A gynecologist asked people what they would change about their visit. Thousands responded.
When picturing a doctor’s office, you might imagine a less than warm atmosphere. Those oh-so-lovely fluorescent lights instantly come to my mind.
Imagine if a doctor told you, “I want to design our visit in a way that makes you feel most comfortable.” Suddenly that annual check-up doesn’t sound so dreadful after all.
Dr. Ryan Stewart, a urogynecologist at the Midwest Center for Pelvic Health, recently asked women to weigh in on the redesign of his office.
Posting the question to Twitter, we wrote: “I have the opportunity to design my office from scratch. I’m asking women. How would you design/optimize a visit to the gynecologist’s office? No detail is too small.”
His tweet ended with “If I’ve ever had a tweet worthy of virality, it’s this one.”
And boy was he right. His tweet nearly instantly received thousands of replies. Turns out, there are a lot of ways to improve a visit to the gyno.
Empathy toward sexual trauma
Acknowledgement that sexual trauma histories can make exams psychologically overwhelming for many. I’d feel safer if it wasn’t dismissed as “everyone needs these exams, it’s no big deal.” It is a big deal! Empathy would help in improving our sense of safety & reducing avoidance.— Kara K. (@karabear_1) December 5, 2021
This includes starting the exam off asking if a patient has any trauma, and not dismissing feelings of discomfort, according to commenters.
No one should ever have to discuss any aspect of their care with anyone (I’m thinking nurse, receptionist) within earshot of other patients. Also, patients should not be able to listen to phone calls or dictation. You wouldn’t believe the things I’ve heard while sitting.— Dr. Erin MacLean MD OB/GYN (ret’d) (@macdoin) December 5, 2021
As part of improved privacy, many advocated to not be asked if an intern can observe while the intern is still in the room.
"It's hard to say no to them," one person wrote.
Another added "I'm sitting on the table in the gown and [the gyno] brings in this young guy and says 'you don't mind him observing this do you?' I consented but have been pissed off ever since and never went back to her."
One person mentioned that their current doctor recently swapped the thin, exposing paper gown for spa style robes, adding both privacy and a dash of luxury.
I'm black and black is beautiful!— Chidiebere Ibe (@ebereillustrate) November 24, 2021
Diversity in Medical Illustration
More of this should be encouraged!
Illustration by @ebereillustrate#pregnant#MedEd#scicomm#inclusion#AcademicTwitter#MedTwitter#illustration#Metaverse
Please support this cause🙏 https://t.co/Tye9WT1hudpic.twitter.com/YGrzINJfoe
This suggestion comes aptly timed, as the diagram (above) of a black fetus recently inspired a viral conversation. Many were noting that they had never seen one in medical imagery before.
One person remarked, "I am 53 years old and have never seen myself represented in anything in a doctor's office, even pamphlets. Change that!"
Mental health screenings
make screening for depression, domestic abuse, human trafficking, anxiety and PPD a normal part of your exam practice. my normal doc screens at every physical for depression, its just normal. Check in on emotional effects of birth control— Anschteeviee (@iamoutofideas12) December 6, 2021
Waiting until the clothes are ON to disclose important info
Don’t discuss care or diagnoses when people are naked, I remember how much more respected and comfortable I felt when a new gynaecologist introduced himself to me while I was clothed, did the exam, then had me get dressed and meet him in his office to discuss care! Much better!— B Davie is officially boosted 💉💉💉 (@davieledgerwood) December 5, 2021
Bottom line: It's already a vulnerable time. Let people have a moment to get comfortable.
One person added "I have always had to specifically ask to be able to talk to my doctor clothed first. Even when I hadn't met that doctor yet. I feel like that should be default, not up to me to ask for. It's such a power imbalance already, don't add unnecessary vulnerability."
Ditching the pink
It's super trivial, but...— Girl Geek for Getting Shaq some Magenta FFS (@girlgeek_rva) December 5, 2021
Not every place that's intended for women to inhabit needs to be pink. There are other colors.
To some, it's mildly annoying. To others, it's even triggering.
One person tweeted, "I went through a breast cancer scare, & EVERY women's medical office I went to–pink EVERYWHERE. I was at a really terrified moment in my life, & pink, pink, pink. I 100% can't stand it anymore."
Offering pain meds
From my non-Twitter-using wife: offer painkillers. Don’t make people ask/have to know to ask. Anyone getting a cervical biopsy should be offered the same suite of painkillers and anxiety drugs I was for my vasectomy.— Hairy Seldon 🌎🤖🚀 (@eschatomaton) December 6, 2021
Potentially painful procedures like IUD insertions or cervical biopsies typically only offer medication upon request. This Twitter user suggested offering them, making it clear that the patient has the option.
More accessibility in the exam and waiting rooms
Find women who are wheelchair/cane/walker/prosthetic users, and ask them what they need most. Wider hallways, exam tables that actually DO lower, more than one bathroom that is fully handicap friendly BY HANDICAP USERS CHECKLIST- not some random contractor. Furniture where a 1— its still a Holly Jolly Pandemic, folks! (@HTTOrganizers) December 5, 2021
Tables that lower for those with mobility issues as well as higher waiting room chairs were among the most frequently suggested items.
And lastly … a variety of speculum sizes
A wide variety of speculum sizes, and introduction to the exam room including a play by play of how the visit will go. Most people never get this and the office staff never ask if it’s their first exam and most people wouldn’t disclose fear or stress if they have it.— Móniquita (@mvasquez_owner) December 5, 2021
The general Twitter consensus: and while you're at it, warm them up too.
Dr. Stewart’s tweet did receive constructive criticism asking for more inclusion
I would not just ask women. I'm not a woman and GYN care is essential to my health.— hannah starflower ♿️ (@HannahntheWolf) December 5, 2021
Physical space is important, but invest in comprehensive training for your staff to ensure the safety of BIPOC, queer, disabled, and other marginalized patients. This is essential.
Dr. Stewart welcomed the insight, sending a follow-up tweet that read:“Folks have [correctly] pointed out that I [incorrectly] said “women” when what I should have said was “folks who may need gynecologic care.” I named the practice with this in mind @midwestpelvis, but I find that I still have a lot of internalized/implicit bias.”
This viral thread might have started a trend. Soon after another medical practitioner tweeted:
“Love urogynecologist Dr. Stewart asking for input on ideal office design and wanted to ask the oncology community something similar: given that no one wants to come to a cancer doctor…what makes the experience MOST comfortable?”
Though Dr. Stewart describes his philosophy online as “I want you to leave every appointment feeling as though you’ve learned more about yourself,” it’s lovely to see that he is equally invested in learning about his patients as well.
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