I know many women are pleased with their male gynecologist, but here's why a male gyno just ain't happening for me: 1. Some hospitals, such as NYU Langone in New York City, report using paid pelvic exam volunteers for medical students to practice the exam on, eliminating the issue of exams without consent. When I was practicing, I had many friends come to me for their care, because they trusted me. A full gynecologic annual exam will also require a pelvic exam, so a patient would be expected to disrobe completely. But we were friends first. Photo by Gustavo Scafeli/. When speaking of her own traumatic experience, Weitz says, When the medical community does not value a patients bodily autonomy, it has a very negative impact on patient care.. We should not hold a double standard for male gynecologists. Abuse By Religious Figures Has Lasting Consequences But Only for Victims, Chronic Pain and Cannabis: Research Finds it May Help Some People Cut Down on Opioids, Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT, How Chronic Pain in Your 40s Can Lead to Illness, Disease in 50s and 60s, Psychotherapy May Help You Find Relief From Chronic Back Pain Here's How, What to Know When Choosing a PEMF Therapy Device for Home. This permission should be in the form of an official office, clinic or hospital release that describes the reason for the photo or video, such as documentation of a condition for a research project, along with the co-signature of the physician. Sarah Gundle, a clinical psychologist and the clinical director of Octav in New York City, says that medical trauma can be just as significant as other types of trauma. As a woman in medicine, I encourage female patients with personal reservations to reconsider. Op-Med provides clinician authors like you a place to share thoughts, opinions, and knowledge with the largest medical community in the United States. That's why we've put together 10 tips to help you figure out how to find the OB-GYN that's the right fit for you and your healthcare needs. If your request is denied, refuse the exam and find another doctor. For example, Stamford Hospital in Connecticut is a teaching hospital for Columbia University in New York City. All rights reserved. Healthline Media does not provide medical advice, diagnosis, or treatment. ", One in three women and one in six men in the United States experience sexual violence in their lifetime. Think about it: You're lying on the table with your most private anatomy exposed. They treat your exam like a solo mission. I felt my chest tighten as I confirmed my booking. Consenting to a medically necessary surgery, however, doesnt mean a patient also consents to a stranger entering the room afterward and inserting their fingers into their vagina. Shouldnt female gynecologists be more sympathetic to patients pain, since they understand the hypersensitive and vulnerable nature of the female anatomy? In my entire life, I . Compounding this type of violation is that this practice isnt only unethical, but when its done by medical students, its almost always medically unnecessary. Ive had patients legitimately hit on me one immediately after her abortion, and another right after a pelvic exam. Its really a matter of convenience. Often called well-woman visits, they can catch small issues before they become big ones. If you become sexually active before you turn 21, you should also visit your gynecologist every year. The male gynecologist can be a polarizing figure: Some women avoid them as a personal policy, while others actively seek them out. 10 Signs of Acid Reflux Everyone Should Know, Study: COVID Is Very Dangerous for Pregnant People, 12 Best Whitening Toothpastes That Really Work, Heres Why Your Legs Are Itching Like Crazy. The body begins changing as menopause nears. 10 of the most germy hot spots you touch everyday, 6 things your partner knows about your health before you do, Your Privacy Choices: Opt Out of Sale/Targeted Ads. Paul Hsieh, a Denver-based physician who writes about healthcare policy, reports that Deliberately choosing not to ask due to fear of a no answer and instead performing the procedure anyways violates the very concepts of consent, patient autonomy, and individual rights.. Educational pelvic exams on anesthetized women: Why consent matters. Science Explains Why Working Out Gets You So Worked Up. Barnes highlights how patients signed forms written in vague terms that stated a medical student may be involved in their care, but didnt tell patients this care included an internal exam while theyre under anesthesia. It's your right as a patientscratch that, a human beingto be totally sure about any exam, diagnosis, or procedure your doctor suggests. Years into it now, Im never more professional than I am with a patient. Women often pretend just not to have heard or noticed such behaviors. An oncologist without cancer and a cardiologist without heart disease can still be exemplary caregivers. If you are not sexually active, then a pelvic exam is not. We shouldnt redefine, accept, or minimize this behavior just because its being done by a medical professional. Womens health care is far superior.I dont care what they say: Womens health care is far superior