This post was written by Philip, one of the founding members of the Pink Robin team.
As a Consultant Obstetrician and Gynaecologist, I spend a great deal of my time talking to women. It is clear that patients are often confused by what health professionals are saying and that they do not understand fully their own bodies, how they work, what can go wrong and what the options are to help when this happens.
There is a traditional assumption that doctors and nurses are “all-knowing” and that patients are “all-ignorant”. This is still largely the case, legally, in the UK – the professional should know what to tell you and have done so and a patient may not have understood what was said to them, even if it was documented that information was given. Usually, and hopefully, common sense prevails. Actually, doctors don’t know it all – in fact, the more senior one becomes, the more one realises that things taught as being clear cut and black or white at medical school are either out of date already or were just plain wrong. Sometimes we (still) do not know the answer or the correct management depends on individual circumstances, both with regards to the patient themselves or the health environment they are being treated in. This confuses some patients as it is not what they generally expect at all.
How to communicate the consequences of different options and ‘uncertainty’ in any given clinical situation can be very difficult – I struggle with this all the time. When it is unclear what is going on, or what to do, and when there are several possible management plans or treatments (including doing nothing) the patient’s input to the decision making process is crucial. This forms the basis of modern ‘informed consent’.
Over the coming months, we will try to add pages about different gynaecological conditions and treatments, starting with a bit of structure (anatomy) and function (physiology). Since these form the basis for much of what follows, you might want to read these first. We are aiming to give an understanding lying somewhere between the traditional lay patient information leaflets and a medical textbook and we will try to give links to interesting examples of both these within any section, as well as patient groups or societies. The explanations are similar to those we might use in clinic, but with the sort of embellishment afforded by the internet (time and an ability to import illustrations). You will understand that we cannot discuss or describe individual cases. The information is designed to arm you with enough understanding to make sense of what is being said to you by your own health professionals, so that your consultation with them is more useful for both parties.
Two important links that feature highly are the National Institute of Clinical Excellence (Government-run, giving guidance and assessments on medicines and technologies): www.NICE.org.uk and the Royal College of Obstetricians and Gynaecologists: www.RCOG.org.uk.
This is not a definitive guide and no medical advice can be taken or implied – it is always best to check the latest information and what is available to you locally. Like all of you, we are constantly learning and change advice based on individual circumstances. Our aim is to debunk some of the mystery that you encounter in medicine so that you are in charge of your bodies and what happens to you.
Please note that the clinical pictures shown are from patients who have given their permission to use such material for teaching. Where patients can be identified (rarely) they have given express permission for publication on a public web-site. Please mention the web-site when using such material. The photographs have been collected over the last 25 years – if there are any errors, either in content or inadvertent copyright issues, please let us know and we will seek to make any corrections and acknowledgements immediately.
Other sites that you might find useful are:
The Centre for Evidence Based Medicine – based in Oxford:
Turning Research into Practice (TRIP) database: