GP is trying pressure me into smear test. Is this acceptable?

[Enfys1982]

A fortnight ago I had a UTI which was treated with a short course of antibiotics. It cleared up but then came back again so I was prescribed more AB’s and did a sample, they couldn’t grow a culture from the sample but I did have raised white blood cells. When the GP rang me to discuss it she initially asked if I could repeat the test and we’d take it from there she noticed on my notes that I was a due a smear and said she wanted to check my cervix as well. For reasons I don’t want to go into I don’t want a smear test, but she went on and on me and basically pushed me into making an appointment with a nurse rather than rechecking my wee sample. I didn’t feel I could say no or explain my reasons why, she didn’t ask me why I felt the way I did either.

Honestly I feel much better now. The unpleasant symptoms have gone so I cancelled the appointment and she’s now phoned me up and asked why I cancelled. I said I felt better and I was busy when my appointment was booked for (both true) but she continued to push and implied that she wouldn’t run any further tests until I’d had my cervix examined. Just thinking about it is making me have a tight chest and panicky I really don’t think I could face it unless I was knocked out. I don’t have any gynae symptoms, my periods are normal etc. I had a fucking UTI! Why is she pushing me to have an invasive test I don’t want or need abs which isn’t relevant to what was wrong with me? She’d already asked if I was currently sexually active and I said no.

The more I think about it the more feel angry. I’ve had similar before from other staff at the practice when I’ve gone in for other things not relevant. Do they get commission for every smear they do or something?

@Enfys1982 you could pay for an hpv test that you can do yourself. If this is neg it is very unlikely to be an issue

You do not need to consent to a smear if you dont want one. It is a screening tests not suitable for if cancer is suspected. If your gp suspects cancer she shouldn't be sending you for a smear

Evening, all. Popping in with a reminder that we are here to support each other - can we please stick to the topic of the thread? Thank you!

@clpsmum

Indeed. Agree 💯.

What an appalling shitshow of a thread which cannot possibly be of any use to the OP. Just pull it please @mnhq.

I’ve always found my doctor/ nurses pushy about smear tests but they are doing it as cervical cancer has a great prognosis at the early stages. They would rather be pushy than have to treat you for cancer. I don’t think they are being unreasonable.

However, it’s clear that there are serious reasons why you don’t think you can have a smear. I think if you could explain to your GP the reasons why you can’t have one then they could talk through some options with you.

Smear saved my life - I had no symptoms - I can’t help but wince when someone won’t have a test that could save their life.

you’re under no obligation of course but educate yourself before declining.

This.

If the GP thinks this is the next most appropriate test, then that should happen before a scan that might be unnecessary. There are probably long waiting lists for people who actually need a scan. There has to be some way of deciding who needs scarce resources most.

As someone who has abnormal cells which were picked up by a smear it frustrates me when women don’t have it done, as it literally saves lives.

My sister refuses to have it done even though she has 2 people close to her who’ve died from cervical cancer.

As women I think it’s really important to be comfortable getting anything to do with our reproductive system/genitals checked out, as we are extremely complicated and so many health problems that women have can be associated with our reproductive system.

Just periods and menopause alone can create massive issues and it’s horrible to think that women are suffering in silence.

However, I absolutely hate this pressure that is put on women to get smear tests and things done.
I have no issue getting it done but if I did then someone going on at me is not going to help at all.

So many women struggle with this and therefore do not get smear tests.
It’s time that something was done about it to change that and make these women feel more comfortable.

They may be optional but why do you think that makes them non vital? Of course they are vital they save lives.

OP, you should never be pressured into a medical procedure you do not want. It's wise to read around any risks or dangers and decide if you're willing to take those risks, but at the end of the day, it's your body and your life and you get to choose what is best for you.

It also doesn’t matter about your sexual history.

My HPV was found after I had not sex for a long time and was told it lays dormant.

I also chose to have an STI test and it was completely clear, so the 2 aren’t associated in any way.

I know it probably doesn’t help much but at least that’s one less thing to worry about if you were.

And if the swab is positive for HPV they can screen the actual smear fully.

100%, it is her choice.

This means: No pressure. No manipulation, no coercion. That's what informed consent means. Not bullying, threatening, or trying to scare her. That's not necessary.

