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?

How did this conversation go?
I'm struggling to imagine how she pushed and pushed. What were you saying to make her keep pushing?

Because going for a scan in a hospital isn't generally the first step in a diagnosis. As a GP you would investigate as many possible causes as you can from the practice setting before onwards referral. Partly because so much can be ruled out within the GP surgery and partly because of a combination of more costly gospital based diagnostics and increased waiting times.

Am sorry you feel like she is pressurising you but she is just doing her job. As other PPs have said you can chat to her about your concerns and see what she says before you rule it out completely. It is ultimately your choice but it might be worth checking in with her first before you rule it out in case it is more serious.

The doctor is doing their job, and it's a useful test. But you don't have to have it, but if they didn't try to get you to do it, then they wouldn't be doing their job. I've reread your post and I can't find anything in it that suggests that you have said that you don't want a smear for any other reason than being busy and feeling better. I'm not saying that you have to explain your reason to the doctor, but given that you have not explained, I think you shouldn't be cross at being pushed.

Also just to say GPs are under an enormous amount of pressure at the moment. She may be being a bit stern with you due to her own workload, healthcare at the moment is a pretty horrendous place to be working.

(Also for this to be the GP chasing you in the current context my guess is she is worried it might be serious. Usually straightforward issues the practice desk would contact you).

Why didn't you just tell the doctor why you didn't want one, rather than waiting for the doctor, in your words, to "try to find out"?

Yup… what she said! And as for wanting to be asleep for it? Seriously a GA for a smear. Have you missed the memo that the NHS is on it’s knees…

I had similar feelings following a bad experience getting a coil, I discussed this briefly with the nurse who completed them and she asked me more questions made me feel safe talking etc. I can't tell you how worth it it was, these topics can be really hard to bring up but I really did find it helpful opening up to a health care professional.

It doesn’t seem related and I don’t see how they can refuse to do any future other tests if you don’t have a smear test. I used to get told every time I went to the GP that I was due one, but kept telling them I didn’t want one. Eventually they stopped mentioning it.

How do they put the plastic thing in and does it hurt? A family member was left with an infection after a smear because she was scratched when the nurse put it in. I can’t even put in a tampon (sorry if that’s TMI). Honestly I know it’s ridiculous you don’t all need to tell me but it fills me with real fear.

Oh so you Googled it - riiiight. And you are not aware that raised white blood cells can be indicative of disease. And you think a GP would send you for a scan for kidney stones, with no other indication for that. 😳

It is your choice not to have a smear test for reasons that are your own. You seem incredibly assertive, I’m surprised you were unable to discuss with the Dr the reasons you do not want a smear test, but whatever they are don’t pretend you have the same medical training and knowledge because you went on Google as it makes you sound stupid.

I can definitely relate, op.

I had a wholly uncomfortable experience at my last smear test. I was actually in the surgery for my child’s routine vaccinations when the nurse noticed I was overdue for my smear test. She pressured me into doing it there and then. Meanwhile my toddler was running around the room opening drawers and bins, all the while the nurse is huffing, sighing and telling me to relax or this will hurt. It did hurt.

I haven’t had one since. Said toddler is now 8. I feel that you should look into getting some help for the issues that are preventing you from having this procedure. I’ll take a deep breath and make an appointment for myself!

Its 100% your choice whether to have a smear test. You can refuse it for any reason and you can also be asked to be removed from the auto invitation list if its too pressuring at that time.

However it's estimated that 7/10 diagnoses will be prevented with cervical screening and HPV vaccination. 1 in 2 people will experience some form of cancer in their life time so it's good to hear that some countries like Australia are expecting to have eliminated cervical cancer within 10 years with vaccination and screening. I've nursed 3 young women in hospice care with cervical cancer so where possible I do feel passionate about trying to reduce barriers to accessing screening to hopefully never see that again.

It sounds like a communication breakdown with the GP and if its stressing you out she's probably not the one you need to speak to for support but it does sound like she's trying to find out why rather than hit a target. I don't think a smear under general is a likely option but there are so so many ways of helping you through it. I will attach a link which may not all be appropriate as is related to previous trauma but its a great resource and things like showing you the brush/having a trusted friend can make a massive difference. My friend who grew up in a very religious household and then suffered from sexual assault and now suffers from vaginismus found it incredibly helpful.

