You might think you're sexually active, but you'd be wrong!
September 6, 2011 11:38 AM Subscribe
[Possibly NSFW] Is it normal for a physician to define "sexually active" this way? And is my doctor's office sketch?
I just saw a new doctor for the first time, and the experience was sketch for a number of reasons (patient charts lying out readable on the counter, able to hear private aspects of other appointments through the thin walls). Most frustrating for me, though, we went back and forth for three minutes while he tried to establish whether or not I was "sexually active".
I claimed that I was but was not engaging in anything that could get me pregnant (i.e. no contact between male and female genitalia, but another activity that involves fluid interchange and thus carries a risk of STI transmission: oral sex). He flat out told me "then you are NOT sexually active", and it took me a couple minutes and the help of the nurse to explain that I understood he must be asking me about risk of pregnancy, but that I was pretty sure most people define "sexually active" through risk of STI transmission (if not even more broadly as "are you doing things which emotionally/psychologically feel like sex?" as in "if you're sexually active, you don't need to ask what it means"). (Google seems to agree with me.)
I assume this doctor must be somewhat conservative and was perhaps meaning to ask "are you actively having vaginal sexual intercourse", but I feel like "sexually active" is a pretty common terminology. Have people heard the phrase used in my doctor's way elsewhere, or does it indeed have that limited clinical definition? And should I feel distrustful of my doctor for this misunderstanding? He was pretty adamant that I was wrong and wasn't making any sense (and I'm pretty certain this wasn't because of a misunderstanding of what I was saying: he was very clear that vaginal intercourse was the only thing he was asking about).
Relatedly: I'm really uncomfortable with how cavalierly the office treated private patient information, which is enough to tell me should switch doctors when possible. Is there a way to report or question this effectively, and if not is it likely a doctor's office would transfer then destroy their own copies of my records if I requested this?
I just saw a new doctor for the first time, and the experience was sketch for a number of reasons (patient charts lying out readable on the counter, able to hear private aspects of other appointments through the thin walls). Most frustrating for me, though, we went back and forth for three minutes while he tried to establish whether or not I was "sexually active".
I claimed that I was but was not engaging in anything that could get me pregnant (i.e. no contact between male and female genitalia, but another activity that involves fluid interchange and thus carries a risk of STI transmission: oral sex). He flat out told me "then you are NOT sexually active", and it took me a couple minutes and the help of the nurse to explain that I understood he must be asking me about risk of pregnancy, but that I was pretty sure most people define "sexually active" through risk of STI transmission (if not even more broadly as "are you doing things which emotionally/psychologically feel like sex?" as in "if you're sexually active, you don't need to ask what it means"). (Google seems to agree with me.)
I assume this doctor must be somewhat conservative and was perhaps meaning to ask "are you actively having vaginal sexual intercourse", but I feel like "sexually active" is a pretty common terminology. Have people heard the phrase used in my doctor's way elsewhere, or does it indeed have that limited clinical definition? And should I feel distrustful of my doctor for this misunderstanding? He was pretty adamant that I was wrong and wasn't making any sense (and I'm pretty certain this wasn't because of a misunderstanding of what I was saying: he was very clear that vaginal intercourse was the only thing he was asking about).
Relatedly: I'm really uncomfortable with how cavalierly the office treated private patient information, which is enough to tell me should switch doctors when possible. Is there a way to report or question this effectively, and if not is it likely a doctor's office would transfer then destroy their own copies of my records if I requested this?
I think the question is, "My doctor defines 'sexually active' as 'engaging in PIV sex.' I do not engage in PIV sex but I consider myself to be sexually active, because I engage in other kinds of sex which can lead to medical complications. Who's wrong here? Does 'sexually active' have a clinically-defined definition that I'm supposed to know?"
if the doctor makes you feel uncomfortable, find another doctor.
Seconded.
posted by muddgirl at 11:44 AM on September 6, 2011 [3 favorites]
if the doctor makes you feel uncomfortable, find another doctor.
