Bad well-visit for dd....

[Cheryl in NM]

I'm still confused as to why she needed to have her privates looked at during a well-child exam. I don't remember having that done until I went for my first pap. Once Ds's circ healed the doctor never looked down there. Is this really what's happening to our girls on a regular basis?

[melissel]

I'm still confused as to why she needed to have her privates looked at during a well-child exam. I don't remember having that done until I went for my first pap. Once Ds's circ healed the doctor never looked down there. Is this really what's happening to our girls on a regular basis?

 

My girls' ped takes a quick peek inside their pants when they're young (under 5, maybe under 4) and explains beforehand, and takes the opportunity to discuss with them that they never let anyone do this unless mom or dad is present and says it's OK, which I'm fine with. He did not do this when I took DD6 in for a pre-camp checkup in June, just asked if she had any questions/problems/complaints in that general area.

[Delighted3]

but I think my daughter had her last one when she was 6 or 7 and the doctor just quickly pulled her pants down to look and back up. It literally took 3 seconds and barely registered to my dd. I have 6 children and my oldest is 19 years old and none of my children have ever been asked to disrobe in the dr.'s office, even last year when my dd had pneumonia and they had to listen intently to her breathing and give her shots in the bottom, they only pushed aside the clothes to get where they needed to be. I think I would definitely lodge a complaint and take her to a different doctor ASAP.

Joy

[Tiramisu]

In all honesty, I have known this doctor for about thirty years. I have never had a bad experience with him. I always thought of him as someone who I could go to if I had any kind of problem with one of my children. He has gone out of his way to be helpful when I've had to call him at home when I've needed to when the kids were sick at odd hours, etc. I have never had one moment of discomfort in his presence before this. Having been treated by the 2 other doctors who have been with the practice for the last twenty or so years, and my children as well, they have always done careful genital exams. I never questioned this because it's all I've known. Before starting this thread, I never knew things were different elsewhere. I don't think I'm being "nice" or "passive." At the moment it happened I was simply in shock so my immediate response admittedly STUNK. Now that I've had time to think about it, I weigh it against everything I know of his character for years and years. I think he did the exam he always does with every patient but he did it in an absolutely unacceptable manner. I will certainly discuss this with our new doctor and go from there.

 

As far as dd goes, we talked about what happened. I told her that she will never go back there, and that we will find a new dr. I asked her what is important to her in a new dr. She surprised me by not mentioning the private parts issue at all--and she is definitely the kind of kid that would and she is very articulate. She said she really didn't like that dr.'s silliness. Specifically, she said, she doesn't like goofing around and rings that honk. Perhaps a more professional manner makes her feel more secure. Our usual doctor in that practice is a younger dr. who is rather new to the practice and she is very low-key, cut and dry.

[newbie]

In all honesty, I have known this doctor for about thirty years. I have never had a bad experience with him. I always thought of him as someone who I could go to if I had any kind of problem with one of my children. He has gone out of his way to be helpful when I've had to call him at home when I've needed to when the kids were sick at odd hours, etc. I have never had one moment of discomfort in his presence before this. Having been treated by the 2 other doctors who have been with the practice for the last twenty or so years, and my children as well, they have always done careful genital exams. I never questioned this because it's all I've known. Before starting this thread, I never knew things were different elsewhere. I don't think I'm being "nice" or "passive." At the moment it happened I was simply in shock so my immediate response admittedly STUNK. Now that I've had time to think about it, I weigh it against everything I know of his character for years and years. I think he did the exam he always does with every patient but he did it in an absolutely unacceptable manner. I will certainly discuss this with our new doctor and go from there.

 

As far as dd goes, we talked about what happened. I told her that she will never go back there, and that we will find a new dr. I asked her what is important to her in a new dr. She surprised me by not mentioning the private parts issue at all--and she is definitely the kind of kid that would and she is very articulate. She said she really didn't like that dr.'s silliness. Specifically, she said, she doesn't like goofing around and rings that honk. Perhaps a more professional manner makes her feel more secure. Our usual doctor in that practice is a younger dr. who is rather new to the practice and she is very low-key, cut and dry.

