the fertility advocate

Talking, writing, educating, and change making in the field of fertility for more than twenty years

What if Doctors Were Taught By Patients How To Give an Exam?

A friend of mine works with  “Project Prepare” where ”trained patients” teach young doctors how to perform breast, pelvic and prostate exams in a caring, and compassionate manner.  These “Patients” also train the doctors how to take a sexual history – in a way that would help the patient free comfortable.  Project Prepare was started because it’s founder, Kat Wentworth become frustrated with how uncomfortable doctors were in discussing sexual issues with patients and how they were trained to perform these delicate exams.

My friend who works as a doctor educator is passionate about his work, and Project Prepare – because he knows that by teaching doctors how to touch and talk in a compassionate manner to patients he is changing the experiences of thousands of patients.

You see, these trained patients or educators give feedback to these young medical students.  You would think that this is how medical students are trained throughout the country – but actually Project Prepare is quite unique.  In most medical colleges the “patients” are simply models who are not encouraged to participate in the exam or give feed back. So the doctors might as well be practicing on a live doll.  What I also learned is that in some states, doctors learn to do these exams on patients while they are unconscious.

I cannot tell you how astonished I am about that one. ! So, you go into the hospital to get your tonsils out – and somewhere in the middle of the procedure while you are “napping” a medical student gets to cop a feel of your ovaries? In a study published in the American Journal and Obstetrics and Gynecology found that 90 percent of the 401 medical students surveyed had performed a pelvic exam on an anesthetized patient. Now isn’t that a comforting thought? If a doctor trains without knowing how something feels for the patient – how are they suppose to learn how to give kind, compassionate and gentle care? After all, most of us are not under general anaesthesia while getting pelvic exams!

As a patient advocate, I totally admire Kat Wentworth. She took her frustration and turned it into an educational opportunity that worked to create change in a system that really wasn’t  working.  I wonder what happen to patient care in the world of fertility treatment if patients could train the doctors?

In many ways, our field with so many good strong patient organizations – has resisted working with our patient groups.  The American Society of Reproductive Medicine (ASRM) which is the trade or professional organization for Reproductive Medicine – didn’t even meet with representatives of the patient groups when they decided that would create informational materials for patients. They didn’t think that they needed the input – after all – they were the doctors right?

I have got to tell you when I heard this, I was speechless! And trust me – that takes some doing. But it didn’t really surprise me – a handful of years ago at one of the big ASRM annual meeting – they decided to hold a patient conference. Now that was a great idea – the only hitch was that they didn’t reach out to the four patient organizations in our country for support, input or help in advertising the meeting to their members. The result was that the patient meeting held at the professional meeting had very low attendance. I remember thinking – when are professional organizations going to learn to really and truly partner with the patient organizations and not just give it lip service? There is so much to be gained –  so much that could be taught by us professional patients – if only the doctors were willing to learn from the very people that they care for! After all, we have earned our degrees too!!!

So hats off to Project Prepare, and it is my hope that Project Prepare will spread it’s work from the West Coast to the rest of the country. Perhaps they will also extend their work from basic pelvic exams to the delicate business of providing infertility care.  Or perhaps, one day soon some very innovative former fertility patient will start something similar to help educate the care givers in our field about what it really feels like to have a vaginal ultra sound wand slammed around your swollen ovaries!!!

About Pam Madsen
Talking, writing, educating and change making in the field of fertility for more than twenty years
1 comment on this postSubmit yours
  1. Thanks so much for this article. As a nurse midwife and GYN practitioner providing compassionate and empowering exams was one of my deep commitments! It is unfortunately rare to find providers with those skills. Training is very much needed!

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