Seconded.
posted by muddgirl at 11:44 AM on September 6, 2011 [3 favorites]
It's not called Oral Cuddling for a reason.
On their cavalier attitude toward patient files, that would be reason enough to fire this doctor. It would seem they'd need to keep records of the visit, but based on their sloppiness, you might be in a position to have sensitive information expunged.
posted by Feisty at 11:47 AM on September 6, 2011 [4 favorites]
On their cavalier attitude toward patient files, that would be reason enough to fire this doctor. It would seem they'd need to keep records of the visit, but based on their sloppiness, you might be in a position to have sensitive information expunged.
posted by Feisty at 11:47 AM on September 6, 2011 [4 favorites]
My family practice doctor has a form I fill out in the waiting room that asks a few questions like if you're sexually active (it had a definition that had to do with the number of partners but not asking for a number...I think more than one was the metric, not pregnancy or mechanics...I'm a guy so I can't get pregnant). When I ticked the box saying I was, it wasn't discussed meeting with the doctor, he just added STI tests to my bloodwork. No judgement or anything. You shouldn't need to feel like you're being judged at the doctor's office.
The office was pretty paperless so the idea of reading other people's charts would mean I'd have to guess the password to log into the computer.
So yeah, get another doctor.
posted by birdherder at 11:47 AM on September 6, 2011 [1 favorite]
The office was pretty paperless so the idea of reading other people's charts would mean I'd have to guess the password to log into the computer.
So yeah, get another doctor.
posted by birdherder at 11:47 AM on September 6, 2011 [1 favorite]
Not sure why you are bothered by the doctor's more narrow definition of "sexually active." He may need to know, for various reasons, whether you are having intercourse. How this narrower definition makes you uncomfortable is a puzzler to me.
Hearing some words through the wall has not been unusual, to me.
None of the stuff you describe is sounding "sketch," to me. But by all means go elsewhere, since it made you uncomfortable.
posted by jayder at 11:48 AM on September 6, 2011 [2 favorites]
Hearing some words through the wall has not been unusual, to me.
None of the stuff you describe is sounding "sketch," to me. But by all means go elsewhere, since it made you uncomfortable.
posted by jayder at 11:48 AM on September 6, 2011 [2 favorites]
If the guy is too unimaginative to believe sex might be anything other than penis-in-vagina, he's too unimaginative to be your doctor. Re the patient charts, that's sloppy. "Sloppy" isn't a good trait in medical partitioners.
>He was pretty adamant that I was wrong and wasn't making any sense
Delightful! What a wonderful demeanor he must have.
DTMFA.
posted by A Terrible Llama at 11:48 AM on September 6, 2011 [32 favorites]
>He was pretty adamant that I was wrong and wasn't making any sense
Delightful! What a wonderful demeanor he must have.
DTMFA.
posted by A Terrible Llama at 11:48 AM on September 6, 2011 [32 favorites]
For the privacy violations you can file a complaint with the U.S health and human services office of civil rights. Go here and scroll down the page.
posted by bananafish at 11:50 AM on September 6, 2011 [2 favorites]
posted by bananafish at 11:50 AM on September 6, 2011 [2 favorites]
I was pretty sure most people define "sexually active" through risk of STI transmission
That's the traditional use of the term. The variant definition is not unheard of (I'll bet Bill Clinton agrees with your doctor :-) ) but I can see where it would confuse most people to only be asking about intercourse.
I'm really uncomfortable with how cavalierly the office treated private patient information
That alone is reason to find another doctor.
posted by Tell Me No Lies at 11:51 AM on September 6, 2011
That's the traditional use of the term. The variant definition is not unheard of (I'll bet Bill Clinton agrees with your doctor :-) ) but I can see where it would confuse most people to only be asking about intercourse.
