Breast exam for 11yo??

[Ruthla]

I just came back from my 11yo's annual checkup.

The doctor basically fired us because I allowed DD to refuse genital and breast exams, and because I didn't want to even discuss vaccinations.

When I took DD1 for her checkup a couple of months ago, she did have a quick genital exam (doctor looked briefly at the exterior) but I don't recall there being any breast exam whatsoever (other than noting that she's developing) and after a long, drawn out discussion regarding vaccines I signed the "cover the drs butt" form.

This time he didn't even take out the form for me to ammend and sign (I always cross off the line about putting my kids at risk by declining vaccines.) He was very calm and respectful, but basically said that, because my philosophy is so different from the philosophy at their office, I'd be more comfortable with somebody else and they're not comfortable having us there anymore. I forget the exact wording and I didn't get anything in writing specifying any of this.

How do I even go about finding somebody else? We're on a Medicaid managed care plan- which basically means that Medicaid pays our HMO premiums and our choice of doctors is limited by the HMO. The only "family practice" doctors on the plan are pediatricians who see 20yos and internists who see teenagers. I'm really not in a position to pay out of pocket for medical care.

What I liked about this practice is the fact that they're respectful of my choices, even though they don't agree with me. I doubt there's a single pediatric practice covered by my plan who agrees with my philosophy- I was quite satisfied with finding a respectful practice. Plus they're conveniently located and very efficient with getting appointments for sick kids. I really don't WANT to switch practices!

Does this mean I can no longer call them if an emergency arises with one of my kids? IMO, that's the whole point of having a pediatrician in the first place!

[alegna]

Wow- genital and breast exam on 11 yr old girls? WTH?

I think that you can call them for anything in the next few months for sure. I would write them a letter and ask for references to another dr. since they fired you. My understanding is they can't leave you "without care" really. They have to at least give you the name of someone else to call.

good luck!

-Angela

[Ruthla]

But I'm not even sure if they DID fire me. I got nothing in writing, just the doctor saying "I think you'd be more comfortable elsewhere."

[eclipse]

I would also register some sort of complaint with the HMO. Just because I'm like that, and would want something on record saying that my kid didn't let him touch her private parts, and they fired us. I think that's a rough message for them to be sending to an 11 year old girl.

[bumblebeej]

DD is 12 and she also went through the quick peek they like to do. I don't see the point in it, other than embarrassing her!

Ruth, maybe you could call them and ask exactly what they meant. Or set up a meeting with the doctor. You have the right to refuse ANY medical treatment, is my understanding!

[CarrieMF]

Is there another dr in the practice you can see instead? It may be this particular dr's opinion but not the opinion of the practice/manager.

[alegna]

Originally Posted by Ruthla

But I'm not even sure if they DID fire me. I got nothing in writing, just the doctor saying "I think you'd be more comfortable elsewhere."

Oh well.... in that case I'd ignore the comment unless you want to find a different dr.

-Angela

[julie128]

How annoying. That happened to me, too. I wrote the office about all the drug ads they had placed EVERYWHERE in their office. I counted over 50 in one of their two waiting rooms. They said to go elsewhere. Immediately afterwards, we had an emergency. Find a new doctor quick!

[Ruthla]

Originally Posted by julie128

How annoying. That happened to me, too. I wrote the office about all the drug ads they had placed EVERYWHERE in their office. I counted over 50 in one of their two waiting rooms. They said to go elsewhere. Immediately afterwards, we had an emergency. Find a new doctor quick!

Oh, I don't even bother addressing those "minor" points such as the drug ads or the formula samples. It all boils down to the concept of finding a doctor who respects my choices, even though I can't find one who agrees.

