to wonder why American women go to the gynaecologist so much, and whether we should to?

[Ribbet]

Do they really have regular check ups or is it something I've seen on TV, just for routine smears, contraception and those services we use GPs/ practice nurses for? And if they do go more often, do US women have better gynaecological health Han those of us in the UK?

There must be an equivalent illness in the UK dreaming. It's not possible that lots of people in the USA get an illness which is unknown in the UK.

Yep I've had it twice since living in the UK. I did think the GP called it strep but to be honest, I probably used the term first (I know if I'm in that kind of pain and I've got great nasty blisters in my throat what it is) and he/she went along with it.

I am no help in solving the mystery. :)

Well then I guess it's pharyngitis. It's more about the throat than the tonsils, if I remember right, although it can also get on the tonsils if you have them.

If you have a child in pain with a sore throat you go to the doctor. I think the difference In the UK you get the name for the "problem" like infection or "tonsillitis" and you get antibiotics. In the States you get the name of the actual bacteria i.e."strep" and get antibiotics.

Money. MIL lives in the States and has had an unbelievable number of CT and MR scans for her numerous ailments.

It's the same family of bacteria, not the same strain. There's loads of different kinds of strep.

Americans have far too many tests, I can't disagree with that. It's a whole process, doctors often do more tests than necessary if they see you have a good insurance which will pay them to do them. This is especially common with elderly people who are all eligible for some version of Medicare (some better than others, as usual) often in addition to another private insurance.

Or, they do extra tests as a safeguard against malpractice lawsuits. :(

www.differencebetween.net/science/health/difference-between-tonsillitis-and-strep-throat/

wouldn't this be a two tier system? i.e. those who have private medical insurance, those on medicaid/medicare ... or however it works?

Medicaid is really only if you're practically on the streets from poverty, or have a disability and can claim it because of that. In addition, many states (most states? I don't know) will cover appointments for children under Medicaid even in situations where the parents might not be eligible for it.

Medicare is for people age 65 and above. It might be 68 now, I'm not sure.

Everyone in-between had better have a decent job offering them insurance, or they are screwed. basically.

And if you are ever diagnosed with a condition, be it diabetes or cancer or anything which requires continuing care, or follow-up care, pray that you never lose your job because if you lose that insurance company, any subsequent one you sign up with will refuse to cover your pre-existing conditions. I believe Obama was attempting to make this illegal, but I'm not sure he was successful.

Healthcare-related debt is the number one reason people file for bankruptcy in the US. :(

No that's been changed, now insurance companies have to accept you with preexisting conditions, as long as you have been continually insured.

oh, that's a good start. I'm not sure why they need that bit in about being continually insured, though. So many people lose their insurance between jobs. Unless they can afford to shell out for COBRA.

(bedtime btw, talk to you ladies later!)

Ahh COBRA, DH company where pretty good when they laid staff off, they would pay for 18months, which was a bit of a life saver literally for people.

what about trying to explain co pay to the Great British Public? my good what a mine field, we couldn't understand it so we went for the top cover which only had a $25 co pay ( I am still not sure if we got it right?) but a British friend with diabetes in the same company read co pay as we would excess on car insurance and went for a $2000 co pay which worked best for her so long as she didn't have another condition which cost more than the co pay, I could never get my head round it.

Obama's health care reforms arn't till next year and can still be derailed as in looking after your fellow countrymen (women and children) is according to republican unconstitutional ! FFS!

Basically the way I understood it that if you became ill your insurance company could not cancel your insurance in the way insurance companies are not allowed in the UK to cancel if you house is suddenly in a flood area.

because they can and will cancel health insurance in the US at the end of a treatment like pet insurance will in the UK.

Wow! A whole lot of misinformation on this thread (and some accuracy). I hope I"m not about to add to it.

The US system of training doctors is different. They don't really have an equivalent to our GPs - the family physicians don't have enough O&G and Paeds experience to deal with stuff like smears, routine kiddy stuff that GPs see in this country - hence the reliance on seeing 'specialists'. However their 'specialists' ie. the O&G doctors/ Paediatricians train for a much shorter time to do basic stuff and it is only the specialised ones who have an equivalent level of training to UK staff eg. Paediatricians in the UK train for 8 years in Paediatrics and 2 years as a foundation doctor (so to become a Consultant Paediatrician you do 10 years after graduation). In the USA you do your internship and then a 3 year paediatric residency and hey presto you are a "Paediatrician". IMO the name is the same but the end product is not and most of the workload that a 'general paediatrician' in the US does can easily be covered by a UK GP.

Strep Throat is a streptococcal throat infection. We don't routinely swab patients with tonsillitis here so we don't make the diagnosis.

"Strep throat" was a common complaint when I was at boarding school (in the UK) - if you had a very sore throat it was swabbed and tested for streptococchal infection, then you were treated with antibiotics. Not the same as tonsillitis.

Gasman, but isn't US medical school longer than in the UK? You do university plus med school, that's 6-8 years, then 3-4 years of further training.

Medical school in the US is a postgraduate subject and lasts 4years. Their pre-med courses (3 years) aren't clinical however - they are basically a biomedical science degree and last 3 years. so I don't think this really accounts for the substantial shortening of clinical training after graduation from medical school.