I'm really uncomfortable with how cavalierly the office treated private patient information
That alone is reason to find another doctor.
posted by Tell Me No Lies at 11:51 AM on September 6, 2011
It kind of sounds like you might be worried about a homophobia issue - "lesbians don't actually have "sex", it totally doesn't count" or whatever. I can't tell for sure, but if that was the issue it's more than enough to drop a doctor for. Fuck 'em if they can't handle reality.
posted by restless_nomad at 11:53 AM on September 6, 2011 [7 favorites]
posted by restless_nomad at 11:53 AM on September 6, 2011 [7 favorites]
Have people heard the phrase used in my doctor's way elsewhere, or does it indeed have that limited clinical definition?
Until fairly recently, I would imagine his definition of sexually active (heterosexual PIV sex) was the most common one. I personally think any contact that could lead to a an STI is "sexually active," and I'm not sure you'll find a non-psychiatric medical professional that cares what sex acts emotionally/psychologically feel like sex to you if they don't carry STI risk.
posted by crankylex at 11:55 AM on September 6, 2011
Until fairly recently, I would imagine his definition of sexually active (heterosexual PIV sex) was the most common one. I personally think any contact that could lead to a an STI is "sexually active," and I'm not sure you'll find a non-psychiatric medical professional that cares what sex acts emotionally/psychologically feel like sex to you if they don't carry STI risk.
posted by crankylex at 11:55 AM on September 6, 2011
Can you contact a mod to update with location information? It will certainly affect who to report your Dr to if not the definition of 'sexually active'.
I'm not sure why it was necessary to have a 3 minute argument with him about the subject though, why did it need to go anywhere beyond him telling you that you're not sexually active? You can disagree all you like for your own purposes but clearly for his, you are not and you know for next time what he means, even if that's not what it means to you or any past or future medical professionals you might encounter.
posted by missmagenta at 11:56 AM on September 6, 2011
I'm not sure why it was necessary to have a 3 minute argument with him about the subject though, why did it need to go anywhere beyond him telling you that you're not sexually active? You can disagree all you like for your own purposes but clearly for his, you are not and you know for next time what he means, even if that's not what it means to you or any past or future medical professionals you might encounter.
posted by missmagenta at 11:56 AM on September 6, 2011
I define sexually active as intentional sexual activity involving genitals. Just me & my genitalia - not active. Me & George Clooney & Sexy Fun involving genitals - active, in the nicest imaginable way. YMMV for definition of nice.
Your doctor seems to have communication issues in addition to flagrant abuse of patient privacy. The poor communication skills, and the awkwardness of the discussion are unlikely to generate issues with the licensing board and/or local medical association. Please report the privacy abuse. The website for the attorney general for your state should have information.
posted by theora55 at 12:00 PM on September 6, 2011 [1 favorite]
Your doctor seems to have communication issues in addition to flagrant abuse of patient privacy. The poor communication skills, and the awkwardness of the discussion are unlikely to generate issues with the licensing board and/or local medical association. Please report the privacy abuse. The website for the attorney general for your state should have information.
posted by theora55 at 12:00 PM on September 6, 2011 [1 favorite]
My gynecologist does not define sexually active as rigidly as your doctor does. If you're looking for others' experiences.
N'thing that you should find another doctor, pronto. I suspect that if your guy is dismissive of your questions about what it means to be sexually active, he'll be dismissive of problems you actually have with your vagina. (And other parts. But it can be especially hard to find a doctor (particularly a male doctor) who earnestly addresses all of your questions about your health (particularly if you are a woman and have questions about your sexual health.) Find a new doctor.
If this doctor's office is listed on Yelp (some are), you can leave a review there. Stick to their sloppy handling of private patient information more so than his terminology.
posted by phunniemee at 12:00 PM on September 6, 2011
N'thing that you should find another doctor, pronto. I suspect that if your guy is dismissive of your questions about what it means to be sexually active, he'll be dismissive of problems you actually have with your vagina. (And other parts. But it can be especially hard to find a doctor (particularly a male doctor) who earnestly addresses all of your questions about your health (particularly if you are a woman and have questions about your sexual health.) Find a new doctor.