An HCP should lay out information or point OP to the relevant info, and allow her to make up her own mind.

OP, if you do decide to have a smear, I have found in the past a sexual health clinic & an experienced gyno is far better at carrying out a smear than a practise nurse. It's like night and day.

I had the same from my Dr a good few years ago. In the end they put a note on my file saying I had refused a smear and to leave it. A few nurses over the years asked why and I just said dont want one and left it at that. The thought of it caused me panic attacks.

Do you know what, I had my first smear 2 months ago at the age of 41. It did not hurt, was over with in a minute. Can not believe how much I had worked it up in my head all these years. I would suggest going to the hospital to have it done (I did as was so nervous) as the Drs are doing it day in day out. Absolute pros at it.

But yet they are still a choice. However obvious the risks and benefits may be, we have bodily autonomy - although in women’s health you often wouldn’t realise.

Additionally, some women may just not be able to due to prior trauma or physiological reasons.

This 100%.

This attitude discourages people who are nervous, vs encourages.

I had similar symptoms to you and ended up having a camera to look into my bladder, it was more unpleasant than a smear test 😬

I understand that some people struggle with smear tests and I think it’s great that they are now working on home kits so you can do it at home. I am over due a smear but I know deep down that it’s pretty easy and I can kind of switch off my anxiety briefly whilst it’s done. But if you really don’t want it done they need to respects you decision.

Thank you for pointing that out! - I was going to say that the opposite of optional is ‘mandatory’. Which is mot what I claimed. I said that they were vital, ie: extremely important. For all the reasons I put in my response.

And for the pain point - yes, there are certain physical conditions that might make it painful. Absolutely - the OP hadn’t indicated that she has one of those conditions.

But if you don’t have one of those conditions, then it’s like when getting jabbed or giving blood ‘hurts’. It doesn’t if you relax (I’ve yet to work out how to do that), but it’s usually fear that causes all your muscles to tense, and then, yeah, it is really painful. But if you’re not all keyed up, then no, it’s not. Often expecting it will hurt and going in all tense becomes a self-fulfilling prophecy.

I was trying to help the OP go in expecting it not to hurt, and open to talking about her fears with staff so they can help calm her down. That was literally the only way for this to have any kind of successful ending for her. Horror stories are the absolute opposite of helpful.

It’s like childbirth. If someone came to you saying, “I refuse to have kids because there’s so many ways childbirth can go wrong and it’s obviously excruciating and I’m terrified of the whole idea,” the last thing you’d do is tell them all the horror stories you’ve heard about childbirth. You’d reassure and say that it isn’t as bad as it’s made out to be. And that it is, in the main, worth it (though you may disagree 😂). And to have some bloody good meds 😁.

GPs do get bonuses based on meeting certain target for routine tests, this is correct.

www.gponline.com/local-targets-worth-11k-year-gps/article/1165383

www.pulsetoday.co.uk/news/clinical-areas/cancer/nhs-review-calls-for-gp-financial-incentives-to-boost-screening-uptake/

'GP practices already receive some additional funding for carrying out cervical screening tests, through QOF payments.'

get the smear done and stop trying to justify it. There aren’t targets. Or commission. It’s literally to save lives.

if your fear prevents you accept that but don’t kid yourself that she’s motivated by anything other than saving lives.

@Enfys1982 I've had problems with smear tests in the past as I had vaginismus. I had my first smear test during a laparoscopy that was being done anyway under general anesthetic, but obviously that was a once off. Another time I was getting something else essential done with an epidural and got it done then. These are only 2 smear tests I've had. I am due another soon and dreading it.

"It’s like childbirth. If someone came to you saying, “I refuse to have kids because there’s so many ways childbirth can go wrong and it’s obviously excruciating and I’m terrified of the whole idea,” the last thing you’d do is tell them all the horror stories you’ve heard about childbirth. You’d reassure and say that it isn’t as bad as it’s made out to be."

No, you'd respect their decision! Particularly as risky and painful are correct.

"And for the pain point - yes, there are certain physical conditions that might make it painful. Absolutely - the OP hadn’t indicated that she has one of those conditions."

That doesn't mean she doesn't have one. If inserting anything is painful, this suggests she does have such a condition.