very nice and treated me kindly but I certainly didn't like feeling like a specimen in a jar to be gawked at.

[debk]

Totally agree w/Deb. I had my son in a teaching hospital and was treated like a science project because of complications. Everyone was very nice and treated me kindly but I certainly didn't like feeling like a specimen in a jar to be gawked at.

There is absolutely nothing wrong with going to a teaching hospital, as many of them are on the cutting edge (no pun intended ...well not much of one.. ) of the latest treatments.

When we moved here in '83...my ex wanted to do a specific surgical procedure on someone with cancer, that could literally save his life....no one here knew anything about that procedure. He was required to go before the surgical board of the hospital to explain that he knew what he was doing, how it would help the patient, the expected prognosis. It was a routine procedure at Duke Hospital...they did at least one or two a week. He was able to get approval, and the guy was fine. I'm certainly not one to toot the ex's horn....but unless the patient had gone out of the area to a teaching hospital....he most likely would have died.

Which is why people come from all over the world to Mayo Clinics, Duke, University of Virginia, Cleveland Clinic, MD Anderson and Sloan Kettering, among others. (even though the US has the worst health care in the world )

The patient just needs to be aware that they may be a guinea pig. And realize that though there are many safeguards....I still would want someone with me who could be there and be my advocate.

[DixieBelle]

^completely agree - but esp. the part about having an advocate with you as much as possible! Even if it's not a teaching hospital. Medical personnel are human and mistakes happen. I would much rather know a trusted family member or friend was nearby when they came into the room to do this or that. My mom did that when I had a broken leg. (loooooooong story, horrible injury, tons of surgeries) and she pestered the crap out of the staff whenever they wanted to touch me.

[Chris]

I don't remember if the last hospital I was in was a 'teaching' hospital, but wouldn't they ask for your consent first?  Of all the paperwork you have to fill out while you're there, I seem to remember it being brought up at least once. 

[DixieBelle]

yeah its in the millions of forms you sign.

[Chris]

I seem to remember being asked about it specifically the other year when I had my eye surgery(s).  Or it could have been in 2003 when I had the shunt replacement done.  It's one of those checkboxes on a form somewhere, similar to "have you visited any of the following countries since 1981?" when you donate blood.

[Randy]

I ended up at a teaching hospital once. They saved my life so I wasn't to awful critical of being on display. They saw me as a miracle so I was sorta flattered that I was so popular.  I was on 3 a day visits and they'd all been filled in already as to what I'd endured. They all had theories they wanted input on so I answered alot of questions. 

[debk]

I ended up at a teaching hospital once. They saved my life so I wasn't to awful critical of being on display. They saw me as a miracle so I was sorta flattered that I was so popular.  I was on 3 a day visits and they'd all been filled in already as to what I'd endured. They all had theories they wanted input on so I answered alot of questions. 

I had scar revision surgery on my arm, at Duke, by a nationally recognized plastic surgeon.

The plastic surgeon said ....."hey I can make this look great! I'll cut here, and here, and here, and restitch it and it will look terrific.....you'll have just a fine line that will eventially disappear"

"ok"...said I....."make it look great". After all, I wasn't having to pay for it. Insurance was paying for most of it,and the urology dept was picking up the difference, and the surgeon was comping his fee.

He took lots of pictures ....after all, my scars from 2 skin graftings were going basically all going to disappear after he applied his wonderful skill with scapel, needle and thread.

He cut and stitched for several hours. I was kind of awake for it....and he couldn't get my arm completely numb.

All those pictures he took?

He added several sets to them.

Everytime he injected the incisions with steroids to reduce the inflamation.

He used them at many lectures all over the world....."Never tell a patient that you KNOW you can make it better....."

31 years ago.....

.....that was the last time I let anyone near my arm with a sharp instrument.....of any kind.

[The Village Idiot]

OUCH!!

[BEG]

Totally agree w/Deb. I had my son in a teaching hospital and was treated like a science project because of complications. Everyone was very nice and treated me kindly but I certainly didn't like feeling like a specimen in a jar to be gawked at.

Since I have a rare auto-immune disease every time I am in the hospital I have interns in and out of my room. When I had my stents there were interns in the operating room too (it was uncommon to use stents in my disease) as well as other procedures. Also when I has my last child I had interns in the room during delivery because I was high risk and the delivery was a bit out of the norm.  There was even an an intern for anesthesia in my room when I was getting my epidural. By the way, my anesthesiologist actually wrote a paper on anesthesia and my auto-immune disease (the general term vasculitis).

I didn't mind it, how else are they going to learn any real life experience before they put their hands on someone?

[longview]

I didn't mind it, how else are they going to learn any real life experience before they put their hands on someone?

Had my oldest at a teaching hospital.  And I didn't mind for the same reasons. 

[DixieBelle]

Well I minded. If it hadn't been my first birth with risky complications, I would have been more at ease. Those med students didn't have good poker faces yet. Made me uneasy. I'm sure they learned a lot, I just wish it hadn't been so scary for me.

[lastparker]

I won't go into detail so as to not gross out the menfolk..... but I had some repair surgery on my nether regions after having baby number one.  I'm sure I signed the consent forms - I don't read all the crap.  Anyway, they all trooped through my room after the surgery to introduce themselves and ask questions, and I was a bit embarrassed when I realized that I was splayed wide open, up in the stirrups, on dispaly for "the class".  But like others here, I got over it.  Where ARE they going to learn?

My Aunt had one of her kids in a teaching hospital, and she said so many different people came through her room wanting a "look", that she just started throwing her legs apart anytime someone came in the door. 

[debk]

I won't go into detail so as to not gross out the menfolk..... but I had some repair surgery on my nether regions after having baby number one.  I'm sure I signed the consent forms - I don't read all the crap.  Anyway, they all trooped through my room after the surgery to introduce themselves and ask questions, and I was a bit embarrassed when I realized that I was splayed wide open, up in the stirrups, on dispaly for "the class".  But like others here, I got over it.  Where ARE they going to learn?

My Aunt had one of her kids in a teaching hospital, and she said so many different people came through her room wanting a "look", that she just started throwing her legs apart anytime someone came in the door. 

I think I was more uneasy showing my "parts" when my son was born, because I knew either the resident or their wives.

When we moved here....my OB/GYN? His office was across the hall from my ex's, and we hung out together some as couples, as my doc was best friends with the ex's partner. Never failed.....I'd have an appointment....and within a week we would be at some function together.  It never failed to embarass me....

[Eupher]

Aw, Deb, I'm sure he was thinkin', "you've seen one, you've seen them all."



 

[debk]

Aw, Deb, I'm sure he was thinkin', "you've seen one, you've seen them all."



 

Yep....that's exactly what my ex said. 


I just always felt awkward.

The doc....was always very professional....never even let on that he had seen me recently.

[Eupher]

Yep....that's exactly what my ex said.  


I just always felt awkward.

The doc....was always very professional....never even let on that he had seen me recently.

I understand the awkwardness. That's the same kinda thing that I object to when a female doctor straps on the glove and some KY and invites me to bend over and crack a smile - time to check out Mr. Prostate via Poop Chute palpation.  

[debk]

I understand the awkwardness. That's the same kinda thing that I object to when a female doctor straps on the glove and some KY and invites me to bend over and crack a smile - time to check out Mr. Prostate via Poop Chute palpation.  

My last male GYN was Auburn's quarterback when he was in undergrad.

Huge hands!!! 


I switched to a female after him.....she was maybe 5foot on a tall day.....petite little hands....should have been going to a woman for years.....

[The Village Idiot]

OKAY. Is this Shortbus yet?