 

I am happy you have shown your daughter by action, that her feelings although not expressed are important enough to change doctors.

 

I would also give new doc heads up on the private exams. Perhaps hold off until teendom. It might be a very sensitive issue for quite some time.

 

I had an exam that went awry, the ob hurt me w/ a speculum and I screamed. I havent been back since.

 

Lots of hugs to you and your dd.

[Joanne]

OK. I am not going to keep "on" this. I understand I do not have a history with this man and I do not mean to disrespect your knowledge of the situation. I found his comments about her emotional state and homeschooling disturbing in and of itself.

 

FYI, the excessive silliness *could* also be a red flag, which might explain your dd's reaction to it.

 

If you haven't already, please read Protecting the Gift by Gavin de Becker.

Edited November 22, 2008 by Joanne

[stripe]

I think it's worth you thinking about, and then talking with her, about what to do when a medical professional wants to do something that your child doesn't want. My kids are still upset about a flu shot went awry, and (I think) my sincere apologies and constant reassurance that there will be no repeats have helped. I also think at this age, she should get a vote / veto over her doctor, and it may be preferable to see a woman.

 

The only other comment I have to make about this weird examination is, starting at the buttocks and moving to the labia spreads bacteria.

[MommyX8]

I have bedwetters so I brought my 7yog, 6yob and 4yob to the urologist. He wasn't all that thorough with my daughter and was a little more investigative on my 4yob, but that is to be expected with testes and hernias and the such. My guy was fine, though. But my 6yob saw this and there was NO WAY anyone was touching him. I was more insistent but the doctor was fine with no examination. So, I think that your doctor crossed the line. You need to follow this through.

[Alice]

I'm just seeing this thread now, and it's obviously a bit late. As a pediatrician I felt I needed to respond...more to some of the posts along the way than the OP.

 

First to the OP...I think that you have handled the situation in a very good way. I certainly would switch docs as you and your daughter are no longer going to be comfortable with this doc. I think it would be appropriate to let the doc or whoever is the head of this practice know why you are switching. I would write a letter to the partners or to the office manager, just letting them know that this exam was done in a way that was inappropriate and that caused your daughter to be more scared of doctors. I've had people complain about things I've done (not this issue but others) and most of the time it's helpful. I have changed the way I do things at times because of feedback....if noone speaks up we can't change.

 

On to this exam itself...I think an exam of the privates of a 6 yr old is completely appropriate. It definitely sounds like as described this doctor did it in a way that was unprofessional and caused trauma. And at the least, showed a poor bedside manner. Especially with the comments after. But I'm actually really surprised at how many people thought any exam was abuse and how many people said their kids have never had a genital exam.

 

This is what we do...we ask all kids to undress for well checks. We tell them to leave their underwear on and we give them a gown for modesty. If we have a kid who is really upset about undressing than we don't force the issus. Often I'll have boys that will take off shirts but want to leave on their shorts. Frankly, many kids in the 6 yr old age group undress and just leave the gown off, by their choice. We ask them to undress because we feel that for a well check we want to be able to do a good skin check and a good exam of their whole body.

 

We used to not have them undress but would pull the clothing up and away when we got to that part of the body. I feel that is actually more "invasive" as it's like I'm undressing the child. I'd rather have them undressed and gowned with me out of the room. I think it's more professional. When we didn't have them undress and we did genital exams...it would take longer for them to undo their pants and slip them down and I think was more embarassing for the child and again felt weird to me....like I was helping them undress. With a child already undressed it's easy to be quicker and more professional about it. I can see all the comments I'll get on this...but I'll emphasize again that we wouldn't force anyone to undress we simply ask. If they refuse, fine. And parents are in the room the whole time.