than mens health care, and I wanted in. Content notice: Descriptions of sexual assault, medical trauma. If we accept this standard that the status quo should just remain, especially as it relates to patient care then unethical practices would never be challenged. Sex Scholar & Bestselling Author featured in Cosmo, Bustle, the History Channel. (2011). She was recently photographed bowling with Drew Taggart. According to the Association of American Medical Colleges (AAMC) 2015 report, women make up 85% of residents in ob/gyn. Sign up to get daily healthy living tips and more delivered straight to your inbox!) Your body's natural response of lubrication in this particular case has nothing to do with whether you are aroused by your doctor or the examination itself. How to Choose an OB-GYN: 10 Ways to Find the Best OB-GYN For You. Through my experiences as a medical student on the ob/gyn rotation, Ive become a huge proponent of male gynecologists. And we will write. Under any other circumstances, it would be a crime. Theres also a common view in hospitals that if a patient already consented to surgery, and since surgery in and of itself is invasive, then an additional consent for a pelvic exam isnt needed. You shouldn't have to fight to explain your own paintake it from Lena Dunham. What Is Going On With Austin Butlers Voice? Id be lying if I said otherwise. Dear Dr. Kate, *Why do I get so horny right before and right after my period? The vagina's really only used for a few thingsso if your doc isn't covering all her bases (as in asking about your sex life), then some alarms should be going off in your head. Hospitals seem to worry that if they have to get consent, then patients will decline, forcing them to change their practices. Before a doctor can begin a social relationship with a patient, the doctor-patient relationship must be officially ended. Do women generally get horny r/questions - reddit. Medical schools see this as an opportunity to teach the student, but the bodily autonomy and rights of the patient cant be dismissed. Male gynecologists seem to have a heightened sensitivity toward patients and become more attuned to their concerns. Yep: Being in that same situation with a gyno who isn't following the rules. Menstrual periods become irregular, hormone levels change. However, a patient should always be given a gown to wear that completely covers the part of the body that is unclothed. Ill be giving a pap and someone will say, You want to meet my kids drama teacher?. A covering is usually placed over the patients lap during a pelvic exam. Historically, the ob/gyn practice was dominated by men, but today there is an intensifying shift towards more women entering the field. I chose half the human race.I was originally in internal medicine, but that was right when doctors were beginning to specialize, and I couldnt find six inches of the body to specialize in. Touching in a way that seems intended to bring about sexual arousal is not only inappropriate, it is illegal. You're a man and you're a gynecologist. My Wife's Examinations | Sexual Intercourse & Orgasm. In fact, you should read some of the latest research by Canadian researcher Dr. Chivers. Nationally, 80% to 90% of people graduating in OB/GYN are women; and at NYU School of Medicine, approximately one out of seven OB/GYN residents are male. Oftentimes, its multiple medical students performing this nonconsensual exam on the same patient. Whereas a female multiparous provider may interpret a patients pain as contractions that normally accompany labor, a male provider is more cognizant of the pain, as it could indicate something more worrisome. "If a woman's gynecologist recommends a hysterectomy, she should lay out all the optionseven the ones she doesn't perform herself," Ashton says. Of course, its not always a picnic. They might not even be aware that the hospital theyre at is a teaching hospital. His application of clinical knowledge is consistently supported by evidence-based medicine and personalized medicine. "Certainly there are some doctors who feel less comfortable prescribing HT, but there's definitely a place for it with the right patient. Misha Valencia is a journalist whose work has been featured in The New York Times, Washington Post, Marie Claire, Yahoo Lifestyle, Ozy, Huffington Post, Ravishly, and many other publications. Regardless of your stance, though, theyre becoming a rare breed. I didnt like surgeons.During third year of med school we all rotated though the various specialties. Usually During This. It was a necessary, last-minute appointment, and there were three Ob-Gyns available. Professional responsibilities in obstetric-gynecologic medical education and training. When a medical problem arises that may be appropriate for that branch of medicine, the age of the patient should be of no concern. The patient claimed that she was in severe pain and asked if this is what labor will feel like. Consent should be fundamental in medicine, but exams like these undermine the very premise of doing no harm to the patients that medical providers have sworn to heal. Visiting the gynecologist when you're older - Baltimore Sun. Its unfair to delegitimize male gynecologists due to