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  #21  
Old 25.08.2013, 21:21
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Re: Gynecological Exams in Switzerland: What to expect

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I'm glad they are direct, to be honest. There's nothing worse that your gynae having a chat about where you are going on holiday and whether I've tried the new restaurant while I'm lying there with a load of metal sticking out of my nether regions.
Personally, I like to be distracted. I'm a nervous (well, not just nervous!) talker and I don't get much more nervous than when I go to the gynaecologist. I had my only appointment with a gynaecologist here last year (that reminds me, must make my annual appointment soon) and the only real difference I saw was what has already been mentioned about the dis-robing. She used a metal speculum (in the UK they're normally disposable) which seemed to be one size fits all. Now for what some weaker-stomached people may consider to be TMI (although not really the right thread to read if you don't want to read intimate information) - in the UK there are different sizes of speculum. They have to use a long one with me in the UK. I explained this before starting and it seemed that it made no difference here... I feel sorry for you very short ladies!

Having said all this, the doctor was great. I very openly told her I was extremely nervous (I went for a colposcopy, not just your normal exam) and she chatted away with me, obviously sensing that's how I deal with stress. she gave me a breast exam too, but as I'm not shy I didn't mind. I did, however, apologise for my hairy armpits!

All in all, despite the unpleasant nature of the exam itself, it was a positive experience. I'll be making my appointment tomorrow!
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  #22  
Old 25.08.2013, 21:27
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Re: Gynecological Exams in Switzerland: What to expect

In the UK I usually ended up there on the day all the students were around- and queued up to have a look, a feel and a comment. You don't mind, do you Mrs C- you understand how training is so important for these young people, etc (as OH trained both under grads and GP trainees).

Last edited by Odile; 25.08.2013 at 22:09.
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Old 25.08.2013, 21:55
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Re: Gynecological Exams in Switzerland: What to expect

Thanks to olygirl for starting this thread, and to those of you who have shared your experiences. I have not been to the gynae here in CH, mostly because I am back in the States often enough it is cheaper to handle routine care there. However I anticipate at some point in the future I will end up getting care here, and it's handy to have this info! You have saved me from in the office to just reading my computer screen.
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Old 25.08.2013, 22:18
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Re: Gynecological Exams in Switzerland: What to expect

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In the UK I usually ended up there on the day all the students were around- and queued up to have a look, a feel and a comment. You don't mind, do you Mrs C- you understand how training is so important for these young people, etc (as OH trained both under grads and GP trainees).
I had a bit of a scare a few months ago, and had to get a lump removed. I had all the students around giving the machine a go and practising their English. It turned out to be a fun afternoon

Even better the week after when my gynecologist called to say I didn't have breast cancer
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Old 25.08.2013, 23:08
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Re: Gynecological Exams in Switzerland: What to expect

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For the older women:

Don't be surprised when you get the 'thank you and goodbye' letter - some gynecologists (note: gyne, not OB) limit their practices to women of childbearing age.

You then need to start searching for a gyne who accepts 'geriatric' ( ) new patients. If you are happy with your gynecologist, do ask if you will be able to continue with him/her as you age.

Also - the standard is baseline mammogram at 50, not 40 as in the US. If you are in a higher risk group you really do need to push hard to be referred for routine mammograms earlier.
That's a really good point Meloncollie, for those of us in the menopause phase and in central Schweiz I can highly recommend Dr. Sabine Steimann at the St. Anna clinic in Luzern. She has a terrific manner, extremely knowledgable about hormone issues and always asks if you are ok with her recommendations. I've sent a few close friends to her and they are also very happy with her. It does take about 4 month to get your first appointment but after that there is never a problem getting in to see her.

I can also recommend Dr. Michael Cebulla who preformed a minor surgery for me, he also has a very caring manner. Both speak English very well.

On the whole here I find the quality of care here is exceptional, except for the gown thing but I also love the skirt idea

Back home in CDN I was sent a letter from the mammography screening program that they highly recommended that woman like me, in a risk group should also have the breast ultrasound exam in addition to the mammogram. Unfortunately despite their warnings to the government it wasn't covered by the universal health care so I had to pay extra each year. When I go for my annual check up here the ultrasound exam is preformed by a specialist doctor, not a technician and I have my answers directly form him/her right there before I leave. I think it's standard procedure here if you are over 50 and considered high risk like me, I didn't have to push at all.
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  #26  
Old 25.08.2013, 23:22
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Re: Gynecological Exams in Switzerland: What to expect

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LOL, hmmm very useful for gynecology (edit, that was in response to a post which has now been deleted).


BTW, here where I live, GPs never do smear tests, and will automatically send you to a gynecologist- or expect you to make an appointment direct. Is that the case all over Switzerland? One person on EF told me their GP does smear tests (and of course in the UK it is mostly done by the practice nurse).
Never had mine done by the practice nurse in the UK (is that relevant?).... always the doctor. Suspect it depends on the practice? or how busy they are?