 

As for the genital exam itself...like I said I do think they are important. I think well-checks in general are important. That's a whole issue in itself I've seen debated here. Assuming that you've brought your child to the doctor for a well-check because you agree that it is important...I think that a complete well-check includes a genital exam. For both sexes, I'm checking for premature or delayed puberty. For boys, I'm checking for undescended testes and hernias. (And I have found undescendes testes on boys ages 7-10 who have had many other testicular exams but it wasn't discovered.) For girls, I'm checking for labial adhesions in addition to signs of puberty.

 

That's the why...here's how we do it. I first say "OK, now I need to check in your privates. This is part of what we do as a doctor. We check you out all over to make sure you are healthy. It's ok for me to do this because I'm a doctor. But it's only ok if your Mom or Dad is with you." This lets them know what I'm going to do and that it's only ok with a parent there. And it gives them or parents plenty of time and warning to let me know if it's not ok with them. Then I ask them if they would like anyone to leave the room (if they have siblings with them or if both parents are there and they might want the opposite sex parent to leave). Then I have them lie down and very quickly do the exam. It should take no more than 10 seconds if everything is ok. And the whole time I try and talk to let them know what I am doing.

 

I do have kids who are very very upset about the idea or who just refuse. For those who refuse...fine. We would never force anyone to have any part of the exam. For those who are very upset or worried I try and talk to them about it and see if I can get them to understand why I think it's important. And I won't do the exam until they are allowing me. I have some kids who I've seen for 3,4,5 ,6 years who refuse. That's ok. I tell them why I think it's important each year but don't make a big deal of it.

 

That's probably enough....I just felt like I had to post from a different perspective.

 

And to end on a lighter note here's two of my favorite kid stories related to this issue...

 

The first...I had a boy about 6 yrs old in for a well check. I got to the gential exam and went through my whole speech about privacy and why we do it and why it's ok. He looked at me after thinking for a few seconds and said "I've got an idea. How about I go home and check myself and then let you know if eveyrthing is ok?"

 

The second...I had a 4 yr old boy in for a well check. I finished his exam, including the gentials. I was talking to his Mom about a few things and he said "Hey, can you do that again?" I thought he what he wanted me to do and he said "The privates check. It really tickles!" After trying really hard not to laugh and mostly succeeding, I explained that we only do that to check him once a year and that I couldn't do it again because that wouldnt' be ok.

 

:)

Edited November 29, 2008 by Alice

[bkpan]

I'm just seeing this thread now, and it's obviously a bit late. As a pediatrician I felt I needed to respond...more to some of the posts along the way than the OP.

 

First to the OP...I think that you have handled the situation in a very good way. I certainly would switch docs as you and your daughter are no longer going to be comfortable with this doc. I think it would be appropriate to let the doc or whoever is the head of this practice know why you are switching. I would write a letter to the partners or to the office manager, just letting them know that this exam was done in a way that was inappropriate and that caused your daughter to be more scared of doctors. I've had people complain about things I've done (not this issue but others) and most of the time it's helpful. I have changed the way I do things at times because of feedback....if noone speaks up we can't change.

 

On to this exam itself...I think an exam of the privates of a 6 yr old is completely appropriate. It definitely sounds like as described this doctor did it in a way that was unprofessional and caused trauma. And at the least, showed a poor bedside manner. Especially with the comments after. But I'm actually really surprised at how many people thought any exam was abuse and how many people said their kids have never had a genital exam.

 

This is what we do...we ask all kids to undress for well checks. We tell them to leave their underwear on and we give them a gown for modesty. If we have a kid who is really upset about undressing than we don't force the issus. Often I'll have boys that will take off shirts but want to leave on their shorts. Frankly, many kids in the 6 yr old age group undress and just leave the gown off, by their choice. We ask them to undress because we feel that for a well check we want to be able to do a good skin check and a good exam of their whole body.

