Vaginal exam. Was this appropriate?

[ReliableLake]

So about 2 years ago I went to a walkin clinic because my doctor was away. I got a male doctor and he prescribed me yeast infection pills after I told him my symtoms. When I took the pill I didn't feel any better, instead I felt worse. I went back to see that same doctor. He said that we should take a few swab samples to make sure it's not another type of infection. There was a nurse assistant in the room with us. Here's what I thought was strange. The swabs seemed to take quite a bit longer to do than expected. He didn't use a speculum because I was extremely red raw and sore so he said he was just going to use his fingers (with gloves). I apologise if this is tmi, he had a finger inside my vagina and was kind of twisting it back and forth and he said he needed to get enough discharge on the swab. Is that normal? He also asked if I had recently had sex and I said no. He then said I seemed quite tight. I'm not sure if he actually meant it in a sexual way. I'm sure he was just commenting on that I was swollen (in today's society the word "tight" is often used in a sexual way which is why I thought it was weird.)
Do you think his actions were innapropriately sexual? I feel kind of weird about it and I'm not sure if maybe he meant it in an innocent way. I'm also so used to having my same female doctor. She's very fast at what she does and this guy seemed to take a longer time down there. I'm not sure if maybe he just wasn't used to taking swabs, I'm sure female doctors do this more than males. I had to go back to him the following week to get my swab results. After I got my results he made a comment that I'm a beautiful girl. I was a bit taken aback but at the same time I think he may have just meant it as a nice compliment. He didn't say anything flirtatious.
I think I felt uncomfortable over the nature of the exam since it's never fun having someone you dont know go in your "area". I think some of his comments borders on innapropriate but at the same time I think it may have just been his type of personality.
Since it was a while ago I feel like my memory is a bit fuzzy on every small detail.

I was just feeling uncomfortable given the fact that I was having a vaginal exam by a Male doctor which I've never had before. I think because of a couple of his comments that's why it made me wonder if the exam was innapropriate. He was also foreign (sorry I dont mean to sound racist in any way), it's just sometimes I think things can be misinterpreted. I guess I'm just looking for some reassurance here. I would have no issues perusing this if I was 100% sure that he was behaving in an extremely innapropriate and sexual way but I think this may have been just an awkward time for me and my anxiety can make me overthink it.

[Sam W]

Hi Reliablelake,

I'm sorry this incident left you feeling uncomfortable. It can suck to feel like something "off" happened when you were in a really vulnerable position. In terms of the swab, it's hard for us to know without being there if there was a reason he may have taken longer (as you pointed out, if he doesn't do this often he might not be as efficient at it). Was he specifically an OB-GYN?

Some of his comments do strike me as inappropriate, especially telling you that you're beautiful. That's not really a comment a healthcare provider should make to a patient because it could make the patient uncomfortable. The question about whether you'd been sexual recently is pretty standard, and you're right that the comment about tightness could have been a comment on how swollen things were (since sex that involves inserting things into the vaginal canal can irritate a yeast infection, that may have been why he asked about any recent sexual activity). If it was about tightness in general, it's a bit odd to comment about that, given that most people aren't going to feel relaxed during a vaginal exam, especially one where there's still pain from an infection. Does any of that help you out?

[Heather]

I do just want to pipe in and let you know that for future reference, you can ALWAYS -- even if everything is above board, you do not need a reason -- refuse an exam by a provider for any reason. You can always tell a provider to stop for any reason (though obviously, if your life is at risk, they may not). You can always state a preference for a certain kind of provider, like by gender.

You also can file complaints for any reason, at any time. It sounds like you're feeling unsure enough here about if everything was appropriate -- which I certainly understand, because some of this is for sure iffy -- and might feel better if someone looked into that, or at least by filing a grievance. If you want to do that, look up your province and something like "file a complaint doctor" in a search engine, and you should find what you need to do that. That way, you can at least rest assured someone bonafide is looking into this matter.

[ReliableLake]

Yes it does thank you.

He is not a obgyn. Hes just a family doctor who primarily does walkins.
Yeah like I assume it was because of the tightness since of course I'm inflamed and obvious right since I'm not comfortable. When he asked if I had sex and I said no he had also asked why? I just said I was having some issues with my boyfriend and then I had been having vaginal issues. He pushed on the topic a bit but I kind of shut it down and he didn't go further. Not sure if maybe he was trying to be helpful. He had then made a comment that since I haven't had sex in a while that it might be painful the next time I do. I'm not sure if maybe I just thought these comments were a bit creepy because it came from a man who I dont know. I feel like if my family doctor said it I probably wouldn't even care. The beautiful comment took me aback. He didn't come onto me or anything but I still felt a bit creeped out. Since it was around Christmas time when this happened he asked what I was doing for new years and I said I was going out with my boyfriend. He then tells me what his plans were. He didn't ask me out. (This part happened during my follow up for my results. Thankfully I wasn't naked when he made those comments but I think I still felt a weird vibe). I've looked up reviews about him and I don't find much. The couple reviews I found said that hes a good and friendly doctor. I dont really want to go and report it to the doctors board and open a formal complaint because that could be a lot of headaches and legal stuff. Since I'm not 100% sure of his intentions I wouldn't want to open that can of worms you know? I'm tempted to maybe call the office where he works and make an anonymous complaint. Do you think this is a wise thing to do?