Jo's cervical cancer trust

If she thinks that that is the next test needed before any others she surely has explained why?

Are you really just going to be able to put a cancer worry (however small) to the back of your mind?

I know I couldn't and that emotionally I'd be better getting it out of the way. You either have an excellent GP or she has concerns if she is phoning you personally.

Ignore them if you like or seek some help to get through the procedure.

I think you are seeking validation of your body your choice, which it is but doesn't mean it comes without risk.

I had this for years. Every time a GP said it’s a long time since you had a smear test I’d just say yes? They shouldn’t blackmail you by withholding treatment unless you have one. I think they get a payment for each one they do ( might be wrong) but after a dreadful experience of a GP doing one 20 years ago I vowed I’d never have another.

Stage 2b Cervical Cancer Survivor here...

I understand that it is really scary and it is not comfortable but (and i am sure it isn't cancer) but if it is cancer the treatment is 20 times worse than a smear test and the longer left the more invasive the treatments are.

As everyone has said, it is your body and you don't need to do it, but from someone that has been diagnosed I am a massive advocate of prevention over treatment!

Good Luck xx

Please don’t be pushed into anything you don’t want to do. You can say no and have it removed from your file. It is your choice and GP’s do have targets to meet.

With each of your posts I'm afraid you're coming across as more and more immature.

Look, you're getting free medical advice and treatment on the NHS. Take it or leave it. It's immature and entitled to complain about someone trying to prevent you from getting a preventable and possibly fatal condition. To then go on to complain she's harming you because she's applying "pressure" is beyond immature. I mean, come ON. My primary aged child does this about injections. Primary!

Don't want it, ignore her. Deal with your decision and the consequences of it yourself, then.

Completely your right not to get it done and I'd write to the surgery if that's your decision.

I'd be conscious Of the reason for screening though. Yehey're not fun, but I'd wager they're a lot more pleasant than having cancer that wasn't found until a late stage.

Yes, still a woman's choice to make.

It doesn’t matter what it is, unless it’s a Copper putting you under arrest, you are under no obligation to agree to anything!

I have been removed from all reminders and just simply say, ‘No, thank you’, if asked to have any procedure I don’t want.

Any further comments are met with. ‘ Stop harassing me.’, and that does the trick.

Its not that uncommon to be really scared OP, I used to work as a practice nurse and have done hundreds of them. Many women would let me know they were apprehensive, some felt better after talking through what was involved and others just wanted my word that I'd stop if they felt uncomfortable (which of course I always did).

I'd firstly try and find out why the doctor is so insistent, if they have concerns that there could be a connection between your symptoms then they should tell you that so you can make an informed decision. Also discuss with one of the nurses the options for smears (you can ask the doctor but tbh nurses do more of them and will probably give a more comprehensive answer).

‘Is there a way I could have it done and be asleep?’

I doubt it for something that takes a few moments.
It may be that a mild sedative would help you & that is down to your GP or clinician.
Have you shared with your GP your concerns? Information that you struggle with using tampons would be helpful for her to understand you better & come up with a plan to help you have what is an everyday clinical procedure. It may be that another nurse or trusted friend can come in with you as reassurance.

It has to be said that many of us have not always had easy experiences of cervical smears, long gone for us all I hope are the days of cold metal adjustable speculums & rushed inexperienced medics. My most recent experiences have been, of well lubed smaller plastic speculums, a quick brush, with an experienced nurse in a quiet relaxed consulting room.

So @Enfys1982 preparing to have the smear by being relaxed, having an extended appointment if required, understanding the process e.g. using a plastic lubricated speculum to gently open the vagina & the wand is briefly used to brush the cervix for surface cells, & it being done by an experienced nurse /GP all go a long way to make a cervical smear an everyday routine procedure. But you don’t have to have the smear & you can opt out - see NHS link below.

www.nhs.uk/conditions/cervical-screening/

Hth.

I do find smears distressing for reasons I won’t go into OP too. It is assault related. But it’s awful I almost block it out so I can get through it. It’s essential it’s done. I wish there was another way but there isn’t.

Please do not be pushed into ha img anything done that you don't want. Just say no. You don't even owe them a reason.