[mombh]

Ruth, from what the ped we go to says they only check "down there " to make sure everything looks normal (basicly to cover themselves) until puberty , after which they don't anymore. I took dd 11 a few weeks ago and there was no more of that taking a "peek down there" much to her relief. Breast exam?????!!!! wt....none of my dd's ever had one past inafancy??
Ive never heard of that....
I would complain......
My kids also have healthcare/hmo through the state and while I usually go to the same dr's office, we do have afew choices (not many but some) and you should be able to change dr.s and practices, you need to call the hmo and fimd out. Also is there another dr. or np at that office that you could see?
to you and dd

[gilamama]

we were kicked out of our ped practice in the us. i had delayed vax and wanted mm in seperate vials. the ped said to call in a week to schedule it with the nurse who can order it. i didnt b/c we were going away in a 2 weeks for a month. while we were away dd got sick and i hadnt received the letter that we were dismissed from their office so i kept calling wanting to speak with our dr and they wouldnt let me i had to trade messges iwth a nurse.. it was very stressful. then i got home and understood. i'd make an appt to see the dr for one of your kids and go in to discuss it. my parents best friend is a lawyer and he wanted to write nasty lawyer letters to the practice. i hope your dr lets you talk to him.

sorry this is so disjointed i am so tired.

[Ruthla]

Originally Posted by mombh

My kids also have healthcare/hmo through the state and while I usually go to the same dr's office, we do have afew choices (not many but some) and you should be able to change dr.s and practices, you need to call the hmo and fimd out. Also is there another dr. or np at that office that you could see?
to you and dd

There are a total of 5 doctors at the practice. It's kind of random which doctor you get at a checkup, but if I ask ahead of time I can request a certain doctor (and make sure to schedule the appt when that particular dr is in.)

I know there are other doctor offices I can select- I just don't know if any of them will be any better. I've heard stories on MDC about doctors being pushy almost to the point of harrasment about vaccines- and the doctors here are quite respectful, even when they obviously disagree with me.

I'm also concerned that another practice might be "worse" only because I am a new patient, coming in with "alternative" ideas. This is the same practice that I went to as a child, and that my cousins go to, and I feel like they're more likely to tolerate me than a brand new practice where I don't have this history. Does that make any sense?

[merpk]

I have never ever heard of a genital or breast exam for any child.

I mean, my newborns' genitals got a look-see the first few well-baby visits, but that's about it. You know?

Am weirded out by this, Ruthla.

[Marsupialmom]

I can see talking about how to do a breast exam with an 11 year old, esspcially if she is developing breast (and sending stuff home with you). I can also see talking about genital health, development, what is normal and what is not periods to pubic hair type of discussion.

But not the actual look at see for "routine". Know if there is a problems, questions, severe cramps, reaccurant bladder infections, et I can see needing to look but you have a reason.

[Contrariety]

Originally Posted by merpk

I have never ever heard of a genital or breast exam for any child.

I mean, my newborns' genitals got a look-see the first few well-baby visits, but that's about it. You know?

Am weirded out by this, Ruthla.

Uh... yeah! NO WAY would I feel AT ALL comfortable for my kid's doc to inspect their genitals beyond infancy. That really creeps me out. Like... really, really creeps me out. I certainly never had mine looked at by any doctor until I was in my 20's, and that was by choice...

[bugsma]

I totally understand why you're so upset, but as an FP, I feel like I need to say that routine genital exams are not the craziest thing in the world. I have personally picked up testicular cancer in a 15 yr old and undescended testes in preteens at well child visits. I know it seems like these are things they would tell you, but sometimes they don't, and they don't/can't trust their parents, or they just don't know. You can also see signs of abuse which might otherwise go unnoticed. There is also a predictable pattern to development and checking for tanner staging (pubic hair, breast dev, armpit hair, which can be done with a peek). That being said, I ask if I can look and explain why I'm asking, if they don't want me to, I say OK, and talk to them about normal development and let them know if they have questions or concerns we could talk about it. I would never 'fire' someone from the practice for refusing an exam, or vax or whatever. It sounds to me like he's encouraging you to leave, but my understanding is that legally, you need a letter saying you have been discharged and why and that they will continue to care for you for 30 days for emergencies, and a resource for finding a new doctor.

All that being said, if you mean a breast exam like we adults get breast exams looking for breast cancer, than I really can't think of a reason that would be indicated.

