A Doctor's Questions... What should I say??

[drlove]

I have a question regarding the right of a medical professional I.e.(a doctor or nurse in an STD clinic) to ask about a patient's sexual history... in particular, how many sexual partners they have had.

I ask this because the last time I was there, the doctor started to ask questions like, how many partners have you had in the last six months, the past year, the last 10 years; have they been steady or casual partners, and so forth.

For one, I can't see how this would impact on the reason I'm there for. It seems somewhat irrelevent; either I have an STD or I don't - numbers don't mean much.

Furthermore, I'm at a loss at how to answer his questions. It's not as though I keep a record of who I see and when. Do I say that I'm a hobbyist and I can only guestimate at the number of partners?? Should I just make something up that sounds good, or should I say "with all due respect, who the hell wants to know??" or something to that effect??

IMO, how many ladies I've seen , or will see in the future is no one's business except mine - end of story.

I would appreciate any comments on how best to handle such a scenerio, should it arise again. Thanks.

 

[sweetnlovinlady]

dear doc

to tell u the truth when i go in for my 6 month check up i don't tell anything to any one. i go regular every 6 months even if i am not active. the only time u have to tell is if u have an std or aids that could have been passed on to others. so tell them it's private and hope for the neg results have a good day hope i helped.

 

[alphaBIT]

These questions are a basic assessment to check your risk to get or pass on a STD. If you go there and you've had only one or two sexual partners in the last 10 years, and have practiced safe sex, they will probably do the test and then tell you that you should worry about other things in life. If you've had two or more partners in the last year, you would be conisdered at higher risk, and they might suggest you check in again in another six months or so and educate you about safe sex etc. The STD test is much more useful if it is done within the context of sexual history and current behaviours.

 

[drlove]

While I agree with the notion that getting tested more frequently is a good idea as a hobbyist (or SP, for that matter), I find myself in agreement with Sheik, and contend that ultimately it is a private matter.

 

[train]

He has the right to ask .......you have the right to refuse to answer . They ask a lot of things that are irrelevant once test results are known.....just remember that half the doctors finished in the bottom half of their graduating class .

 

[drlove]

They ask a lot of things that are irrelevant once test results are known.....just remember that half the doctors finished in the bottom half of their graduating class .

Actually, he asked before the tests were conducted....

That just fills me with confidence.

 

[drlove]

Was this the Hassle Free Clinic? I don't recall anything like that when I was at HFC.

That's why they call it the Hassle Free Clinic!

 

[MuffinMuncher]

Another possibility

If your answer is "more than 10", maybe he just wants to get a few leads from you.

 

[taylortime]

I completely agree with train. You have no obligation to answer anything you don't want to . "He has the right to ask .......you have the right to refuse to answer . They ask a lot of things that are irrelevant once test results are known.....just remember that half the doctors finished in the bottom half of their graduating class "

Naughty dreams

 

[Big Daddy]

The real reason is

I my judgement the real reason why doctors ask that question is to decide how carefully they should test you. Doctors may do the casual tests if you are monogamous. However, if they know you are a hobbiest then they will do a rigrous tests. I have seen that happen to me.

 

[drlove]

Re: The real reason is

I my judgement the real reason why doctors ask that question is to decide how carefully they should test you. Doctors may do the casual tests if you are monogamous. However, if they know you are a hobbiest then they will do a rigrous tests. I have seen that happen to me.

I hear you... that's what happened to me the last time. I have no problem with the blood and urine tests; they're a cake walk.

I only started to regret being honest when after giving him an answer to his "sexual partners" question, he looked at me and said "we better do a swab."

As it turned out, it was all for nothing, since I was asymptomatic when I went in (it was a routine check-up). Basically, I endured a lot of needless pain and suffering. Swabs are NOT fun!

I don't want to be a sucker for punishment, that's all.

 

[Jacques_Offe]

tell 'em

Teh poster ahead is correct. you screw one or two and you are a MUCH lower risk than if you nail 20-30. Believe me the doc does not give a shit about your sex life..he/she wants to know what level of testing you need.

 

[train]

Re: tell 'em

Teh poster ahead is correct. you screw one or two and you are a MUCH lower risk than if you nail 20-30.

Given the fact that it only takes once this seems like a poor practice to me . Either you get a complete test or there is a chance they missed something . What exactly is the point of incomplete testing ?

I'm sure I would be quite understanding if I asked to be tested and they missed something because some yahoo decided I was a B-level risk and only requested a b-level test.