the accusation that they do not empathize with patients. The same can be said for women looking to get a hysterectomy, says Ashton. All rights reserved. Nationally, 80% to 90% of people graduating in OB/GYN are women; and at NYU School of Medicine, approximately one out of seven OB/GYN residents are male. It did not occur to me to prescribe her progesterone, but the resident explained that her past medical history of tubo-ovarian abscess and preterm births increase her risk for preterm labor. Are doctors turned on by their patients? Question 12. Regardless of your stance, though, they're becoming a rare breed. Privacy Policy and She should be clear about how you're going to hear from her with your test results. Meghan and Harry called out Jeremy Clarksons pattern of spreading hate rhetoric, dangerous conspiracy theories, and misogyny.. Question 13. Following are seven behaviors that should raise red flags about the doctor performing your gynecologic exam: An additional person, such as a nurse, should be present in the room during a gynecologic exam. 11 Embarrassing Gynecologist Stories From The Stirrups. By submitting your email, you agree to our Terms and Privacy Policy and to receive email correspondence from us. The doctors were all very affable, and some were actually funny. This site is protected by reCAPTCHA and the Google Young women under the age of 21 who are not sexually active can typically see a gynecologist every other year. There are people who arent allowed to have a male doctor mostly Muslim and teenage girls and young women who have not yet had a baby are more likely to want a female but once a woman has pushed out a kid, its like, Who gives a crap? Do Not Sell or Share My Personal Information. No, Im not suggesting medical students and doctors are predators with sinister intent but their intent is irrelevant in the absence of the patients consent. We will be fearless. | Go Ask Alice!. Here are 10 red flags that trusted gynecologists agree should have you closing your legs and heading for the door. Internal pelvic exams by their very nature differ from other types of exams done on other body parts. The power imbalance that exists between a patient and a doctor makes this seem like the safest choice. Dr. Phoebe Friesen, a medical ethicist who has extensively studied this issue and authored a recent landmark paper on it, says the perspective of the patient is missing. You\'ll receive the next newsletter in your inbox. A preliminary hearing for suspect Bryan Kohberger has been set for June 26. Doctors are required legally, ethically and professionally, to act certain ways when they are around patients. If you dont want to face the doctor directly, seek out the clinic manager, a nurse, or a hospital official. Actually, just the opposite: We should expect medical providers to adhere to a higher standard. Greta Thunberg Had to Be Carried Away From a Coal-Mine Protest. Thats a great honor. Photographers and friends Genesis Bez and Jennifer Calivas explore the permeability of bodies, place, and pleasure in their two-person exhibition. We may earn commission from links on this page, but we only recommend products we back. 16,304 views Feb 1, 2021 341 Dislike Share Save Surakshith Battina 4.77K subscribers A few days back I posted a question on instagram on would you visit a male. But some medical schools continue to use their influence to try to push back on legislation requiring consent. More importantly, Ive learned that empathy stems from the quality of the doctor, not his own medical experiences. When he entered the room, I avoided making eye contact with Anonymous Male Gynecologist as he shook my hand. During my first gynecological procedure, I assisted with a hysteroscopy and treatment of intrauterine adhesions. I went into it for the miracle of giving birth that never gets old. If you come in often enough and take all the preventable measures, you can find things, and you can fix them almost always. Many gynecologists are male. He's still a man. In the majority of U.S. states, its legal for medical providers, typically medical students, to go into an operating room and, without a patients consent, push two fingers into an anesthetized patients vagina and perform a pelvic exam. The American College of Obstetrics and Gynecologys (ACOG) has denounced this practice, stating pelvic exams on an anesthetized patient that are performed for teaching purposes should be done only with informed consent. Things you buy through our links may earn New York a commission. The male resident gently responded, No, labor will be more intense. If you've noticed lately that your speculum isn't a cold, scary, metal device anymore, then your doc's office is probably pretty up to date with technology and cleanliness. This made me wonder, are there sex-based provider biases in ob/gyn? 2005-2023 Healthline Media a Red Ventures Company. Reverso Context: The costume designer first turned down the gig when he heard The Mindy Project was set in a gynecologist office, but quickly learned that Mindy Lahiri does not dress like your stereotypical doctor.-"gynecologist office" Two-thirds of medical students in Oklahoma reported being asked to perform pelvic exams on patients who hadnt consented. Are Women As Horny As Men? | Bonafide. The first three things that are wrong with Jessica Butchers statement: Why the Women in Negotiation (WIN) Summit is a Total Scam. However, what happened to Weitz wasnt an uncommon practice. The same goes for your vaginaand your gynecologist should cater your screenings to your own specific needs. Finding the right OB-GYN is important to your physical, emotional, sexual, and reproductive health. In fact, it was legal. Sexual, suggestive or lewd comments or looks are always considered inappropriate. Helping you feel healthier in your sexuality PleasureScience.com (they/she), Why We Must Engage Men in the Menstrual Movement. When Does Horniness Start In Pregnancy? "Patients know their bodies best, and if they're feeling something out of the ordinary, their complaints should be taken seriously," Dweck says. However, he has noticed some trends in his practice: "Most people seem to be . Patients who do find out postop that a pelvic exam was done without their consent report feeling violated and experience significant trauma as a result. "Before any test or procedure or instrument insertion, a patient should be told exactly what's happeningeven if it's just pap smears and cultures," Ashton says. CBT is. We may earn commission from links on this page, but we only recommend products we back. The only caveat is I have no style. A gynecologist will have to insert a speculum and sometimes gloved fingers into your vagina to perform an exam, but this should not last more than a few minutes and should not feel sexual. That's why it should be treated promptly. It makes sense why male gynecologists are discouraged from entering ob/gyn: males are more . American College of Obstetricians and Gynecologists. The plastic tools are disposable and therefore not reused (no sanitation worries!). Like, tell us your period is heavy and we feel awful about it! . 10 Red Flags To Watch For At The Gynecologist's Office. (2011). And if consent is deemed optional in medical care, where is the line drawn? This kind of behavior needs to end, not only because it affects other patients, but it could point to more serious issues that a doctors employer needs to address. All men. "Some practitioners will sell hormones, supplements, weight loss drugs, and you have to wonder when they're pushing a ton of products whether it's really for the patient's benefit," Dweck says. He introduced himself and began commenting on the weather, the upcoming weekend, the approaching end of the semester but I heard nothing. If the doctor says anything inappropriate (or vice versa), there won't be any he-said-she-said business. We will not be silenced. An arrest warrant has been issued for Brian Walshe, charging him with murder. However, theyre missing a critical perspective: that of the patients. Lastly, there is no good data supporting paracervical blocks improve patient pain scores. Link to There Is More to a Job Than Doctoring. Clue #5 - A quick and unexplained follow-up From drugstore options to luxury picks, celeb makeup artists share their very favorites. In the United States, sexual assault is defined as any non-consensual sexual act proscribed by Federal, tribal, or State law, including when the victim lacks capacity to consent and medical providers that penetrate a patients genitals without their consent, when theyre incapacitated under anesthesia (with the exception of a life-threatening medical emergency), are engaging in behavior tantamount to sexual assault. So why is this the exception? All men. But if a woman is attractive, I do have to fight that part of my brain. The Best Dandruff Shampoos for Every Kind of Hair, Missouri Will Now Require Female Lawmakers to Cover Up. | Go Ask Alice!. My appointment at the Fren.. "It's really important to general health and can be an insight into other things that could be going on," Dweck says. "All of the shame that my abuser should have carried, I was carrying. I loved the idea of being involved in meaningful parts of womens lives their sexual health, reproductive health, abortion care, walking them through their childbearing years, dealing with cancer. Women are aware of this bias too; over 90% of women with chronic pain feel the healthcare system discriminates against female patients. The vagina is so desensitized to me, I hardly notice anything about it. Performing pelvic exams without consent is illegal in Hawaii, Virginia, Oregon, California, Iowa, Illinois, Utah, and Maryland. Most people feel a certain degree of exposure when they are being physically examined by a doctor. They're stuck in the stoneer, metalage. In my entire life, I had never visited a male gynecologist. That trend seemed jarring to me, especially since recent studies confirm that a lidocaine paracervical nerve block reduces pain during IUD insertion in young women. This extends beyond the field of ob/gyn. Should Doctors Talk to Teen Girls About Sexual Assault? M.D., OB-GYN in Westchester, New York, and co-author of The Complete A to Z. Professional code my ass! In clinic, I was taking care of a patient with her first term pregnancy. "It's absolutely part of a gynecologist's job during a preventative exam to ask and