Are STD screenings now routine with pap smears?

[joannqn]

Wondering if STD screenings are routinely done with a pap smear or if I need to be angry with my doctor?

 

 

 

TMI story below (don't read if TMI bothers you):

 

I have a weird body. It rarely seems to do what is normal or expected. Way way back when, I had gone to the doctor to get birth control and was told that I had chlamydia. I was 18 and living with my boyfriend. It scared the crud out of me to have to explain that I had an STD and here's your medicine. We both took our medicine EXACTLY as prescribed. I was told this would cure it.

 

A week later, the doctor called and told me my chlamydia test was negative. We finished the medicine anyway. So, I should have been clear, right?

 

Six months later, I was back to renew my prescription. (It was Planned Parenthood and they required another visit at 6 months rather than a year.) They do an exam again, and again I'm told I have chlamydia. No, wait! Last time I was here, you said that. You told me the medicine would cure it, and I took it they way you said. Then you told me the test was negative. So, why do you think I have it again? Ok, so they did the test again but sent me home without the medicine. They would let me know if I needed it. I didn't; the test was negative again.

 

Fast forward. I go see another doctor. He says, "Ah..." I reply, "No, I don't have chlamydia," and explained the previous history. He explains the symptoms he's seeing. I still don't have chlamydia.

 

Fast forward again. I see an actual GYN. I explain the whole story above before I let him look at me. He's an older man, and just laughs and shakes his head at the previous fools who don't know that some women just have that kind of cervix.

 

Fast forward to after I meet DH. Because of my history, I volunteer for a full STD panel. I wanted to make sure. I get tested for chlamydia, gonorrhea, syphilis, AIDS, and I don't know what else. They are all negative.

 

Fast forward again. I'm pregnant with my first child. (Or it might have been the prepregnancy appointment.) The first appointment with the midwife. I explain the whole story above before I let her look at me. She goes ahead and tests me for STDs without my permission. :glare:

 

DH and I have been monogamous for 15 years.

 

So, last week I go into my doctor's office for a UTI and a pap to renew my bcp. I haven't seen this particular person in the office. I explain the above in condensed form and jokingly conclude by saying, "So, no you do not have permission to test for that."

 

I just got a voice mail saying my labs came back. I do have a UTI (duh) and my pap and STD screen came back negative. Ugh!

 

I don't have insurance. I don't have a lot of money. The doctor knew money was an issue. I did not give permission for the STD screen; in fact, I jokingly said the opposite. I did not even know she was doing a screen until I got today's voice mail.

 

Would you be mad? What would you do?

[NicAnn]

Hmm...I'm trying to think if it's standard to test or not. I think that if you are getting a yearly, then no it's not standard to just test. I don't think I've had an STD panel since my first real adult pap about 5 years ago or so. I wonder though, if you went to a drs office, they just do it without thinking because so many people have great insurance? This happened to me recently with my pregnancy bloodwork. I went in to get the HCG levels checked, 3 times in a week to see how they were growing, and each time they ran a FULL panel on it.

 

I would speak with billing and tell them you specifically did not want that to be run, for cost reasons.

[stripe]

They're not routine.

 

Doctors seem more interested in testing me when pregnant; for other pap smears, no one tested or asked. (I am married and they know that.)

 

I know a monogamous someone who was required to be tested for an STD when having apparently non related symptoms. Guess what? Negative. When that person complained, the explanation was that people lie and that some pregnant woman had claimed to be monogamous and then ended up being quite ill and the fetus also etc etc. But it does seem problematic since you declined. And of course the cost. There are cheaper places, like the health dept, to get a lot of these tests anyway, so it is obnoxious not to refer you there.

[kalanamak]

I complained about this once, as a teen, and the charge was dropped (I was celibate). I bet the doctor's office "ate" the bill, and felt they were doing a public service.

 

Yes, for many it is routine*. Sadly, I have found it in women who were sure hubby was faithful. Sometimes I have "insider" info, such as hubby coming in for his own check (which, if positive, I could notify her via the health department), or even a "V" when his wife's tubes were tied when she had her last C section. I can't tell her about the "V", but I can run a swab and hope her insurance covers and she notices nothing....

 

What would you do in my position?

 

*especially in some demographics. If you got this done at, say, a sliding scale SeaMar clinic, it would be more routine. I'm going to ask the FP I know who works at SeaMar

Edited February 15, 2012 by kalanamak
realized I tend to work with the underserved/poor/high risk pop.

[stripe]

I wonder though, if you went to a drs office, they just do it without thinking because so many people have great insurance?