UK Medical school lasts 5years and if you do an integrated science degree it is 6 years.

The direct comparitor for the US system in the UK would be the 4 year graduate entry programmes available at places like St. Georges & Cambridge (there are more). The graduates from these medical courses still have to do the same grind as the rest of us to end up as 'specialists'.

US trained specialists can't get access onto the UK specialist register as Consultants as the training isn't considered equivalent.

so does this healthcare system mean that there is differentiated access to ob/gyn care for women?

how did strep throat come into it?

As said above a lot of countries are different from the UK. I have moved here from Germany and am still a bit wary of going to the GP for everything.

I guess it's just a bit of a different system but the OB Gyn in Germany does breast exams etc as well, and it's a bit more of routine testing. Also, some of them do check your uterus and internal organs in the yearly check up so you know you don't have cysts or anything. I quite like the check ups and go when I am seeing my family. It just feels a bit safer to get regular check ups.

I also had issues with birth marks before (had to be removed as they were growing tumours, not cancerous thank God) and I can be seen by a specialist dermatologist no problem. My GP here told me it's not necessary to get everything checked by a specialist yearly but when you have had a hand full of tumours removed already because they were growing the 'I am sure it's fine without a specialist' just doesn't cut it.

However, I do like how a lot of ailments here can be treated by nurses. I often think it's unnecessary to see a doctor for everything and often seeing a nurse is more than enough.

That above post doesn't really make sense I think, sorry, it's late. I wanted to say that I think often people are over treated and nurses having more power etc is great.

But, nevertheless, I find it an alien concept to not be able to see specialists easily. And I am missing routine checks, here it feels things are only getting done when it's already quite bad, whereas I think prevention is a good way of doing it. But that might be my bias.

I hope that clears up my above contradictory post a bit.

Thanks Gasman, that's interesting!

I guess for me it feels like a bit of a tradeoff -- US specialists might have less training to start off with, but they are more accessible.

Dermatology is another good example. Like Gravity, I used to see a dermatologist for yearly cancer checks (high risk, lots of precancerous biopsies). When I went to my UK GP about a dodgy mole, she looked at it for a split second from about 4 feet away and said 'oh that's no problem'

I also had to go off my rosacea medication because another GP had never heard of rosacea and wouldn't prescribe it!

What gasman said. Seeing a "gynaecologist" here in the US is not the same as seeing a UK hospital consultant gynaecologist, and much of what they do is done by GPs/nurses in the UK. If you had a particularly complex or serious case you would probably expect to be referred to a specialist in the nearest big teaching hospital.

Is there more care here if you want it? Yes. Does that automatically make it better care? Not necessarily. Unfortunately I think it is now ingrained into the culture here that it always is, and doctors and health organisations make a lot of money out of it. You are supposed to see a gynae here once a year but I don't go that frequently as I think it is an over-medicalisation of women's bodies.

Overall gynaecological health in the US is probably worse than in the UK because so many women don't have health insurance; although there are places like Planned Parenthood which serve low-income women. Although the Republicans seem to be doing their best to shut them down.

Gasman is correct, I have loads of US doctor friends as my hospital in the UK took US med students from St Georges in Genada, really lovely people, very committed but a US degree out of UNI is considered in world terms only equivialent to say a higher A level, best I can discribe it, so they have to do a degree before they can start a med degree, to prove they can do the course.
St georges is an interesting University, because if you can pay you can play, I meet a woman in her 50's mary who discribed herself as a jewish princess, rich husband who had died, she was stay at home mum, kids in 20's she had the money to pay to be a doctor, she was a bit of a airhead, but also intelligent iyswim, study paeds, I just bet she smashed it, I would go to her,
I meet an a Famous American football? could have been baseball? player for New york??? studying to br a doc in his 40's BOB, when I lived in America it drove my American freinds mental that I could not realy remember his name and even what sport, just he was Bob, and he drove a New jag whilst a student in the 90's and would take me out for dinner :) NO! nothing else! DIRTY GIRL!
what I remember best about Bob was when he would come in and say "can I have a Venflow mam" I was 19 lol...I am so outing myself tonight with my stories ...runs away in panic ..

I am in the states but came from the uk.
I love the fact I routinely get my breasts checked without having to ask....unlike uk.
The ob has time to discuss contraceptive options.
She called me when my baby was born in the hospital as it had not been her who delivered as baby was early.
It is very personal here and I have to say I have never felt more cared for. In the uk I could never get an appointment on the day I needed it and was dismissed by a nurse when I mentioned a possible breast lump......as I was so young...in my 30 s ...it put me off ever raising something like that again.

I know the us has some major issues in terms of ensuring care is there for all but if you are insured, the care is amazing.
Just had my second baby and frankly the whole experience was like flying club class.......not once did I need to ring the bell to ask for help...the nurses were checking if I needed water....drugs....they body bathed me...they even gave me a card to congratulate me...each had signed it.....the catering dep sent me a cake with candle card and bottle of non alcoholic cider to welcome my baby....

So I can never knock the us system.frankly the care provided is exemplary.