If this doctor's office is listed on Yelp (some are), you can leave a review there. Stick to their sloppy handling of private patient information more so than his terminology.
posted by phunniemee at 12:00 PM on September 6, 2011
Yeah - I've never heard "sexually active" limited to penis-in-vagina sexual intercourse. This all sounds kind of wacky.
posted by rmd1023 at 12:03 PM on September 6, 2011
posted by rmd1023 at 12:03 PM on September 6, 2011
Here in the UK, leaving patients' records visible would be sufficient grounds for a complaint to the regulatory body (the General Medical Council). And if he wanted to know whether you were having heterosexual, vaginal intercourse, he should have asked you just that. I wouldn't go back to him, and I'd consider complaining as well.
posted by Perodicticus potto at 12:12 PM on September 6, 2011 [2 favorites]
posted by Perodicticus potto at 12:12 PM on September 6, 2011 [2 favorites]
His definition of "sexually active" matters because he might avoid or decline ordering certain tests for a patient because he doesn't consider them to be sexually active, even though they are engaging in activities that might be risky. I think such a narrow view is troublesome not just because of that, but because on a larger scale he could be generally out of touch and not the most proactive or responsive doctor.
Between that and the patient records thing, I would switch ASAP.
posted by DrGirlfriend at 12:18 PM on September 6, 2011 [5 favorites]
Between that and the patient records thing, I would switch ASAP.
posted by DrGirlfriend at 12:18 PM on September 6, 2011 [5 favorites]
This is a terrible practice. Leave immediately.
FWIW, my paediatrician classed me as sexually active when I started having sexual contact with partners. This was about 1985, for God's sake. Intercourse is not the threshold for this and your doctor is a dinosaur. DTMFA.
posted by DarlingBri at 12:19 PM on September 6, 2011 [1 favorite]
FWIW, my paediatrician classed me as sexually active when I started having sexual contact with partners. This was about 1985, for God's sake. Intercourse is not the threshold for this and your doctor is a dinosaur. DTMFA.
posted by DarlingBri at 12:19 PM on September 6, 2011 [1 favorite]
Here's the website to file your HIPAA Complaint through the Office for Civil Rights.
Also, n'thing getting a new doctor. This individual sounds like a pure jackass.
posted by Mister Fabulous at 12:20 PM on September 6, 2011 [5 favorites]
Also, n'thing getting a new doctor. This individual sounds like a pure jackass.
posted by Mister Fabulous at 12:20 PM on September 6, 2011 [5 favorites]
Well, intercourse is the highest risk factor for the bad stuff like hiv, so it is actually quite reasonable for him not to be concerned about the much lower risk stuff. You seem like you are overreacting a bit, though he had poor communication and patient privacy practices.
posted by yarly at 12:46 PM on September 6, 2011
posted by yarly at 12:46 PM on September 6, 2011
Actually, anal sex is riskier. The OP was a bit coy about what she actually is talking about, and if she was equally coy with the doctor there's really no earthly reason for him to assume she was talking about only "safe" stuff.
posted by restless_nomad at 12:53 PM on September 6, 2011
posted by restless_nomad at 12:53 PM on September 6, 2011
Yeah, seriously, "Sexual History-Taking 101" states that a doctor must use specific language and not leave it to the peanut gallery to try and decipher what they mean when they're asking about sexual activity ("Are you sexually active?" "No, I just lay there.").
He's an ass, leave.
posted by tristeza at 12:54 PM on September 6, 2011 [6 favorites]
He's an ass, leave.
posted by tristeza at 12:54 PM on September 6, 2011 [6 favorites]
That's true - and if she was being coy she also has no reason to complain. But otherwise, to a doctor, the concern is gauging risk, not asking what you "emotionally" consider to be sex.
posted by yarly at 12:56 PM on September 6, 2011
posted by yarly at 12:56 PM on September 6, 2011
How this narrower definition makes you uncomfortable is a puzzler to me.
