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I just learned from @DocMCohen that lots of male family docs skip pelvic exams when women come to them with problems for which such an exam would help diagnose the problem and instead make a referral. Avoiding a basic and critical exam for half the population is just plain wrong.
I can imagine someone might be out of practice and lose confidence and then refer all gyne-related issues out. Sure this is easy to do, but it delays women getting a diagnosis, which not only prolongs uncertainty, but may result in poorer outcomes. It also fills Gyne wait lists.
Good news: if you're one of these docs, you can change. Talk to a trusted colleague and rebuild your skills in a calm and supervised way. Or talk to the #CME office at your nearest medical school to get some leads about regaining this skill.
I can also imagine as a male family doc you may think women don't want a male physician to conduct a pelvic exam, and so avoid the exam. Good news: just ask your patient. Once you tell her why it's a good idea to do a pelvic exam, she'll tell you what she'd like to happen.
I guess I had it easy in my training. I had great docs from all genders teach me how it was my duty to respectfully examine my patients (with their consent) every single time there was a good reason to do. Doing otherwise was a dereliction of duty.
For sure there are some exams which take extra time to explain, set up, pull in a chaperone, conduct, and later debrief with the patient. But. That's. Our. Job. Having had the privilege of caring for many women - in clinic and the ED - I was stunned to learn many just skip it.
So the past is the past. Going forward, don't continue to deny women a full exam when it is warranted. Doing so is the exact opposite of what Family Medicine is all about: whoever you are as my patient, I will do what I can to help you. Learn-up. Get skilled. Talk to CME.