It was always in a closed, curtained room with only my female doctor. Thank Him Upstairs, I don't have to have that done now.

One thing I did learn though, after 20+ years of the ice cold clamp, I have a backwards leaning foofoo and should have always had the smear laying on my side with knees on chin!
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Old 25.08.2013, 23:58
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Re: Gynecological Exams in Switzerland: What to expect

Chair-side manner I've encountered here seems pretty evenly split into two camps. My current gynae interacts with me in a way that's extremely down-to-earth and nontechnical, might almost say a bit earthy. I jokingly describe her as a vet who decided to practice on humans. I find her manner quite comforting, but I do know some women who would be irritated or even slightly affronted by it.
My previous gynae was in the other camp: very professional and clinical, and seemed to feel that technical language would be the most reassuring as it shows you are in good knowledgeable hands.

It's just a difference of manner, both gave me excellent care, but if you are more comfortable with one style than the other, it's worth knowing that they do both exist here.


Especially if you live in a small town, do not expect patient confidentiality to be quite as sacred here as in the US. (This goes for small-town GPs too by the way.) Notionally it exists, but in practice my experience here has been that doctors talk to their families about their work day, and children talk to their little friends, and before you know it your husband is being asked in the post office how his wife's (insert sensitive lady-medicine issue) is progressing. We managed to laugh it off, but if that would be a mortal embarrassment to you, best emphasize the fact to your doctor before it has a chance to happen - or consider looking for a gynae two or three towns up the road.
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Old 26.08.2013, 08:03
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Re: Gynecological Exams in Switzerland: What to expect

I also find the quality of equipment in my gyn's offices are very modern compared to back home. Back home they always have you lay down flat on your back and have you put your legs up in the stirrups leaving you starring up at the ceiling while they do their business. Here they use an special upright chair which I actually prefer as I can look at my doctor as we talk about what she is doing. It seems to be standard equipment to have the ultrasound probe and I am always very interested when she points out exactly what it is she is seeing on the ultrasound screen.

Also the attitude here towards HRT seems to be more progressive and doctors are allowed to treat you according to your personal risk factors and health needs. Back home it seemed that all gyn's were just flat out banned from offering any hormone replacement therapy after the WHI study was published.
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Old 26.08.2013, 08:19
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Re: Gynecological Exams in Switzerland: What to expect

edot, thanks for your informative post. Would you mind sharing or pming which Dr(s). you saw in Bern? I am currently looking for one there and would appreciate recommendations.
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Old 26.08.2013, 08:35
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Re: Gynecological Exams in Switzerland: What to expect

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I also find the quality of equipment in my gyn's offices are very modern compared to back home. Back home they always have you lay down flat on your back and have you put your legs up in the stirrups leaving you starring up at the ceiling while they do their business. Here they use an special upright chair which I actually prefer as I can look at my doctor as we talk about what she is doing. It seems to be standard equipment to have the ultrasound probe and I am always very interested when she points out exactly what it is she is seeing on the ultrasound screen.

Also the attitude here towards HRT seems to be more progressive and doctors are allowed to treat you according to your personal risk factors and health needs. Back home it seemed that all gyn's were just flat out banned from offering any hormone replacement therapy after the WHI study was published.
I agree on the offices being really modern and I like all the scans. But when it comes to "risk factors," I find there is more intervention here. My experience and that for many friends in their 30s was that they really push for extra tests like amnio here during pregnancy. It could relate to the privatization model..not sure. But if you're very firm when you say you don't want it, it's accepted and you move on.

That's really informative to read what you said about HRT. I'd never have imagined doctors would refuse to prescribe it based solely on that study.
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Old 26.08.2013, 10:50
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Re: Gynecological Exams in Switzerland: What to expect

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That's really informative to read what you said about HRT. I'd never have imagined doctors would refuse to prescribe it based solely on that study.
I had a very difficult time finding a doctor back home who could help me. I had quite severe symptoms but was frequently dismissed and not treated. In fact I never did find any help until I got here. After the study was published there were lots of scary sound bites in the news telling women that HRT was dangerous so many women just stopped taking what they were taking.

Of course, in our lawsuit-crazy society, many doctors ran away from prescribing HRT even faster than their patients.

It also started a whole new marketing trend with lay people selling bio-identical hormones and treatment so many doctors and their professional organizations took a stand against those treatments and groups.

I believe with some new research recently published the professional bodies back home are revising their positions. I'm just really happy I was finally able to get treatment from a highly competent, knowledgeable doctor here, and so is the hubby
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  #32  
Old 26.08.2013, 11:26
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Re: Gynecological Exams in Switzerland: What to expect

You dont need to go to the doctor for the day after pill. Just ask at any pharmacy. They will ask you a couple of questions (have you taken one bofore/are you healthy) and give it to you.