I'd say because this speaks to core competency. If you can't trust your doctor to share your definition of "sexual intercourse" then what else is in doubt? And I'm not saying the patient needs to know everything the doctor does—that's why she's going to the doctor—but she should be expected to be able to communicate on basic things.
Sexually active to me means engaging in sexual activity. If specific acts are needed then those need to be asked.
I've had doctors ask is I engage in "high risk" activities. If a doctor then proceeded to define high risk differently than the accepted definitions I'd be concerned.
posted by cjorgensen at 12:57 PM on September 6, 2011 [2 favorites]
I'd say because this speaks to core competency. If you can't trust your doctor to share your definition of "sexual intercourse" then what else is in doubt? And I'm not saying the patient needs to know everything the doctor does—that's why she's going to the doctor—but she should be expected to be able to communicate on basic things.
Sexually active to me means engaging in sexual activity. If specific acts are needed then those need to be asked.
I've had doctors ask is I engage in "high risk" activities. If a doctor then proceeded to define high risk differently than the accepted definitions I'd be concerned.
posted by cjorgensen at 12:57 PM on September 6, 2011 [2 favorites]
Wasn't the doctor also being coy by asking about "sexual activity" when he really meant "vaginal penetration with a penis"?
posted by muddgirl at 12:57 PM on September 6, 2011 [4 favorites]
posted by muddgirl at 12:57 PM on September 6, 2011 [4 favorites]
I think that the vast majority of patients probably understand "sexually active" to mean penatrative sex. The sex-positive "anything is sex if you think it is" Internet world hasn't taken over yet. But of course if the doctor wanted to be more precise it wouldn't hurt.
posted by yarly at 1:01 PM on September 6, 2011 [1 favorite]
posted by yarly at 1:01 PM on September 6, 2011 [1 favorite]
and if not is it likely a doctor's office would transfer then destroy their own copies of my records if I requested this?
To address this specifically, doctors are under regulation that requires them to keep a copy of your records for _x_ years. X varies by jurisdiction.
What usually happens is your file goes into a cabinet, in alphabetical order. Once the doc hasn't seen you in _y_ years, your file goes into another, longer term storage. This may be offsite.
There are all kinds of reasons for docs to hang onto records, including insurance billing, lawsuits, covering his ass, and your health and well being. If you turn up with cancer in 2 months time, he wants to be able to point to his exam notes and insist that nothing was abnormal when you presented to him.
Patients lose their person copies of records all the time. House fires, negligence, etc.
So. All of that to say, there is no chance in hell that your doc will discard or destroy these files, unless he is absolutely crazy.
posted by bilabial at 1:05 PM on September 6, 2011 [1 favorite]
To address this specifically, doctors are under regulation that requires them to keep a copy of your records for _x_ years. X varies by jurisdiction.
What usually happens is your file goes into a cabinet, in alphabetical order. Once the doc hasn't seen you in _y_ years, your file goes into another, longer term storage. This may be offsite.
There are all kinds of reasons for docs to hang onto records, including insurance billing, lawsuits, covering his ass, and your health and well being. If you turn up with cancer in 2 months time, he wants to be able to point to his exam notes and insist that nothing was abnormal when you presented to him.
Patients lose their person copies of records all the time. House fires, negligence, etc.
So. All of that to say, there is no chance in hell that your doc will discard or destroy these files, unless he is absolutely crazy.
posted by bilabial at 1:05 PM on September 6, 2011 [1 favorite]
A voice in defence of the doctor here: not sure why you're so bugged by his definition of 'sexually active'. As said before, depending on your complaints he could specifically want to know whether you engage in PIV sex for a whole number of reasons, perhaps beyond your direct understanding. The 'medical definition', if there is one, not only depends on whether you can or cannot catch an STI from the act. For example, did you see him with abdominal pain? Urinary tract infection? Complaints that might carry a psychosocial component? Could it not also be a first question, which after confirmation of PIV could be followed by questions on more specific aspects of your sexual health? There are a whole lot of issues to which it is relevant to know what a patient does between the sheets, e.g. pregnancy, pelvic pain, relational issues, depression, etc. Physicians sometimes just need to know their patients private stuff to do their job right. The tugging over the definition is just a miscommunication.
