No woman would choose to begin her day with a colposcopy. It can be anxiety provoking, both due to the uncertainty of her health status revealed by an abnormal Pap test, and the prospect of a painful, embarrassing pelvic procedure. As clinicians, we have the ability to ease this experience for the patient both physically and emotionally. Here are the strategies that I have found work well for me as a family doctor as well as for my patients. I hope they work for you too.
1 – Refocus the exam
Colposcopes can be intimidating medical devices for patients. If possible, move the colposcope aside when the patient enters the room and before the exam, or use a non-threatening colposcope. You can bring the colposcope into the correct position when she is already on the table. This method allows the patient to focus on your conversation about her health rather than on the difficult and sometimes painful procedure ahead.
2 – Use a compassionate biopsy method
Standard biopsy tools like the Tischler-Kevorkian Biopsy Punch can cause pain and bleeding which can be avoided without compromising on sample quality by using an alternative biopsy method such as a Histologics SoftBiopsy with medical fabric.
3 – Set clear expectations
Inform the patient about what will happen during her upcoming examination before she arrives for her appointment. Reiterate what is involved in the procedure on the day of the exam, and talk the patient through each aspect of the exam itself to ensure she is informed about what she will experience.
4 – Involve the patient
Ensure you have the ability to show the woman her cervix and explain what you did or will do during a procedure, either with an attached video monitor or on the screen of the colposcope. This empowers the patient with knowledge about her cervical health and enables her to feel more comfortable with the examination.
5 – Improve the patient experience
Make sure the temperature in the exam room is a little warmer than is comfortable for the practitioner so it is pleasant for someone without pants on. You can set the thermostat ahead of time or get a dedicated space heater. It is also good practice to provide little booties for the stirrups to keep the patient’s feet warm.
6 – Be sensitive to patient embarrassment and discomfort
Be sure to have some kind of cover available for the patient’s legs so she won’t feel quite as exposed during the examination. Also provide tissues or moisturized towelettes to enable the woman to clean up after the exam. Also, provide panty liners in case of any bleeding.
7 – Have a hand-holder
Invite the patient to bring a friend/partner or have a designated hand-holder in your clinic, if you can, who can provide physical and moral support to the patient during the examination. This is a great option for any pelvic procedure.
8 – Bedside manner counts
Have a calm, pleasant bedside manner. Understand this is a potentially painful, embarrassing, and unpleasant procedure. Be patient. It’s your millionth colposcopy but probably her first or second.
Jonah Mink, MD
Are you a women’s health provider?
What tips would you share with your colleagues for best practices in colposcopy and women’s health? Continue the conversation on Twitter or Facebook with the #ColpoCorner hashtag. You can also share your comments below, or if you’d like to contribute some ideas or an article to this section.