Also does anyone know, if you go to the doctor to find about contraception, do they do an exam as well?
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Old 26.08.2013, 11:30
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Re: Gynecological Exams in Switzerland: What to expect

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I agree on the offices being really modern and I like all the scans. But when it comes to "risk factors," I find there is more intervention here. My experience and that for many friends in their 30s was that they really push for extra tests like amnio here during pregnancy. It could relate to the privatization model..not sure. But if you're very firm when you say you don't want it, it's accepted and you move on.
Maybe the intervention aspect differs by doctor-my second child was born after I turned 35, so my insurance would have covered an amnio or CVS. However, given the results of the nuchal and blood screen, I was not advised to have the test (I was very low risk for my age, 1 in 1000 vs 1 in 400, which was normal risk). My sister in law's screen was 1 in 4, and she did have the amnio (all was okay!).
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  #34  
Old 26.08.2013, 12:05
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Re: Gynecological Exams in Switzerland: What to expect

The fact that Switzerland is not lawsuit crazy also means that there are more docs doing the OB part - i was surprised to learn that some docs ask you to leave once you've passed childbearing age, but i guess they want to specialize in obstetrics.

In the US, it can be increasingly difficult to find an OB, especially in private practice because of the enormous costs of malpractice. Most are associated with large groups.
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Old 26.08.2013, 12:51
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Re: Gynecological Exams in Switzerland: What to expect

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You dont need to go to the doctor for the day after pill. Just ask at any pharmacy. They will ask you a couple of questions (have you taken one bofore/are you healthy) and give it to you.

Also does anyone know, if you go to the doctor to find about contraception, do they do an exam as well?
Yes, you're right-you don't need a prescription. I meant to write that the doctor will give you the pill (not prescription), so it's convenient to just ask when you're there for your check-up, even if you don't need it. Sorry about that!

When I went to ask about a contraception method change (pill to vaginal ring), I was given an exam (even though it had been only 9 months since my previous exam). I think if you have an appointment to see a gynecologist, generally an exam is expected, especially if you specify the reason for the exam.
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Old 28.08.2013, 09:43
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Re: Gynecological Exams in Switzerland: What to expect

Another important issue is the bill. I usually get mine about a month after the appointment so I guess there are stadard prices.
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Old 28.08.2013, 10:22
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Re: Gynecological Exams in Switzerland: What to expect

Lots of good info here. Could we make this a sticky? Thanks.
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Old 28.08.2013, 11:02
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Re: Gynecological Exams in Switzerland: What to expect

In the practice I go to at the moment:
First usually a urine sample is requested. (Little shelf and behind it a little door between the loo and the lab - sample is put on the shelf and taken from the other side later. If you have to write your name on the comtainer yourself, remember to do it before you fill it. It's easier than afterwards!)
Practice assistant does weight, blood pressure and will check haemoglobin if I like.
Read magazines and enjoy seeing wonderfully glowing pregnant ladies...
Go into 'office' part of the consulting room. Talk to gynae about any problems. Go into examination room. Get undressed 'down below' in the little screened off area.
Stroll across room and get settled in the examining 'chair/couch'
A previous gynae asked me to keep my shoes on, as the feet fitted in the foot-rests better. (Cannot for the life of me remember if the present one does or not - only been going there regularly for 25 years!)
During the examination the gynae tells me more or less what she is doing.
Then I loosen top clothing and she does a breast check. Reminds me to do it regularly myself too.
I then get dressed again (good supply of panty liners which is great) while we chat across the room about e-bikes.
We go back into the 'office' part. We discuss any medicinal requirements.
Then I put my coat on and toddle off round a couple of book-shops as I think by then I deserve a reward!

I only have to go every two years now - geriatric and all that - and I can ring the practice between times to send me a repeat prescription if I need one.
On one occasion she said she hadn't a lot of time as she unexpectedly had to rush off to the hospital after seeing me. If I had anything I wanted to discuss, we could postpone. I said it's Ok. Nothing special. However, during the examination, I had the feeling she had all the time in the world for me. Most impressive.
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Old 28.08.2013, 11:18
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Re: Gynecological Exams in Switzerland: What to expect

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As Swissintraining pointed out, there are no gowns given.
Tip: wear a skirt. You can drop your knickers behind the curtain and walk to the examining chair looking all dressed up.
Or a longer shirt, blouse etc., it looks like you are wearing a mini-mini-skirt. It is awkward to walk half naked in the room, but given the fact that the Swiss are very pragmatic..
I am suggesting this because some doctors might not get your subtle idea and ask you again to undress...
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Old 28.08.2013, 11:39
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Re: Gynecological Exams in Switzerland: What to expect

Very Helpful thread. Swissintraining, American women will thank you. I was shocked at my first exam here, but realize now that it's just the way it's done. And I like the exam procedure here better.
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