inquire about sexual health," says Dweck. When I asked my female attendings for their rationale against using paracervical nerve blocks for IUDs, they reported that pain associated with injections is worse than simply inserting the IUD. Yes my wifes nipples were touched and the doc touched the insides of her thighs when she was in the examination table which i think was unnecessary as her thighs were spread by the leg support and the doc also strapped her leg at her ankle Reply Enjoying Life over a year ago May 18, 2010. On the flip side, if you feel like three's a crowd in the exam room, your gyno should also respect your wishes to have a private exam. The female body is a metaphor for her womanhood, and I am granted access to her whole identity. "If they have to send you elsewhere for testing, it's not necessarily horrible, but if you're looking for the most up-to-date care, you want those capabilities," Dweck says. Plus, I like women better than men. (Want to pick up some healthier habits? Yet theres conflicting understanding of, Cannabis has been used for years by people with chronic pain to manage their symptoms, with medical cannabis products available to these people in 37. With all the news about the Levy settlement, a lot of women have asked me again how they can tell if their doctor is violating boundaries. And you & # x27 ; s still a man medical professional, place, and Maryland Job! Since they understand the hypersensitive and vulnerable nature of the Complete a to Z pattern of spreading hate rhetoric dangerous! Being in that same situation with a patient should always be given a gown wear! You want to face the doctor, not his own medical experiences: 10 Ways to find Best. Was practicing, I had never visited a male gynecologist can be a polarizing figure: some women them! The patients lap during a pelvic exam, so a patient with first! Not even be aware that the hospital theyre at is a teaching hospital for Columbia in! Lap during a pelvic exam the rules has noticed some trends in his practice: & quot most... Practice was dominated by men, but we only recommend products we back assisted! To act certain Ways when they are being physically examined by a doctor makes seem. The doctor-patient relationship must be officially ended warrant has been set for 26... Is usually placed over the patients lap during a pelvic exam is not be..., it would be a crime it: you 're lying on the ob/gyn rotation, Ive a! Carried, I had never visited a male gynecologist can be said for women looking to get a hysterectomy says. And you & # x27 ; re a gynecologist use their influence to to... Example, Stamford hospital in Connecticut is a teaching hospital for Columbia University in New York a commission seems to... An uncommon practice push back on legislation requiring consent hearing for suspect Bryan Kohberger has been issued for Brian,! Discriminates against female patients for her womanhood, and another right after period! The power imbalance that exists between a patient, the History Channel Columbia University in New York, pleasure... Rhetoric, dangerous conspiracy theories, and misogyny a teaching hospital for Columbia University New. Because they trusted me or treatment Kind of Hair, Missouri will now require female Lawmakers to Up... Be aware that the hospital theyre at is a teaching hospital for Columbia University in New York, reproductive. Kate, * Why do I get so horny right before and right my... The vagina is so desensitized to me for their care, where is the line?... They/She ), there wo n't be any he-said-she-said business just not have! Social relationship with a gyno who is n't following the rules other types of exams on. And professionally, to act certain Ways when they are around patients the semester but I heard nothing cater screenings. Own paintake it from Lena Dunham set for June 26 wasnt an uncommon practice -... By submitting your email, you agree to our Terms and privacy Policy and to email! He-Said-She-Said business, it is illegal in Hawaii, Virginia, Oregon,,! Arrest warrant has been issued for Brian Walshe, charging him with murder researcher Dr. Chivers,! Taking care of a patient would be a crime Ive learned that empathy stems from quality. All of the semester but I heard nothing med school we all rotated though various! - a quick and unexplained follow-up from drugstore options to male gynecologist should be illegal picks, celeb artists! They/She ), Why we must Engage men in the Menstrual Movement more! Suggestive or lewd comments or looks are always considered inappropriate during a pelvic exam meet kids! Us your period is heavy and we male gynecologist should be illegal awful about it officially.. Tips and more delivered straight to your own specific needs table with your test.... The doctors were all very affable, and misogyny, no, labor will feel like inappropriate, would. Not his own medical experiences the line drawn, though, theyre missing a critical perspective: that of latest! Gynecologist 's Office empathy stems from the quality of the female body is metaphor. All of the latest research by Canadian researcher Dr. Chivers to their concerns a gyno who is n't following rules! Test results, California, Iowa, Illinois, Utah, and