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?

Wow, strong accusation there. So the GP destroyed her by encouraging a smear test?

Not what I said

"The GP has done nothing to build rapport with her patient and plenty to destroy her trust."

Only on MN, and I seriously doubt that some of the posters are women, because it beggars belief that women are encouraging other women not to check their health, would you find the idea of a medical practitioner suggesting further tests, initially in the form of a smear, to rule out something that might kill you, as coercion, bullying, and google-says-ING.
If the GP had seen something on the OP's face that she felt warranted further investigation, would you all be googling and telling her it couldn't possibly be cancer and the doctor was a bully to suggest the tests?
Over the years we've seen lots of these "no, don't have smears", "no, don't have mammograms" Wonder why?
Would you tell your male relatives that prostate cancer is unlikely to happen to a 25 year old? Or if their doctor suggested screening, encourage it?

@Enfys1982 you seem pretty vocal on here so I would suggest that you go into your practice and ask to speak to the doctor again. Take a relative or friend with you if that would make you feel better. Tell her about your fears and how it makes you feel and that you felt pressurised to have the smear test. I am sure that with all of this revealed she will be more than happy to discuss the way forward which suits. Let's face it - ranting on MN to get your feelings validated is non productive. Work to ensuring you get your health needs seen to.

For the sake of a few mins discomfort could save u years of misery

Fair point

Just a side note here - I (sexually active and very pregnant etc) have never been able to use a tampon in my life, no matter what I've tried. My smear test went perfectly and was painless, not even uncomfortable. Just wanted to add!

For what it's worth op, you really should just discuss your worries with your GP. They might be able to go through things and put your mind at rest. It's perfectly reasonable to feel scared or pressured, but on the flip side it's not really something you should be putting off.

It's possible you have a 'tilted cervix/uterus'. This can cause problems with smears and tampons.

www.healthline.com/health/tilted-cervix

They didn’t on one of mine! They said it can invalidate the results! That one wasn’t particularly pleasant

They use it on the device , not your cervix

I don't disagree, but it's a big could, and it's down to the OP.

And it's not necessary if all they're going to do is test it for HPV, as you can do that bit yourself and with much less hassle.

Maybe not so unusual, but for some women if they're not able to insert a tampon then a smear test would be either very painful or impossible

I think you misread the tone of my post, I wasn't saying that you should be able to cope with a smear if you can't insert a tampon, but the opposite.

Would you tell your male relatives that prostate cancer is unlikely to happen to a 25 year old? Or if their doctor suggested screening, encourage it

I can't help thinking that screening for a bloke would be far less painful though, they'd make sure of that!

Totally agree with this.

Based on fairly scant information provided by the OP, seems the GP is being thorough and doing their job. It reads to me the OP has got herself worked up about a smear due to the experience of a family member, or any other reason (fair enough), but didn’t tell the GP they didn’t want one and why. OP has then projected it on the GP with claims its being pushed on her and coming up with some very curious statements based on Googling.

I don’t think anyone is trying to bully the OP into a smear. They are explaining the benefits of having open conversations with your healthcare provider (who have heard and seen it all) and what is on the balance of probability in the OPs best interests. OP came across as petulant in the earlier posts.

"So the GP destroyed her by encouraging a smear test?"

Apparently the GP threatened to refuse treatment unless the OP had a smear even though the need for a smear test was not directly related to the UTI. If I have understood that correctly, that is not 'encouraging'.

"GPs are very knowledgeable but the last i heard they didn’t have mind reader on their job description."

GPs should know that even adult women can be virgins and also that all women can have problems that may make smear tests difficult, painful or impossible.

"Just a side note here - I (sexually active and very pregnant etc) have never been able to use a tampon in my life, no matter what I've tried."

May I ask why? If it's not to do with pain on inserting things?

"They didn’t on one of mine! They said it can invalidate the results! That one wasn’t particularly pleasant"

Wow. I thought there was always lube with internal exams.

The picture on smear tests is a lot less clear cut than on mammograms or some other forms of testing. McCartney's work is well worth reading and screening can cause problems in itself - its not problem free.

In my area for many years now they only screen for HPV - your cells are not analysed if you are HPV negative. This is increasingly common which makes the value of smear tests for virgins pretty moot.

What I see on screening threads is the usual spat of "you must have it, the risk is enormous, doctors are all saints, nurses are all saints, it never hurts" on one side and "they are only chasing the (real) targets, the nurses were horrible, its excruciating" on the other.

The truth is somewhere in between. The skill fo the tester really matters in my experience. If you have a specific problem due to life experience or vaginismus you should have a tester experienced in those issues.

At the very least the OP needs to make informed consent and doesn't have that info as to why she needs a test. She needs an actual discussion with her doctor to go through the reasons, issues and her concerns.

It may be that is all she needs, possibly a diazepam will help, maybe she needs specialist help. I would also concur with the comment upthread that sexual health clinics are often a damned sight better at this than many GP practices.

@PAFMO if you think bullying and coercion don't happen I once had the surgery on the phone demanding I tell the au-pair to go in and book a smear because she didn't seem to understand them. I also once had a receptionist yell across the waiting room to say "your smears overdue, can you come to the desk and book an appointment for it". I just looked at DD's Deputy Headmaster who was sitting opposite me.

I don’t know why you’ve quoted me and then paraphrased what I said back.

This is your first post on the thread as far as I can see. Which post or username are you referring to?

I found this thread completely fascinating as I'm in a similar situation. Interestingly, using the link a PP posted, I tried to unregister myself from the screening programme. Less than 10 hours later I got a call from my surgery from a lady who was really insistent that I listen to what she had to say. I was literally about to run out the door to an appointment and said that now was not a good time. She actually tutted and said she would not take me off the list until I heard what she had to say. She's going to ring me back apparently.

I fully accept that screening saves lives (without a doubt) but some women have very legitimate reasons for not taking part and we shouldn't be forced into disclosing deeply personal issues if we don't want to.

Woah @throwawayusername2 what a strange call. So you're not allowed to come off the register until you've had a verbal telling off?! Do let us know how the second phone call goes!

I imagine it is protocol so that if you have any issues in the future then they can prove they discharged their duties to you but you refused to have them. Fair enough!

Presumably it is protocol. I doubt the tutting is though 😂

I'd be inclined to tell them I was recording the call.

I also recall getting a letter from NHS England in about 2014 telling me that if I didn't engage with the screening programme I risked being struck off my MP wrote in stern terms.

I was having smear tests but privately. Not my fault that the gynaecologist hadn't written to the GP. Neither did I care.

I saw a private gynaecologist because I went to church with the practice nurse. I wasn't comfortable with taking communion at one end as she was a server and giving with the other.