Then also, before you file a HIPAA complaint, exactly how sure are you that the information lying around was sensitive?
No offence, but I get the feeling you might be reacting a bit tense, both on your doctors question, and the whole 'sketchiness'. Still, get another doctor if this one doesn't feel right.
posted by tvdveer at 1:46 PM on September 6, 2011 [2 favorites]
Then also, before you file a HIPAA complaint, exactly how sure are you that the information lying around was sensitive?
No offence, but I get the feeling you might be reacting a bit tense, both on your doctors question, and the whole 'sketchiness'. Still, get another doctor if this one doesn't feel right.
posted by tvdveer at 1:46 PM on September 6, 2011 [2 favorites]
Do you know that these were active files? My Drs office has stopped using paper files and has only computer files. I'd switch medical providers if I were you, but I think complaining that you're seen file folders lying around isn't enough for anyone to really mount an investigation.
posted by Ideefixe at 1:47 PM on September 6, 2011
posted by Ideefixe at 1:47 PM on September 6, 2011
It is most important that you and your doctor communicate well, which clearly isn't happening here. Maybe I am over thinking this, but I must ask: Are you simply reluctant to tell him that you are gay or lesbian, though you do have some contact with another person in an intimate way? I know that having the question asked in a specific way can be off-putting, but if this happens to be the reason, try to find a way to address it honestly and directly the next time it comes up, as it is bound to do. The doctor's task is to try to guide you to the right health information for you.
posted by Riverine at 1:50 PM on September 6, 2011
posted by Riverine at 1:50 PM on September 6, 2011
It doesn't excuse his other practices, but I think some gynological exams are only necessary if you're active in a PiV-way. I remember one (awesome, totally non-sketch and very good at his job) doctor discussing it and explaining that, at my age and as long as I wasn't having PiV activity, it wasn't necessary to do certain screens yearly. Wish I could recall what particular exam it was--nothing to do with STDs, but something that's part of a yearly ladies check-up.
Still, the privacy issues and his lack of communication would have scared me off in your case. Find an awesome doctor that you can trust and talk to.
posted by ninjakins at 2:07 PM on September 6, 2011
Still, the privacy issues and his lack of communication would have scared me off in your case. Find an awesome doctor that you can trust and talk to.
posted by ninjakins at 2:07 PM on September 6, 2011
if she was being coy she also has no reason to complain
Wow, strongly disagree with that one. It's part of a medical professional's job to be able to elicit information that patients don't volunteer in a clear and unequivocal form. Sometimes people are embarrassed, especially about matters related to sex and/or genitalia. Sometimes people just don't know how to describe things. It's the care provider's job to draw out the necessary information and, preferably, to do so in a way that doesn't make the patient feel as if they've just been scolded or told they're stupid.
posted by Lexica at 2:28 PM on September 6, 2011 [4 favorites]
Wow, strongly disagree with that one. It's part of a medical professional's job to be able to elicit information that patients don't volunteer in a clear and unequivocal form. Sometimes people are embarrassed, especially about matters related to sex and/or genitalia. Sometimes people just don't know how to describe things. It's the care provider's job to draw out the necessary information and, preferably, to do so in a way that doesn't make the patient feel as if they've just been scolded or told they're stupid.
posted by Lexica at 2:28 PM on September 6, 2011 [4 favorites]
My guess is that the doctor probably wasn't worrying about your risk of STIs, but might have been thinking primarily about your requirement for cervical smears, contraceptive advice, or preconception counselling. If the doctor had just met you for the first time I think it's understandable that he didn't launch into a detailed enquiry about exactly what kinds of sex you've had with exactly which kinds of partners.