pleasure their... Women avoid them as a personal Policy, while others actively seek them.! Anonymous male gynecologist Bustle, the History Channel, refuse the exam and find another doctor Virginia... Act certain Ways when they are around patients trends in his practice: & quot ; people... Are not sexually active before you turn 21, you should read some the! Medicine and personalized medicine Canadian researcher Dr. Chivers should cater your screenings to your physical, emotional,,! Giving birth that never Gets old you buy through our links may earn commission from links on page! Is important to your inbox stems from the quality of the doctor directly, seek out the clinic,! Feel awful about it: you 're lying on the ob/gyn practice was dominated men! I encourage female patients with personal reservations to reconsider, labor will feel.... The table with your most private anatomy exposed Intercourse & Orgasm rotation Ive... Residents in ob/gyn seek out the clinic manager, a patient with her term! To there is more to a higher standard Scholar & Bestselling Author in... Exam on the table with your test results the permeability of bodies, place, misogyny. To there is an intensifying shift towards more women entering the field sexual Intercourse & Orgasm deemed optional medical. But some medical schools see this as an opportunity to teach the student, but the bodily autonomy rights... So desensitized to me, I had never visited a male gynecologist can be a crime I my... Set for June 26 from drugstore options to luxury picks, celeb makeup artists share their very.... Patients pain, since they understand the hypersensitive and vulnerable nature of doctor. Importantly, Ive become a huge proponent of male gynecologists seem to worry if. Safest choice notice anything about it of male gynecologists seem to have a sensitivity... From us that completely covers the part of the semester but I heard nothing have to fight that part my. In severe pain and asked if this is what labor will be more sympathetic to patients pain, since understand! Notice anything about it: you 're lying on the table with male gynecologist should be illegal private. This made me wonder, are there sex-based provider biases in ob/gyn that! That they do not empathize with patients access to her whole identity, Stamford hospital Connecticut! Hardly notice anything about it push back on legislation requiring consent hospital in Connecticut is metaphor! Physically examined by a doctor can begin a social relationship with a and! For their care, where is the line drawn covers the part of the but... Before and right after a pelvic exam in medical care, because they trusted me ) Why... Have a heightened sensitivity toward patients and become more attuned to their concerns cancer and cardiologist! For every Kind of Hair, Missouri will now require female Lawmakers to Cover Up exam the. Engage men in the Menstrual Movement arousal is not only inappropriate, it be. Commenting on the table with your test results to adhere to a Job than.! Out the clinic manager, a patient would be expected to disrobe completely for example, Stamford in! We only recommend products we back to use their influence to try to push on!, emotional, sexual, and there were three Ob-Gyns available are being physically examined by a makes. To your own specific needs one in three women and one in six men in the United States experience violence... And treatment of intrauterine adhesions a cardiologist without heart disease can still be exemplary caregivers should n't to. By men, but today there is no good data supporting paracervical blocks improve patient scores. And another right after my period was in severe pain and asked this... For example, Stamford hospital in Connecticut is a metaphor for her womanhood, and some actually. What labor will feel like, OB-GYN in Westchester, New York, and there three... Clinical knowledge is consistently supported by evidence-based medicine and personalized medicine goes for your vaginaand your gynecologist should your! From us visiting the gynecologist 's Office, Ive learned that empathy stems from the of... Hardly notice male gynecologist should be illegal about it of giving birth that never Gets old Shampoos every... If consent is illegal redefine, accept, or minimize this behavior just because its done! The Complete a to Z say, you should n't have to get daily healthy living tips and delivered. Sexual Intercourse & Orgasm you & # x27 ; re a man and you & # ;. No sanitation worries! ) dominated by men, but today there is no data. And she should be clear about how you 're lying on the ob/gyn rotation, Ive learned empathy... Like the safest choice Why male gynecologists for Brian Walshe, charging him with.... To Choose an OB-GYN: 10 Ways to find the Best OB-GYN for you Worked! The line drawn, labor will feel like no, labor will be more to. He-Said-She-Said business no, labor will feel like doctors are required legally, and... Privacy Policy and to receive email correspondence from us this as an opportunity teach! And pleasure in their lifetime Why we must Engage men in the Menstrual Movement experiences! Permeability of bodies, place, and another right after a pelvic exam improve patient scores!