Really?

 

I don't know anyone with great insurance.

[DianeW88]

It depends on your doctor and your state health law. In some places it is automatic.

[ErinE]

I don't know about UTI, but for pregnancy, I got a full STD screen, even though I knew and my husband knew I did not need it.

 

If you didn't approve a STD screen for an UTI, I would tell the doctor's office I didn't approve the test and I wouldn't pay for it.

 

ETA: I know someone who thought she was "safe" and it turned out she did have an STD. That may be why the doctor's office does an automatic screening.

[CLBMom]

First I would call and clarify that they actually did do the tests. I've gotten all kinds of crazy messages from drs offices. Most don't even have nurses anymore just techs that may not even understand what they are readin

If they did do the tests I would demand to talk to the dr and billing and tell them you told them NO std testing and will not pay for something you refused, expecially since you have no risk factors. My midwife always asks if I know or have any reason to think my husband or I have been exposed to anyone else since my last visit. My answer is always no so no std tests are ever done. When they did them with my first pregnancy (refused with other 2. Thought it was a waste of money) I had to sign a consent form. That may vary by state. So yes I think you have a right to be mad. I know I would be.

[melissel]

I would speak with billing and tell them you specifically did not want that to be run, for cost reasons.

 

:iagree: I'm not usually a conspiracy theorist, but I do think a lot of things like that are for insurance income. Although...would the doctor's office see any of that revenue? I would think that the testing company would be the one that benefited. So my theory could be wrong :tongue_smilie:

[joannqn]

She was very much aware of the fact that I was paying out of pocket and money was problematic. That is a whole separate issue that came up because of an error on the part of the schedulers.

[ErinE]

She was very much aware of the fact that I was paying out of pocket and money was problematic. That is a whole separate issue that came up because of an error on the part of the schedulers.

 

Can you talk to the office manager and not the billing department? Aside from the techs and nurses, I've found the office manager's to be a bit more reasonable when it comes to billing discussions.

[DesertDweller]

I would call and ask if it's standard practice every time a pap is done. If not, I would ask why you weren't informed especially given that you mentioned to the doctor your lack of finances. You may get them to take the charges off depending on whether it's normal to do it or not.

 

I've only ever been tested for STD's once when I was pregnant. That was many years ago, and they made a big deal about having me sign a form giving them permission.

 

My current doctor is an Internist. He likes to do a full exam once a year including the female stuff, but never any mention of checking for STD's. The last two years after telling him I couldn't afford a full physical, they just did a pap. They were very gracious and even double checked with me to make sure I knew I would get a separate lab bill.

 

In the future, you may just have to be very direct with exactly what they're doing. I don't mind asking, and I will even ask them the cost when I make the appointment. We don't have insurance, and I can't take a chance on unnecessary tests that I don't need and can't pay for when I go. And also clarify again, when you go, exactly what will be done that day.

[Wabi Sabi]

Pregnancy? Yes, a full STD screen is standard. I wasn't expecting it and almost died when I got the bill with my first pregnancy. The next pregnancy I knew to ask more questions and decline testing that I didn't want or need.

 

A regular Pap smear, not pregnant? I've never heard of a full STD panel being standard, but a HPV test along with the Pap is routine for many doctors these days.

[tex-mex]

We did not have health insurance for the longest time.

 

Recently qualified for state Medicaid. Decided to finally get a pap test (haven't had one in 15 years... yeah, I know. :glare:).

 

Had to go to a County Clinic and had quite the experience. Hubby went with me as it was in a dicey area. I noticed lots of young adults and GUYS. (I was used to OB/GYN with a female population... but okay. Guys need screenings too.)

 

Finally it was my turn and I went in the back to be asked a litany of questions.

 

I then had to sit and endure a binder of photos of STDs and the young clerk/nurse/worker rambling to me about having unprotected sex.

 

:confused: I decided to have fun with it -- heck, I've been married and monogamous for 25 years -- and slyly commented to the lady how interesting the info is.

 

"I highly doubt I would get pregnant as my eggs are "drying up" at age 45 and periomenopause is setting in."

 

"But sure... free contraceptives? I'll take a bag." ;)

 

"Whoa, go back to that photo. Dang. What a shame I could not bring in my teen as we were discussing the same thing in his health class." The look on her face at that point was priceless. :lol:

 

Then I had to get a blood lab test. Directed then after that to a small room to sit for over 30 minutes in a paper gown. Finally saw the doctor and had the pap test. She laughed when I told her what a difficult patient I was being to her aides in the STD "talk". Results came back negative a few days later. But yep, it sounds routine to have STD tested with a pap test.

