Can unmarried women choose a married medical check-up package?
Doctors suggest that when employers provide medical benefits for employees, they should give more privacy protection and freedom of project selection.
Our reporter Liu Xiaoyan
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In women's health check-up, there are often two options: unmarried and married, and the two are mainly distinguished by gynecological examination items.
Married women's physical examination items include a number of examinations, while unmarried women are mainly gynecological color Doppler ultrasound imaging examinations.
However, doctors said that women over the age of 21 who have a sexual life history should undergo gynecological examinations, TCT, HPV and other tests, regardless of whether they are married or not.
Xiaobu, who lives in Hangzhou, Zhejiang Province, is 31 years old this year. He has experienced several romances, but he is unmarried.
Xiaobu, who is busy with work on weekdays, has no time for a physical examination. During the Spring Festival this year, she underwent a full-body examination at her home county hospital. She did not expect this experience to be unforgettable for her life.
"The medical examination form issued by an old doctor only asked for his name and age, and then he ordered a set of medical examination packages of more than 300 yuan, including gynecological examinations." Xiaobu checked the contents of the medical examination form item by item until Lying on the bed for the gynecological examination, I realized that something was wrong.
It turned out that the old doctor, after knowing Xiao Bu's age, "naturally" prescribed a married check-up program to her unmarried.
Married or unmarried medical check-up package is selected by default
According to Xiaobu's recollection, the doctor who also noticed that the situation was not right hurriedly asked: "Have you ever had sex?" Xiaobu answered truthfully no, and the doctor immediately asked her to re-issue the unmarried medical examination.
Shen Zhiqian, chief physician of the gynecology department of Zhanxi Road Hospital, Xicheng District, Beijing, said, "Gynecological examinations on the one hand make patients psychologically repulsive. Abdominal gynecological ultrasound."
Ms. Lu, who works in Hangzhou, recently experienced the opposite.
At the end of 2021, Ms. Lu's company organized employee medical examinations. Since she knew that Ms. Lu was not married, the relevant personnel chose the unmarried package for Ms. Lu by default when choosing the medical examination package.
Ms. Lu understands that although she is not married yet, she has already had sex and should undergo a full gynecological examination.
She took the initiative to find a colleague who was in charge of filling out the medical check-up package and asked to change the unmarried package to married.
"Actually, I would feel very embarrassed to take the initiative to say these privacy, but I have learned about the relevant content from the Internet, so for my own health, I insisted on changing the package." Ms. Lu said.
Gynecological exams can screen for cervical cancer and other risks
When women choose a medical check-up package, the available categories are often married or unmarried, but in the actual medical check-up process, the doctor repeatedly confirms to the female patient: "Whether there is a sexual life." So, which distinguishing standard Is it more in line with the needs of the patient?
The reporter checked the women's physical examination packages of many hospitals through the Jingyitong platform and found that the conventional married package for women has three or four more gynecological examinations than the unmarried package, and the latter is mainly gynecological color Doppler imaging examinations.
Shen Zhiqian told reporters that the examination items for married women assume that the patient has sex by default. "Under this premise, the doctor will take cervical cells and use them for HPV, TCT and other screening items."
Shen Zhiqian mentioned that once a woman has sex, she is at risk of contracting the HPV virus, and the probability of developing cervical cancer is also greatly increased.
"Through the method of bimanual diagnosis, doctors can more accurately understand the health status of patients."
Ding Lei, deputy director of the Health Management Center of Beijing Tsinghua Chang Gung Hospital affiliated to Tsinghua University, said, "In addition to screening for cervical cancer and other diseases, gynecological examinations can also screen women who are preparing for pregnancy for abnormal reproductive structure development."
"According to the current consensus on cervical cancer screening at home and abroad, regardless of whether they are married or not, it is necessary for women over 21 years old with a history of sexual life to undergo gynecological examinations, TCT, HPV and other tests." Ding Lei said.
It is necessary to confirm before the inspection, and humanistic care and health education are also indispensable
During the interview, the reporter found that many women did not know that during the physical examination, they should choose the examination items based on their sexual life history rather than their marital status.
In order to avoid the "Oolong" examination caused by lack of knowledge, in recent years, many hospitals and medical examination institutions will repeatedly confirm before female examination.
Ding Lei said that the physical examination institutions will, according to industry management regulations, such as the "Beijing Medical Institutions Health Physical Examination Quality Management and Control Indicators (2015 Edition)" formulated by the Beijing Municipal Physical Examination Quality Control Center, do a good job of knowing the gynecological examination of female participants. agree.
"Before participating in the examination, the inspection kit should be confirmed. The entrance of the gynecological clinic and the table of the clinic are also posted with the precautions for gynecological examination items. After entering the gynecological examination room, the doctor will ask again whether there is a sexual life history and confirm the inspection items. , and make a signed record of informed consent on the process sheet." Ding Lei said.
However, how to prepend the selection to avoid other women encountering experiences similar to Xiaobu and Ms. Lu in the physical examination, it is necessary to more clearly identify whether there is a sexual life history as a distinguishing factor for whether a gynecological examination is required.
Ding Lei believes, "On the one hand, gynecological examination items will increase the corresponding cost, and many organizations consider the fairness among individuals, and generally choose a set of items according to their marital information status; on the other hand, gynecological examinations also involve privacy protection, and some women may not want to Disclosing your sex life at work."
Shen Zhiqian, based on her 35 years of experience in gynecology, said that in the female physical examination, many physical examination package introduction pages do remind unmarried women that they must go to the front desk to sign and confirm after choosing a married package, but this content is mainly for the purpose of being a good doctor. The responsibilities of both parties are clear, but there is a lack of humanistic care and health education.
"Actually, a reminder can be added to the selection page of the medical check-up package: If unmarried women have a history of sex, it is recommended to choose a married package."
Shen Zhiqian suggested that employers should also give more privacy protection and freedom of project selection when providing physical examination benefits for employees. For example, the department responsible for the procurement of medical examination packages can understand the wishes of the medical examiners in advance and provide guidance for female employees to choose projects.