 

[Jacques_Offe]

risk

I did not say you could not get a disease...I said you are a lower RISK...sure you can get it from one time but the risk goes up proprtional to the exposure

 

[gala]

Re: Re: tell 'em

Given the fact that it only takes once this seems like a poor practice to me . Either you get a complete test or there is a chance they missed something . What exactly is the point of incomplete testing ?

Statistics. Really weird statistics that your doctor understands, but which you don't.

Suppose that 1 person in 100,000 has a particular disease and that there is a test for this disease that is accurate 99% of the time. That's a pretty good test, right?

Wrong. The test is WORTHELESS. A positive result means you only have a 1 in 1000 chance of having the disease because you expected to get 999 incorrect positive results (100,000 times 1%) for every one person (1 times 99%) that you correctly identified as having the disease. All you've done is waste a lot of money on unnecessary extra testing, and worry a whole lot of people for no reason.

But suppose you can ask some "lifestyle" questions and as a result you can identify people who have a 20% chance of having this disease. Suddenly this test becomes worthwhile: Now if you test 1000 people you will get only two false positives (1% * 20% * 1000) for every person you correctly identify. So now if you get a positive result you have a 33% chance of having the disease and that justifies spending some money on extra testing.

It is in YOUR BEST INTEREST to answer the doctors questions honestly as what he's doing is trying to avoid you winding up as one of the 999/1000 people who worry for no reason.

 

[james t kirk]

Having just been to the hassle free clinic myself about 3 weeks ago I can tell you this......

1. They don't ask how many people you have had sex with. (They don't care, and there are lots of people out there who have sex with a hundred a month, or more.)

2. They ask you about your sexual practices, namely, do you have unprotected vaginal sex? Do you have unprotect anal sex? Do you have sex with men? Do you have oral sex, Do you use intervenus drugs? Do you share needles? etc.

They don't know you, nor do they judge you.

The AIDS and syphilis testing is anonymous. The other STD testing -Chlamydia , Gonorrhea, etc. is not anonymous. You can do one or both.

I opted for both, and a Hepatitis B shot while i was at it.

Bottom line I guess if you play, you have to suffer a bit of embarassement (assuming you are responsible enough to keep on top of it.)

Their website is

http://www.hasslefreeclinic.org

You must make an appointment, and they do not give results over the phone.

Still a well run oufit though.

 

[gala]

I got my math wrong above--the lifestyle questions help a lot more than that.

Here's correct math:

If 1:100000 have the disease, your test is 99% accurate, and lifestyle questions can identify high risk people who have even a 5% chance of having the disease, then:

With no lifestyle questions you get 1 true positive, 1000 false positives, 98999 true negatives, and virtually no false negatives. A positive test result means you have a 1/1001 chance of having the disease or about 0.1% chance, the test is worth nothing.

If you ask lifestyle questions and test only those people who have a 5% chance of having the disease then you will find 4950 true positives, 950 false positives, 50 false negatives, and 94050 true negatives. A positive test then means you have a 4950/(4950+950) or 83.8% chance of having the disease, and a negative result means you have a 94050/94100 or 99.94% chance of being clean.

It would be a big waste of money to test everybody and learn nothing, but a valuable test to perform on the 5% who are high risk.

That's why doctors ask lifestyle questions and do "incomplete testing" -- because they are aware of the underlying statistics and the relationship between those statistics and the effectiveness of their tests.

 

[train]

Now I'm confused . If I understand this correctly the reason they ask the lifestyle questions is because the test is not accurate enough to be relied upon by itself ?

Out of curiousity do you have a medical background or is this info from some other source ?

 

[DonBusch]

My personal experience is that some tests are more invasive than others, i.e, swabs versus urine test, the more invasive ones usually being more specific and accurate. Whenever I tell a doc that I have had only one or two partners, only a urine test has been done. Tell a doc that I'm a hobbyist and I usually get recommended the full battery of tests. IMHO, regardless of what you're going to tell the doctor, always get the full range of tests. Most stds are easily treatable, ignore the symptoms and its just gonna get worse, while some stds seems to have relatively minor effects, they can make you more vulnerable to HIV infection

 

[gala]

Now I'm confused . If I understand this correctly the reason they ask the lifestyle questions is because the test is not accurate enough to be relied upon by itself ?

Correct. On their own MOST medical tests are worthless because the base rate of the condition they test for is simply too low. But when combined with information that increases the base rate--such as observable symptoms, or information that the person is in a certain risk group, then the base rate is not low and the test provides useful information.

Out of curiousity do you have a medical background or is this info from some other source ?

This analysis is well known to anybody who has taken an undergraduate course in probability and statistics, for example here:

http://statweb.calpoly.edu/chance/oldstat321/lectures/day8sols.html