As for leaving charts lying around. I personally don't think that seeing the name of a patient on the cover of a chart is a gross confidentiality violation, since you might very well expect to meet other patients in the waiting room.
posted by roofus at 3:15 PM on September 6, 2011
As for leaving charts lying around. I personally don't think that seeing the name of a patient on the cover of a chart is a gross confidentiality violation, since you might very well expect to meet other patients in the waiting room.
posted by roofus at 3:15 PM on September 6, 2011
I remember one (awesome, totally non-sketch and very good at his job) doctor discussing it and explaining that, at my age and as long as I wasn't having PiV activity, it wasn't necessary to do certain screens yearly. Wish I could recall what particular exam it was--nothing to do with STDs, but something that's part of a yearly ladies check-up.
Off-topic: probably the Pap smear (to check for cervical cancer). New guidelines (described on this page) say that under certain conditions it's no longer necessary to have this test every year.
posted by shiny blue object at 3:35 PM on September 6, 2011
Off-topic: probably the Pap smear (to check for cervical cancer). New guidelines (described on this page) say that under certain conditions it's no longer necessary to have this test every year.
posted by shiny blue object at 3:35 PM on September 6, 2011
I would personally be very uncomfortable with a doctor who couldn't talk about sexual activity with me in a calm, straightforward, non-judgmental, and detailed way. The people who are saying that there might be reasons for him to want to know about PIV only are missing the point, as are the people saying that it's only a miscommunication. The important thing is that he should have been able to make a simple statement like:
"Oh, I'm sorry, it's clear we're having a misunderstanding because I didn't use a specific enough term. When I asked if you were 'sexually active' what I actually needed to know, and should have said more explicitly, was whether you are having vaginal intercourse. Thank you for clarifying."
Sure, it's a miscommunication. But that's the point -- part of his job is being able to communicate with you, and if a miscommunication trips him up so badly that he gets defensive and condescending, then he's wretched at at least part of his job.
I think you would be entirely justified to find a new doctor on this basis alone. I sure would.
posted by ootandaboot at 3:46 PM on September 6, 2011 [17 favorites]
"Oh, I'm sorry, it's clear we're having a misunderstanding because I didn't use a specific enough term. When I asked if you were 'sexually active' what I actually needed to know, and should have said more explicitly, was whether you are having vaginal intercourse. Thank you for clarifying."
Sure, it's a miscommunication. But that's the point -- part of his job is being able to communicate with you, and if a miscommunication trips him up so badly that he gets defensive and condescending, then he's wretched at at least part of his job.
I think you would be entirely justified to find a new doctor on this basis alone. I sure would.
posted by ootandaboot at 3:46 PM on September 6, 2011 [17 favorites]
I hope ootandaboot either is a doctor or is in training to become one, because her answer is the best in this thread, and I'd like her to be my doctor.
posted by marsha56 at 5:11 PM on September 6, 2011
posted by marsha56 at 5:11 PM on September 6, 2011
Honestly, it sounds like it was an awkward/strange conversation all around. It sounds to me that you were both really stubborn -- instead of getting to the business at hand, you were both tied up in a ridiculous issue of semantics.
FWIW, I have always assumed 'sexually active' means PiV when it relates to me, a heterosexual female. If I were exclusively having oral sex and they asked me if I were sexually active, I would say 'I have oral sex'. If they said, 'oh ok, then you're not sexually active," I wouldn't have a problem with that. What the hell does it matter what they call it, as long as everyone knows who is doing what with which body parts and all the correct tests can be run?
Get a new doctor -- you guys can't communicate. I also don't like the sound of the files being left out for patients to see.
posted by imalaowai at 6:10 PM on September 6, 2011 [2 favorites]
FWIW, I have always assumed 'sexually active' means PiV when it relates to me, a heterosexual female. If I were exclusively having oral sex and they asked me if I were sexually active, I would say 'I have oral sex'. If they said, 'oh ok, then you're not sexually active," I wouldn't have a problem with that. What the hell does it matter what they call it, as long as everyone knows who is doing what with which body parts and all the correct tests can be run?