 

We used to not have them undress but would pull the clothing up and away when we got to that part of the body. I feel that is actually more "invasive" as it's like I'm undressing the child. I'd rather have them undressed and gowned with me out of the room. I think it's more professional. When we didn't have them undress and we did genital exams...it would take longer for them to undo their pants and slip them down and I think was more embarassing for the child and again felt weird to me....like I was helping them undress. With a child already undressed it's easy to be quicker and more professional about it. I can see all the comments I'll get on this...but I'll emphasize again that we wouldn't force anyone to undress we simply ask. If they refuse, fine. And parents are in the room the whole time.

 

As for the genital exam itself...like I said I do think they are important. I think well-checks in general are important. That's a whole issue in itself I've seen debated here. Assuming that you've brought your child to the doctor for a well-check because you agree that it is important...I think that a complete well-check includes a genital exam. For both sexes, I'm checking for premature or delayed puberty. For boys, I'm checking for undescended testes and hernias. (And I have found undescendes testes on boys ages 7-10 who have had many other testicular exams but it wasn't discovered.) For girls, I'm checking for labial adhesions in addition to signs of puberty.

 

That's the why...here's how we do it. I first say "OK, now I need to check in your privates. This is part of what we do as a doctor. We check you out all over to make sure you are healthy. It's ok for me to do this because I'm a doctor. But it's only ok if your Mom or Dad is with you." This lets them know what I'm going to do and that it's only ok with a parent there. And it gives them or parents plenty of time and warning to let me know if it's not ok with them. Then I ask them if they would like anyone to leave the room (if they have siblings with them or if both parents are there and they might want the opposite sex parent to leave). Then I have them lie down and very quickly do the exam. It should take no more than 10 seconds if everything is ok. And the whole time I try and talk to let them know what I am doing.

 

I do have kids who are very very upset about the idea or who just refuse. For those who refuse...fine. We would never force anyone to have any part of the exam. For those who are very upset or worried I try and talk to them about it and see if I can get them to understand why I think it's important. And I won't do the exam until they are allowing me. I have some kids who I've seen for 3,4,5 ,6 years who refuse. That's ok. I tell them why I think it's important each year but don't make a big deal of it.

 

That's probably enough....I just felt like I had to post from a different perspective.

 

And to end on a lighter note here's two of my favorite kid stories related to this issue...

 

The first...I had a boy about 6 yrs old in for a well check. I got to the gential exam and went through my whole speech about privacy and why we do it and why it's ok. He looked at me after thinking for a few seconds and said "I've got an idea. How about I go home and check myself and then let you know if eveyrthing is ok?"

 

The second...I had a 4 yr old boy in for a well check. I finished his exam, including the gentials. I was talking to his Mom about a few things and he said "Hey, can you do that again?" I thought he what he wanted me to do and he said "The privates check. It really tickles!" After trying really hard not to laugh and mostly succeeding, I explained that we only do that to check him once a year and that I couldn't do it again because that wouldnt' be ok.

 

:)

 

Thank you for that explanation, Dr. Alice. I wish you were in my town!

 

Kim

[Gretchen in NJ]

Alice, I think what you describe was wonderful. You sound like agreat doctor. This doctor touched a child's privates without the child's or mother's premission. The child was violated. If he didn't have a Dr. infront of his name, he would be in jail. I have to agree with Martha, Joanne and Blessedfamily.

[Blessedfamily]

I'm just seeing this thread now, and it's obviously a bit late. As a pediatrician I felt I needed to respond...more to some of the posts along the way than the OP.

 

First to the OP...I think that you have handled the situation in a very good way. I certainly would switch docs as you and your daughter are no longer going to be comfortable with this doc. I think it would be appropriate to let the doc or whoever is the head of this practice know why you are switching. I would write a letter to the partners or to the office manager, just letting them know that this exam was done in a way that was inappropriate and that caused your daughter to be more scared of doctors. I've had people complain about things I've done (not this issue but others) and most of the time it's helpful. I have changed the way I do things at times because of feedback....if noone speaks up we can't change.