[ReliableLake]

Thank you Heather. I actually googled it (I'm in Canada). It says that you need to do a written formal complaint that discloses all your information and he has to be told who made the complaint. Then all the legal stuff gets involved, etc. That just makes me feel uncomfortable especially because it may be a misunderstanding you know?
I'm tempted to maybe call the physician office and try to just make an anonymous complaint about it.

[Heather]

Ugh! What a problematic system for the patient! I'm so sorry to hear that.

I agree, that sets you up to be even more vulnerable when you're already feeling that way. I think calling the office like that is for sure a better option.

[Sam W]

Thanks for elaborating. If he isn't a trained OB-GYN, then his experience doing things like vaginal swabs is going to be far more limited than that of an OB-GYN, which may explain why he took longer. Also, given some of his comments (like how if you haven't had vaginal sex in awhile the next time may hurt, which is an overly-simplistic answer given that "time since you last had sex" is not really a factor when it comes to painful intercourse) he may not be that familiar with that part of the anatomy, period. We can't know for sure without asking him, but that could be one reason for it taking longer.

I can see why his comments about sex left you feeling weird. While some questions about sexual history or activity are to be expected during a reproductive health check, pushing about the reasons why you're not sexually active is a bit odd, and could tip from the kind of personal questions expected during an exam to questions that feel personal but not relevant to what the exam is for (especially since you were there for an issue that would make any kind of vaginal stimulation uncomfortable).

As far as reporting or making a complaint, you get to choose whatever course of action is the most comfortable for you (I agree with Heather that the board complaint system sounds deeply unhelpful to patients). Since it sounds like you're leaning towards calling the office, do you know if they have a formal complaints process you could use, one that's separate from a board complaint?

[ReliableLake]

Thank you both for being understanding about this.
It makes me wonder that maybe he was trying to be helpful and gather more info on why I've been having vaginal issues which is maybe why he made some of those comments about sex and how long it's been, etc. I also feel like men dont grasp the female anatomy and sex in the same way women do. Maybe it was a bit out of line but maybe it was stuff he learned about in a textbook you know?
And just the way he was twisting his finger back and forth during the exam felt odd, I dont recall my other doctor doing that before it made me wonder if it was a sexual thing. On the other hand it also makes me think that it may be his technique of getting enough discharge for the swab plus like you said, he may be inexperienced in vaginal exams which is why it may have felt a bit off and took longer than I expected. I guess there's really no way to know.
I think I'm going to call the pharmacy place where he works and ask how I go about making a complaint. The only thing I know is that with any formal conplaint you must disclose who you are so that they can check your records.

[Heather]

You do also have the option of telling HIM directly. In other words, you can contact him and tell HIM what did not feel appropriate to you (like comments on your appearance, which for sure isn't professional or appropriate), or just felt uncomfortable.

I'm not sure if that's something you'd feel better or worse about doing than your other options, but it is one option.

[ReliableLake]

Hmmm that could possibly be an option. I'll probably talk to a manager there first but I won't disclose my information.
In your opinion does this all justify an actual legal complaint? Or do you think just an anonymous complaint is good enough?
Like I said before, I feel that it may have been innocent or there may have even been a culture clash as to how he meant the things he said. On top of all that having a man down there just made me feel uncomfortable right from the beginning. I've had men in the past who I didn't know tell me I'm pretty or beautiful and it has sometimes creeped me out especially if it came from someone who was a "professional". I think because of that it's made me on high alert if that makes sense.

[Heather]

I really think that's about what YOU want and what you feel most comfortable with.

This kind of thing...well, aside of the comment about your appearance, it's so hard to have a good sense of what happened without being the person involved. You know how this felt emotionally: we don't. That said, the process of reporting something like this is not something where YOU have to figure out if what happened was or wasn't okay or lawful. That's the job of whoever is doing the investigating of a report you make. So, you don't have to figure that out to report, you just have to decide if you want to report, which means giving someone else the information to figure that out. Make sense?

It of course makes sense that that comment set off red flags for you: it should, because like we've all agreed right with you, in a professional and/or medical setting, it's not appropriate.

