What a doctor’s viral Tweet shows us about gynecological care


December 16, 2021 – A doctor’s tweet that began as a simple question about office design exploded into a viral tool for comments on gynecological care – a corner of medicine that many believe often neglects patient comfort.

Earlier this month, Indiana gynecologist Ryan Stewart, DO, asked his followers on Twitter to help him design a new office.

“I have the opportunity to design my office from scratch. I ask the women. To design / optimize a visit gynecologistoffice? Problems, frustrations, solutions. “No detail is too small,” he wrote.

He posted a tweet before taking his friend’s son home after bed. By the time he returned half an hour later, answers had already arrived about problems with comfort, diversity, gender stereotypes, and pain management when it came to gynecological health care.

Five days later, the post was retweeted more than 2,000 times and had more than 9,000 likes.

Stewart says the number of responses alone and the range of issues addressed are proof of how much the field needs to be improved.

“A lot of the answers are common sense, and the fact that they came up at all tells me we have a lot of work to do,” he says. “I will never know what it’s like to be a gynecologist, and my only option is to listen.”

Some fits they were as simple as asking that the bottom of the table not face the door, and search the office is not saturated with pink.

Others touched on more serious things, such as the need for diverse representation and painkillers for painful procedures like cervical biopsy.

“Make sure you have pictures / pamphlets, that contain depictions of people in color,” tweeted fellow urogynecologist.

In fact, the absence of patient-centered features in many gynecological surgeries is rooted in the history of the practice, Nicole says Enough, MD, gynecologist from Obstetrix Medical Group in Houston. J. Marion Sims, MD, also known as “father of gynecology”, Pioneering techniques in the field. But he did so by cruel experimentation on enslaved black women without anesthetic.

“The OB area was started by men,” Plenty says. “From there, more and more women started entering the field, but society is still very much driven by men. The people who built those spaces and established those practices were mostly men. ”

Researchers have found that deficiency pain prevention in gynecology it can be at least partly attributed to inaccuracy perception that women experience less pain than men. The same problems last when comparing pain levels of white patients to those of color patients.

Simple measures to make patients more comfortable – such as taking the time to warm up the speculum underwater, listening to concerns and explaining what will happen during the examination – may be skipped in some cases as insurance companies encourage urgency to pay doctors based on patient numbers. which they see, says Plenty.

“It’s important to listen, to talk to people, to really take that time and not allow it insurance companies completely dictate our daily lives, ”she says.

Doctors face challenges when designing their surgeries, which often have rooms that are not only used for gynecological examinations, he says. Megan is ugly, MD, is an obstetrician-gynecologist affiliated with the University of Michigan.

But it is important to consider the specific needs of each patient – including their emotional needs, she says.

“It simply came to our notice then anxiety it can come in coming to the exam. People may worry, ‘Do I have cervical cancer? Will this feel like a traumatic experience from the past? ‘”She says. “I think it starts by taking a step back and saying, ‘If I were a patient who has this checkup, how would that feel?’

Stewart says he plans to take advantage of what he learned from his responses on Twitter and write an op-ed for the Journal of Obstetrics and Gynecology to help educate other doctors in the field.

“The fact is that as doctors, our training encourages us to objectify things, and this kind of tweet drives the human side of medicine,” he says. “These are primarily people, not disorders or diseases.”


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