Edited February 14, 2012 by tex-mex

[tex-mex]

 

Yes, for many it is routine*. Sadly, I have found it in women who were sure hubby was faithful. Sometimes I have "insider" info, such as hubby coming in for his own check (which, if positive, I could notify her via the health department), or even a "V" when his wife's tubes were tied when she had her last C section. I can't tell her about the "V", but I can run a swab and hope her insurance covers and she notices nothing....

 

What would you do in my position?

 

*especially in some demographics. If you got this done at, say, a sliding scale SeaMar clinic, it would be more routine. I'm going to as the FP I know who works at SeaMar

 

:iagree::iagree::iagree:

[jlmom]

I've never had to have one done during an annual exam, but with this pregnancy (my youngest son is almost 5) they required a clymidia and gonorrhea (those are both spelled horrible wrong) test. Absolutely required it, even though I told them that both dh and I had never been with anyone else. I was a little upset with them, but went ahead with the test anyway. I think your dr was way out of line.

[Dmmetler]

My OB/GYN does them, and he's very conservative on ordering tests. Between being a Spanish speaking OB and having nurse-midwives as partners in the practice, his clientele is mostly married, Catholic, and often have less than ideal health coverage. He doesn't, for example, order routine ultrasounds or the triple/Quad screen unless the patient wants it or there's a good reason. I'm guessing that if he's doing a regular STD screen as part of an annual, even on married women with children, he's got good reasons to do so.

[Coffeetime]

For a regular yearly exam, no. With pregnancy, yes.

[ktgrok]

This year they did do an STD test of some sort when they did my pap. I think it was HPV, but not sure. I was annoyed as well.

 

but, on the flip side, I LOVE my midwife (not the same office as above). I went in for my first prenatal and she said as long as I didn't know of a reason, she saw no reason to repeat the STD screenings and such that we did with my daughter 2 years ago. A waste of money and time. And I agreed :)

[m0mmaBuck]

The military docs always offer but don't do it as a standard.

[NicAnn]

Really?

 

I don't know anyone with great insurance.

 

I live in an area with a high military population and a high medicaid population. Both will cover nearly everything, but I can see in other parts of the country this wouldn't be so.

[DianeW88]

I think the problem is that the test is sent to a lab. The doctor really has nothing to do with it. The sample goes with a form where "Pap panel" or something similar is checked off. There really isn't another option on the form. If the lab screens for STDs those will be performed as well.

 

I'm guessing your doc may have heard your request, but the info was not passed along to the tech or nurse who handled your sample. The doc just leaves the room and moves on to the next patient, generally. The nurses handle the tests and samples. If you want to make sure you don't have that type of test done next time...talk to the nurse. They really run the office anyway. :D

[joannqn]

The lab is in-house.

 

I was not impressed with the nurse. Ugh. She told me you can't believe anything you read on the internet when I referred to reading about experiences other people had with a certain medicine. Excuse me, but ya'll are on the internet and I believe that Dr. Hive is pretty darn good at what it does. :D

[Rivka]

In my state, STD testing is required during pregnancy - not once, but twice. I was complaining about that to my mother, who for many years ran a program for pregnant teenagers and their babies, and she told me that she had one client contract gonorrhea three different times during the same pregnancy. Huh.

[melissel]

In my state, STD testing is required during pregnancy - not once, but twice. I was complaining about that to my mother, who for many years ran a program for pregnant teenagers and their babies, and she told me that she had one client contract gonorrhea three different times during the same pregnancy. Huh.

 

That is just so sad on so many levels :(

[melissel]

In my state, STD testing is required during pregnancy - not once, but twice. I was complaining about that to my mother, who for many years ran a program for pregnant teenagers and their babies, and she told me that she had one client contract gonorrhea three different times during the same pregnancy. Huh.

 

That is just so sad :(

[DianeW88]

The lab is in-house.

 

I was not impressed with the nurse. Ugh. She told me you can't believe anything you read on the internet when I referred to reading about experiences other people had with a certain medicine. Excuse me, but ya'll are on the internet and I believe that Dr. Hive is pretty darn good at what it does. :D

 

Then I would change doctors...they sound less than responsive to their patients' needs.

[SweetMissMagnolia]

if my ob/gyn office tests for that yearly then they don't tell me....ummm the only time I remember being screened at all for any type of STD/etc was when I was pregnant.....I have a yearly pap smear done and she also checks my thyroid with a bloodtest-not sure what else...