 

On to this exam itself...I think an exam of the privates of a 6 yr old is completely appropriate. It definitely sounds like as described this doctor did it in a way that was unprofessional and caused trauma. And at the least, showed a poor bedside manner. Especially with the comments after. But I'm actually really surprised at how many people thought any exam was abuse and how many people said their kids have never had a genital exam.

 

This is what we do...we ask all kids to undress for well checks. We tell them to leave their underwear on and we give them a gown for modesty. If we have a kid who is really upset about undressing than we don't force the issus. Often I'll have boys that will take off shirts but want to leave on their shorts. Frankly, many kids in the 6 yr old age group undress and just leave the gown off, by their choice. We ask them to undress because we feel that for a well check we want to be able to do a good skin check and a good exam of their whole body.

 

We used to not have them undress but would pull the clothing up and away when we got to that part of the body. I feel that is actually more "invasive" as it's like I'm undressing the child. I'd rather have them undressed and gowned with me out of the room. I think it's more professional. When we didn't have them undress and we did genital exams...it would take longer for them to undo their pants and slip them down and I think was more embarassing for the child and again felt weird to me....like I was helping them undress. With a child already undressed it's easy to be quicker and more professional about it. I can see all the comments I'll get on this...but I'll emphasize again that we wouldn't force anyone to undress we simply ask. If they refuse, fine. And parents are in the room the whole time.

 

As for the genital exam itself...like I said I do think they are important. I think well-checks in general are important. That's a whole issue in itself I've seen debated here. Assuming that you've brought your child to the doctor for a well-check because you agree that it is important...I think that a complete well-check includes a genital exam. For both sexes, I'm checking for premature or delayed puberty. For boys, I'm checking for undescended testes and hernias. (And I have found undescendes testes on boys ages 7-10 who have had many other testicular exams but it wasn't discovered.) For girls, I'm checking for labial adhesions in addition to signs of puberty.

 

That's the why...here's how we do it. I first say "OK, now I need to check in your privates. This is part of what we do as a doctor. We check you out all over to make sure you are healthy. It's ok for me to do this because I'm a doctor. But it's only ok if your Mom or Dad is with you." This lets them know what I'm going to do and that it's only ok with a parent there. And it gives them or parents plenty of time and warning to let me know if it's not ok with them. Then I ask them if they would like anyone to leave the room (if they have siblings with them or if both parents are there and they might want the opposite sex parent to leave). Then I have them lie down and very quickly do the exam. It should take no more than 10 seconds if everything is ok. And the whole time I try and talk to let them know what I am doing.

 

I do have kids who are very very upset about the idea or who just refuse. For those who refuse...fine. We would never force anyone to have any part of the exam. For those who are very upset or worried I try and talk to them about it and see if I can get them to understand why I think it's important. And I won't do the exam until they are allowing me. I have some kids who I've seen for 3,4,5 ,6 years who refuse. That's ok. I tell them why I think it's important each year but don't make a big deal of it.

 

That's probably enough....I just felt like I had to post from a different perspective.

 

And to end on a lighter note here's two of my favorite kid stories related to this issue...

 

The first...I had a boy about 6 yrs old in for a well check. I got to the gential exam and went through my whole speech about privacy and why we do it and why it's ok. He looked at me after thinking for a few seconds and said "I've got an idea. How about I go home and check myself and then let you know if eveyrthing is ok?"

 

The second...I had a 4 yr old boy in for a well check. I finished his exam, including the gentials. I was talking to his Mom about a few things and he said "Hey, can you do that again?" I thought he what he wanted me to do and he said "The privates check. It really tickles!" After trying really hard not to laugh and mostly succeeding, I explained that we only do that to check him once a year and that I couldn't do it again because that wouldnt' be ok.

 

:)

 

I agree with this exactly.

 

This response could have been written by our pediatrician without any changes except the part where she laughs at my dd4 for saying, "She's checking my hind parts, now Mom", during her exam. :001_smile: