Expert: Norman Solberg - 6/21/2010

Question
I am soon to be married and am a virgin. I have decided to get a prescription for the pill. I have read extensively on health issues affecting women and on the matter of informed consent will be declining any tests that are often associated with BCP. I am happy to have BP taken and weight etc. For example the birth control pill has nothing to do with a pap smear or even a pelvic exam as I know I am not pregnant. Legal advice informs me that doctors cannot force these exams in return for a pill prescription. Should I take a lawyers letter with me to the consult or would it be better to just call the police if there are any attempts at coercion? Maybe it is best to let the police deal with it? I have to say I find it incredible that these measures are even potentially necessary.

Answer
I find it incredible that you would go to see your doctor with such an antagonistic attitude.  In my opinion, the doctor-patient relationship should be one where 2 people are working together in the interests of the patient.  I don't know New Zealand law, so I can't comment on that.  In the US, just as a doctor can't force a patient to have any type of exam, neither can a patient force a doctor to prescribe any treatment.  I think you're correct that the birth control pill has nothing to do with a Pap smear, but in the US it would be considered poor medical practice to prescribe the pill without doing a pelvic exam.  You may know you're not pregnant, but your doctor doesn't.  In case you had uterine fibroid tumors, the pill can cause them to enlarge, and knowing that they're there would be important.  If you don't feel you can trust your doctor to do right by you, I suggest you get your prescription through your lawyer.  If you came to see me with your lawyer or the police demanding a prescription without an exam, I would tell you to find another doctor.