to be so upset? GP surgery told me I would be removed from their list if I don't have a smear test

[veryworried29]

Namechanging uber-regular here.

I received a text from my GP surgery which said "Please confirm address by phone. If not you will be removed from surgery list."

I rang immediately and was told that if I don't come in for a smear test then I will be struck off the surgery list!

Dh and I have been with this surgery for 18 years and our children since they were born.

I don't feel I need a smear test. We very rarely have sex and when we do it is always with a condom. I have had years of clear smears before me.

I find them horrifically unpleasant, in the same way that some people are phobic about the dentist, infact think I may have a form of vaginismus (sp?) hence the lace of piv sex.

Tbh, it almost feels like I must agree to be raped (sorry for emotive language, but this is how it feels to me) in order to keep a place at my GP surgery.

I cannot begin to describe how upset I am about this. There have been tears.

I'd be grateful if you could bear this in mind when replying ... I know this is aibu, but I do feel I have a genuine aibu to run past you all with this one.

breatheslowly - as I understand it, HPV is a major cause of cervical cancer, so yes, if you have only had one sexual partner, and you are that person's only sexual partner, then your risk is reduced.

But, as far as I'm aware, HPV is not the only cause of cervical cancer (although I don't know what else causes it). Someone upthread linked to some research about nuns having cervical cancer.

So, personally, I think I'm at low risk of getting cervical cancer because I've only ever had sex with DH, and (assuming he's being honest with me) he's only ever had sex with me. But, because I don't believe HPV is the only cause of cervical cancer, I go along to the smear tests anyway. Just in case.

Dear Practice Manager

I am writing to complain about the way I have been approached regarding my overdue smear test.

I received a text this morning which said, in its entirety "** Surgery calling. Plse confirm address by phone. If not you will be removed from surgery list."

I rang back straight away and was told by the receptionist that it was to do with unbooked smear appointments, and that if I did not book one there and then, I would be removed from your books. I was struck completely speechless by this and the receptionist audibly softened a bit and said "this isn't our choice, we are being kind to you and giving you the chance to not be removed from our books by making an appointment" .

I was in tears at this point and so made an appointment.

I am writing to complain on two fronts:

1. I'm really angry that no one thought to consider the possible reasons for my failure to book a smear test. Surely it is not uncommon for patients to be nervous to the point of phobia and that the first consideration, from your practice's perspective, should have been to sensitively try and find out why the invitations for testing have been ignored?

1. I think I should have been informed in writing that I am in danger of being removed from the practice list, and why, and by whose authority. Not told in a phone conversation that was initiated under false pretences (I was asked to confirm my address, not make a smear test appointment). I would expect to see the legislation that supports this drastic move. I am surprised that a GP practice can remove a patient because they decline to take part in optional screening programme.

I look forward to hearing your response to my two complaints.

Yours sincerely

I'm glad you came back OP, there is some helpful advice here and I hope you are not too distressed by the unkind and unhelpful comments. Some people just cannot understand that for others this procedure is simply impossible, even though it takes only a few minutes. I ended up having one after 15 years under a light general anaesthetic because I needed something else done which would also have been impossible had I been awake. I hope you sort it out and are ok.

I feel really sorry that you are being put through this OP.

I would have a heck of a problem discussing any of this with the Practice Manager. I know they are responsible for budgets, but the OP's medical issues are nothing to do with them.

Thinking about it, the surgery is probably having a purge of 'ghost' patients. People who have moved away & not told them. An alert about overdue for a smear would have come up when they looked you up when you called back. Still can't coerce you into having one.

OP - would you mind if I suggested a thing or two about the letter?

Good letter op - if you want to make it a bit punchier you could remove the middle two sentences from point 2 (Not told...drastic move) as you have already described what happens plus have questioned the authority for this threat already but not a big deal.

veryworried29 - I hope you don't mind some feedback on your letter - I think it may be worthwhile emphasising under point 1 that you personally are nervous to the point of phobia about the smear test.