[Peppamint]

Wow, I'm a bit ... did they intend to do an internal exam?

Personally, I'd only be comfortable with a doctor who would be teaching the girl to do a breast exam on herself (ya know, to be proactive and empowering at the same time though 11yo seems young to burden with breast cancer worries). An internal genital exam would have freaked me out at 11yo. I never went until I was 19 and married, only because I felt I should before getting pregnant.

Wow.

I guess I'd call and clarify with the office, so that in the event of an emergency you don't find yourself without care.

[forthebest]

None of my children would be having genital or breast exams from a doc unless there was a very,very good reason and tho there may be some good reasons out there, detecting testicular cancer, as a pp says,being one, I can't see these as 'needing' to be done often or ever with plenty people. They just don't ask to do these exams here much as far as I know but then my kids haven't been at the docs much so I don't know, just don't think this is much done here. I think it's highly innappropriate and just cos the docs want to do it doesn't mean that it would help a child to have routine exams like this and as for taking a quick peek?? I feel strongly about this and have had unneccessary internals, like a lot of women, and it's degrading and perhaps a very underhand way to belittle us and make us behave like good patients and there's a sexual angle, putting us in our 'place' imo. I have been explaining to my dd 15 that she does not have to subject herself to the routine fingering that goes on for absolutely no good reason. I got one when I was 'measured' up for a cap, long ago. I was even more disgusted, violated, ashamed, embarressed etc etc when I realised there were sizes, small, medium and large. I actually refused to try the cap after that so thats a shame. I think these are serious sexual and other control issues being dished out at to women and girls at the docs. I think it needs to stop. I had issues with one doc at age 9, my foster mother used to leave the room and he had his hand just too far down there for my liking and it was regular cos I had chronic sore throats, sorry for tmi but also at the sex health clinic at 18 I was very much manipulated by the doc and it was known in the unit as I wasn't the first to complain, this crap does happen regular, much more than people will care to admit. We need to empower our dd's in particular imo that their bodies are their own, there is no way having exams like these, a peek or more, are not stressful and degrading, I know how I felt and it is played down.
Ruthla, that is very stressful being treated like that and spot on standing up for your dd, you shouldn't be punished for that and imo thats what they are doing, typical of the punitive and damaging mindsets of certain medical proffessionals. Please do not let them stress you, not good for health, and feel strong and have plenty faith in your convictions, they are your rights. I would go get a referral as pp's say or something, one docs narrow-minded, controlling methods do not a healer make,: you are entitled to be able to get medical help, healthcare for your family. This is bullying....and more.

[momtoalexsarah]

While I don't feel that a full pelvic is nessasary on an 11yo I do belive that a doctor or NP should be able to have a peek. I had labial adhesions as a child and they where still fused when I got my first cycle at 13, I ended up tearing them when I tried putting in a tampon the first time. If we had known about them proir to then they could have been treated.
I also don't think that 11 is to young to be teaching a young lady about breast exam and teach her about her breasts.
We need to foster a sence of familiarity with our bodys and I belive that doctors should play a part in that.
Just think about the statistic that 5% of american girls have had intercourse prior to there 13th birthday, I would much rather my DD's learn about there bodies from Me and there doctor then some older boy!

[Ruthla]

Originally Posted by bugsma

All that being said, if you mean a breast exam like we adults get breast exams looking for breast cancer, than I really can't think of a reason that would be indicated.

Yes, that's exactly what he was doing. I forgot to ask DD1 last night if the dr did a similar exam on her in Sept- I don't think she did. I do recall the dr having a quick peek externally to look for pubic hair, as well as checking her armpits for hair.

Originally Posted by busybusymomma

Wow, I'm a bit ... did they intend to do an internal exam?

no, just a quick peek externally.

Oh, and I have no problem teaching DDs to do their own breast exams. I got a little thingie about BSE from my own doctor (they were giving out those laminated shower cards) and "on my to-do list" is to sit down with them and explain how to do a BSE and why.