Women with prolapse often feel disheartened after an appointment with their family doctor. They report feeling as if the GP didn't believe them, or didn't understand the impact prolapse has on their lives. This is a real barrier to women managing their prolapse effectively.
However, prolapse and the constellation of symptoms around it can be difficult to deal with as a GP with no special training in women's health. It can also be hard to fit in an impromptu counselling session if you only have 10 or 15 minute slots in which to see your patients.
A useful way of trying to overcome this problem is to ask the question: What do your patients want when they come to see you?
Of course patients want medical advice. However, in order for you to deliver this advice effectively, and for patients to follow it, it may be helpful to think about what else your patients want when they come to your surgery.
- Patients want to be heard. Many women with prolapse have suffered in silence for months or even years. You may be the first person they have spoken to it about. Discussing symptoms to do with their genitals, sex life, or continence may be very embarrassing and distressing - it may have taken a long time for them to get up the confidence to see you. Repeating the symptoms they have described back to them as confirmation is one way you can show you have heard them.
- Patients want to have their concerns taken seriously. You may feel that a patient has nothing to be concerned about. But if they have made the time to come and see you about a taboo topic like their genital health, then they are concerned nonetheless. Saying something as simple as "It sounds like your symptoms are distressing" shows that you respect the patient's experience of their own body, without invalidating any reassurance you then give them.
- Patients want you to be honest, including being honest about your level of knowledge. GPs are in a difficult position, because patients often expect them to have an encyclopaedic knowledge of every condition. You may feel that you have to maintain this illusion in order for your patients to respect you and listen to your advice. However, the vast majority of your patients would much rather you refer them to a specialist if you are unsure about how to diagnose or treat their prolapse.
Early detection and management of prolapse can vastly improve the health of many women, and GPs have a vital role in making that happen.
If you know a GP or other health professional who would be interested in this resource, or who may benefit from using it as part of their practice, please feel free to direct them to this website.