The wording above could be misinterpreted as you complaining on behalf of patients in general who may feel unable to complain themselves, IYSWIM.

Oops cross post with Salmo who has the manners I lack

veryworried. Please use the words "undue pressure" in somewhere in no1 as its important from a point of consent and will get them to seriously consider the manner in which they have approached you.

Eg:

1. I'm really angry that no one thought to consider the possible reasons for my failure to book a smear test. I feel that the way in which this has been done put me under undue pressure to book an appointment which has caused me distress and undermines whether I am consenting freely to screening. Surely it is not uncommon for patients to be nervous to the point of phobia and that the first consideration, from your practice's perspective, should have been to sensitively try and find out why the invitations for testing have been ignored?

Any comments welcome!

I was going to say pretty much what maillot and Shadow said but I would avoid "I was in tears by this point" and replace it with "This made me very anxious".

I'd also be more general about the telephone convo:-

"When I phoned the receptionist explained X, Y, Z which I was extremely surprised by and she subsequently further explained A, B, C..."

I hope you don't mind the suggestions!

Ah! "Undue pressure" is good!

Yes I think what Salmo said about the tears - good to sound calm and business like however pissed off you are actually feeling.

I agree with the others. Keep it business-like and in writing.

I think that is a pretty good email - I would send it as is.

OP I would also mention Gmc guidance that's been linked to here.

Yes, good suggestion there about GMC guidelines.

Unacceptable undue pressure? Inappropriate and undue pressure?

Replace I'm really angry with I am extremely angry

1. I think I should have been informed in writing that I am in danger of being removed from the practice list, and why, and by whose authority. Not told in a phone conversation that was initiated under false pretences (I was asked to confirm my address, not make a smear test appointment). I would expect to see the legislation that supports this drastic move. It is my understanding that you must have reasonable grounds to remove patients from your patient list and that the GMC guidelines state that not accepting treatment or participating in national screening programmes does not constitute sufficient grounds.

Also... I really feel for you and I am actually so glad you posted this as you have really helped me to articulate some things I have felt myself for a long time.

I do not have vaginismus and the only smear test I've had was uneventful. However I hate them in a way that is really impossible to convey in words. It also feels like being raped to me - and I say that as someone who has been sexually assaulted. Personally, I would hate sedation or drugs of any kind because to me, it would feel as though I were enabling an assault on myself. The effects of having an exam like this for me are not 2 minutes of discomfort. Afterwards, I feel the kind of sick shame and violation that I think many women would associate with unwanted sexual contact. I have intrusive thoughts and nightmares for weeks or even months after.

I get through this by deciding for myself that I will have smears. However if a practice ever tried to bully me into one, they would lose me as a patient as it's too close to coerced medical procedure.

So good for you for standing up for yourself. You are doing an awesome thing. And to all the people saying it is 2 minutes of discomfort, it fucks me off mightily that women's feelings about their own bodies are being dismissed opinion what should be a supportive community for women. You should be ashamed of minimising another woman's feelings like that.

I think it's disgusting the pressure they've put you under. Isn't their motto "First do no harm"? You'd think a doctors would understand people are complex and have all sorts of worries about things. I think you should have a chat with your local MP. They need to know things like this are going on. Look upset it's made you. What about the person that's under severe mental strain and it's the last straw. It's unfeeling and trying to control you - shades of Nazi Germany or what.

You could include the link someone had to the GMC recommendations.

I hate this crap when people go on about how stupid someone is not to have a smear of spread the scare stories.

Some people simply choose not to have any medical tests unless they have symptoms. I am not one of them but after reading 'The Patient Paradox' I fully support anyone's decision not to have them and it isn't like people who don't have them know what risks they are taking.

Me? I wish they could test for pre-cancerous cells everywhere but some of this guilt tripping here is disgusting. Everyone has a right not to have smear tests without people telling them they are stupid etc.