Get a new doctor -- you guys can't communicate. I also don't like the sound of the files being left out for patients to see.
posted by imalaowai at 6:10 PM on September 6, 2011 [2 favorites]
Yep, get a new doctor; at the very least the fact that he was too shy[?] or had trouble with a direct conversation about sex is enough to look for another doctor.
If he wanted to know whether you did X, Y and/or Z then he should be able to ask you quite directly, don't you think? Why is he hung up on the two of you sharing a coded message?
The second he realized that you might not be using the same terms, he just should have gone more clinical or direct with his vocabulary.
posted by calgirl at 7:15 PM on September 6, 2011
If he wanted to know whether you did X, Y and/or Z then he should be able to ask you quite directly, don't you think? Why is he hung up on the two of you sharing a coded message?
The second he realized that you might not be using the same terms, he just should have gone more clinical or direct with his vocabulary.
posted by calgirl at 7:15 PM on September 6, 2011
This brought back shades of my early experiences with seriously annoying heteronormative GYNs:
"Are you sexually active?"
"Yes."
"Are you using birth control?"
"No."
Followed by expressions of shock and/or lectures on birth control. Until I was forced to explain that there was actually another answer, involving lesbianism. Oy.
So, yes, I do not define "sexually active" to be exclusive to PIV activity. Nor would I continue seeing a GYN who did. Find a different doc.
posted by gingerbeer at 7:39 PM on September 6, 2011 [4 favorites]
"Are you sexually active?"
"Yes."
"Are you using birth control?"
"No."
Followed by expressions of shock and/or lectures on birth control. Until I was forced to explain that there was actually another answer, involving lesbianism. Oy.
So, yes, I do not define "sexually active" to be exclusive to PIV activity. Nor would I continue seeing a GYN who did. Find a different doc.
posted by gingerbeer at 7:39 PM on September 6, 2011 [4 favorites]
I think this is one of those areas where there's likely to be a disconnect between how Internet People perceive "sexually active" to be properly used, and how it's actually used in many areas.
I definitely know people who use "sexually active" as a more polite / roundabout way of saying "had penile/vaginal intercourse." I would expect more precise terminology from a doctor (or any medical professional), but lots of doctors get lulled into sloppy terminology with patients because of what happens to be common in their area.
I'd say the correct response is just to ask bluntly for a clarification of exactly what "sexually active" means in that context, and then respond appropriately. Frankly I think "sexually active" is a pretty dumb term in general and just opens everyone up to misunderstandings (e.g. if you define 'sexually active' as PIV sex, and the patient is gay...then what? it's a pretty clearly heteronormative definition).
That alone wouldn't be reason to dump the doc, but the fact that you're uncomfortable with the whole interaction is. If you're uncomfortable then it's not OK, and provided you live in an area and have the option of going to another doctor I would just do that.
posted by Kadin2048 at 9:17 PM on September 6, 2011
I definitely know people who use "sexually active" as a more polite / roundabout way of saying "had penile/vaginal intercourse." I would expect more precise terminology from a doctor (or any medical professional), but lots of doctors get lulled into sloppy terminology with patients because of what happens to be common in their area.
I'd say the correct response is just to ask bluntly for a clarification of exactly what "sexually active" means in that context, and then respond appropriately. Frankly I think "sexually active" is a pretty dumb term in general and just opens everyone up to misunderstandings (e.g. if you define 'sexually active' as PIV sex, and the patient is gay...then what? it's a pretty clearly heteronormative definition).
That alone wouldn't be reason to dump the doc, but the fact that you're uncomfortable with the whole interaction is. If you're uncomfortable then it's not OK, and provided you live in an area and have the option of going to another doctor I would just do that.
posted by Kadin2048 at 9:17 PM on September 6, 2011
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Sexually transmitted diseases can be transmitted by means other than sexual.
I am having trouble understanding what your question is, but if the doctor makes you feel uncomfortable, find another doctor.
posted by dfriedman at 11:42 AM on September 6, 2011 [7 favorites]