[ReliableLake]

That makes sense. I just see it this way. I could make a complaint. But since it happened so long ago my memory is a hit fuzzy of the exact details you know? I feel like that makes the complaint lose credibility. Then it turns into a he said she said thing. Of course he would deny it and I'm already unsure if it was a sexual thing or not. No one can really make that call because they weren't there. Yes what he did during the exam felt a bit weird but at the same time he may have been inexperienced which is why he didn't totally know what he was doing. I can agree that his beautiful comment was innapropriate but I dont know if I want to open up a huge legal investigation on something like that. Not sure if that all made sense but I'm just trying to think about it logically.

[ReliableLake]

I actually just called the place and spoke to the manager. I told her what happened and she informed me that the nurse assistant in the room is required to be there and they would make any notes on the file if they felt he was being innapropriate in any way. She told me there has never been a complaint about that doctor before. She wrote down what I told her and she said I can tell her my name if I want to so that she can look into my file. She said it wouldn't go any further. She said the doctor would be spoken to by management about his behaviour. Obviously no investigation would take place unless I were to call the doctors board to file a formal conplaint in which he would then be investigated and probably have his license suspended. She also told me with that process that both parties get lawyers involved and it can turn into a lengthy and costly process. I decided to leave myself anonymous for now and that I may call back later to give my name so that she can see my file. She said if I disclose my name I can choose whether or not my name is also disclosed to the doctor.

[Heather]

That all sounds like a pretty good response to me. How are you feeling about it?

[ReliableLake]

I don't feel great but I feel better than I did yesterday. I think I just have a lot of adrenaline and anxiety in me right now lol. It made me feel good that she took it very seriously and wanted to make me feel better by saying they always require a nurse in the room during an exam. She said even with me being anonymous that she will look through all the files of where there was a vaginal exam and double check if there were any suspicious notes or anything. I don't think anything will make me feel amazing about it, I think it's just something I have to kind of accept and deal with over time you know? I'm glad though that he will be spoken to.

[Heather]

I get it.

With this -- or anything else -- is there anything else we can help you with right now?

[ReliableLake]

Hmmm I don't think so. Do you think it's worth it to disclose who I am? Or just leave it as an anonymous complaint?

[Heather]

Again, I really think that's something for you to figure out for yourself, and that what feels right for you is the right choice.

[ReliableLake]

I just wanted to say thank you to both of you for talking to me about this situation which makes me uncomfortable. I really appreciate it. I've been thinking about it more and I still feel a bit uneasy because of the uncertainty if it was all innocent or not. I think for the most part he was probably just trying to be nice. I talked to someone else about it and they even suggested that he could have been trying to ask more about my relationship and my lack of sex to try and make sure I wasn't going through any abuse or any other issues.
I'm feeling a bit more comfortable about the whole thing. The only part that still made me question things is the way he was moving his fingers around during the exam. My apologies for the tmi, but I've been fingered before by my boyfriend and it felt different than what the doctor did (thankfully!). However I feel like the "twisting" motions with his fingers seemed to go on for quite a long time. Since this also happened so long ago and I couldn't actually see what he was doing it makes me wonder if it was maybe the swab he was twisting around. I'm not sure. Is it normal for a doctor to twist around inside during a vaginal exam? The only vaginal exams I've had involved my doctor just doing a quick papsmear. I dont recall my doctor ever going in and feeling around with her fingers although I hear that's normal if they're checking for abnormalities.

[Heather]

That twisting motion is often part of a bimanual exam, yes. That's about palpating the cervix and surrounding areas to look for lumps or other possible problems.

Just for the record, so you know moving forward, the clear part of what was not appropriate to us was his commenting on your appearance the way he did. Whatever his intent, a doctor should know better: that's commonly understood as unacceptable in professional environments.

[ReliableLake]

Okay thank you for clearing that up. I honestly don't remember my family doctor doing that before, if she did then I didn't notice her taking that long compared to this other doctor. Hopefully what I felt was just what you're describing. Since I was so sore and uncomfortable down there its sometimes hard to tell if be was only using his fingers of if he was also twisting the swab.
Thank you.

[Heather]

Sure thing.

Btw, it feels to me like you're feeling bad about how you have been feeling about this. I hope you can recognize that the onus is really on healthcare providers to make patients feel comfortable, not the other way around. And it's okay for you to feel uncertain about situations like this, and it's also always okay to question things like this.

[ReliableLake]

Thank you I appreciate your kind words. I'm trying to make sense of the whole thing. You know when you've experienced something kind of out of the ordinary and you want to make sure it was normal practice. Thanks for letting me know its okay to feel uncertain. I still do but talking through this has also made me think that what he was doing for the actual exam was appropriate practice and maybe since I've never experienced it before it was a bit weird and questionable.

[Heather]

Absolutely. Hope you're leaving this feeling better than you came in.

[ReliableLake]

Thank you. It gets a little bit better day by day.